Calif.’s hospital collapse domino effect can be stopped. It’s time to fix Medi-Cal.

“The reality of low Medi-Cal reimbursement rates remains the 800-pound gorilla” following the collapse of Madera’s hospital, writes Madera County Supervisor Jordan Wamhoff.

As a newly elected Madera County Supervisor, I was surely not expecting the closure of Madera Community Hospital to be first on the agenda, but that was the unfortunate reality.

This facility served as a lifeline for our already underserved community, providing vital medical care to those who needed it most. However, the hospital’s unfortunate closure and subsequent filing for Chapter 11 bankruptcy has left our community grappling with the daunting task of reopening the only acute care facility between Merced and Fresno.


Recognizing the urgency of the situation, State Assemblywoman Esmeralda Soria (D–Fresno) and State Senator Anna Caballero (D–Salinas) drafted legislation to provide emergency funds for struggling hospitals throughout the state and Governor Newsom recently signed this legislation into law.

These funds offer hope for our residents. However, the funds come with a condition – Madera Community Hospital must have a detailed plan to reopen, which, unfortunately, is not in place at this time.

In response, the Madera Board of Supervisors has taken proactive steps by authorizing and funding a comprehensive analysis. This analysis will carefully evaluate the hospital’s ability to reopen, considering all the variables associated with its bankruptcy in addition to finding potential suitors that could acquire the hospital; a plan to reopen.

The cause of the hospital closure needs to be analyzed. Care under Covid was the straw that broke the camel’s back. It is no secret that there is a healthcare worker shortage in America and healthcare professionals were put under immense pressure during Covid.

The shortage of nursing staff created a free-market free-for-all for nurses who were willing to travel to provide care to the highest bidder. Nurses were leaving their permanent jobs in droves to get the traveling nurse rates. It was common to see nursing staffing agencies charging facilities over $200 per hour for their services.

Madera Community Hospital saw upwards of 40 percent of their nursing staff being supplemented by traveling nurses; an unsustainable model that put the hospital in the red over $1 million per month. 

In addition to the traveling nurse price tag, the reality of low Medi-Cal reimbursement rates remains the 800-pound gorilla.

These static rates have long been a burden for hospitals, making it increasingly difficult for them to cover their expenses in an era where record inflation is driving the costs of providing quality care to new heights.

Madera Community Hospital is no exception, and unfortunately nearly a dozen other similar hospitals around the Golden State are finding themselves in similar financial straits. 

There is no mistaking that the healthcare system in America is broken. When government takes over an entire industry by being the largest insurance provider via Medi-Cal, there is no surprise that they don’t accurately calculate all the variables associated with providing necessary reimbursement to rapidly rising costs.

Even if the hurdle of reopening the hospital takes place, current state reimbursement rates make keeping a hospital open with a high percentage of low-income patients unsustainable.

I call on the State Legislature and the Governor to tackle the rising costs of care and adjust reimbursement rates to ensure our hospital that served the least among us cannot just reopen but stay open.

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