- 65 -
ambulatory surgery center care for all members of the Redlands
community irrespective of their ability to pay.”
This proposed finding of fact is not supported by the
record. Neither before nor after petitioner’s involvement with
it has the Surgery Center provided charity care. Moreover, the
administrative record indicates that one aspect of ambulatory
surgery centers that makes them attractive investment
opportunities in the first instance is that they boast favorable
“procedure and payer mixes”.18 Consequently, it is not apparent
from the record to what extent the decision to perform a surgery
at the Surgery Center has ever been an “economic” rather than a
“medical” decision, or exactly how that situation might have
changed after April 1990.
Even if we assume, arguendo, that a change in criteria did
occur after April 1990, the record does not establish
petitioner’s role in effecting any such change.
18 The administrative record includes an investment summary
with respect to SCA and another national health-care provider,
Medical Care International, published by Shearson Lehman
Brothers, dated Aug. 7, 1991. The report states: “To a large
extent the favorable payer mix is a function of the fact that
many procedures safely performed on an outpatient basis happen to
be those with a young patient population.” Similarly, in its
arguments to justify the Surgery Center’s low rate of Medi-Cal
patients, petitioner notes that the Surgery Center does not
perform the types of procedures--emergency room treatments and
obstetrics and gynecology--that typically account for a
"substantial majority" of low-income surgical expenses for a
community.
Page: Previous 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 NextLast modified: May 25, 2011