1. Although discussion of the memo in the material was not deferred, I came away no more the wiser. The Hospital missed the 1/1/2002 deadline. OSHPD has taken no license action for this clear violation of the regulations in the intervening nine years. There is no legal bar from OSHPD taking action at any point because Alameda Hospital is in clear violation. Therefore, if I stated that Alameda Hospital has no legal authority to operate then I was incorrect, but only in a technical sense so let me try to be more precise although this may not be exactly right either:
Alameda Hospital is in clear violation of state building code at the present time operating with acute care services in a building that is NOT certified as NPC-2 or higher. Based on this violation, the Hospital is subject to license action that would lead to closure at any time. What defenses the Hospital might have because of the non-action by OSHPD for the last nine years is unclear to me, but it is clear that the Hospital is in violation and remains in violation.
2. The restructuring of IGT has led to an anticipated reduction in revenue by the Hospital of about 1 million dollars. This will mean that the best the Hospital can hope to do this year from a financial point of view (based on its present trajectory and barring a political intervention that restores this money) is break even. The more likely outcome is a loss of between 100,000 and 400,000 dollars. The weakening of the balance sheet due to expenditures for various capital purchases and accruals will be more significant than that suggests. So seismic retrofitting is off the table for the near and possibly intermediate future.
3. I conclude and this is my opinion only that the numbers suggest that Alameda Hospital will be closed within the next four years because it cannot meet the state seismic requirements. There are many hospitals that have struggled to meet the requirements, but the last statutory exemption available for the SPC -2 deadline is 1/1/2015. At that point 95% or more (I have to check but I think the actual number if you believe the reports is over 97%) of the hospitals in the state will be compliant and that counts those hospitals with valid 2020 extensions in the non-compliant category. Given the fact that the CNA (nurses union) opposes the extension of deadlines and that so many hospitals would have already been closed and/or expended large sums to become compliant, in my opinion, the pendulum will have shifted in the Legislature to AGAINST offering additional opportunities for extensions. Only a political solution can save Alameda Hospital and I do not foresee the political will or clout to make that happen.
The Board can start planning now for a future that ends acute care services in the present location or can let events overtake them, but I would be willing to gamble (if my wife would let me and if it was not the worst conflict of interest) that Alameda Hospital will look nothing like its present form by 1/1/2016.