Huge win for HCA as judge upholds plan to expand trauma centers

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In the ongoing dispute over new trauma centers in Florida, an administrative judge upheld a state Department of Health proposal, which provided a major victory for HCA healthcare, one that could open the door for a significant expansion of the trauma care system.

Administrative Judge R. Bruce McKibben’s provided just the latest development in a three-year long legal battle over who will be allowed to treat severely injured patients, which represent substantial revenue from insurers.

Existing trauma centers, such as Tampa General, St. Joseph’s and Bayfront Health, challenged the proposed DOH trauma center plan, claiming regulators exceeded authority by using a rule that was “arbitrary and capricious.”

Kris Hundley and Alexandra Zayas of the Tampa Bay Times are reporting that McKibben, a judge for the state’s Division of Administrative Hearings, issued a 71-page order on Friday rejecting the argument, concluding the proposed DOH rule used “facts, logic and reason.”

Through testimony from 15 witnesses, doing the Tallahassee hearings held in March, April and May, trauma center representatives tried to prove that new trauma centers would result in declining patient volume.

McKibben did not agree, saying “The fact that the proposed rule may cause petitioners economic harm is not a basis to invalidate it.”

The Times reports that currently there are 27 facilities in Florida with the specialized medical units used for traumatically injured patients.

McKibben acknowledged the DOH rule allowing new centers to open in Florida that meet criteria such as population, volume of trauma patients and transport times. The rule also takes in “community support” from local officials. That criteria are what existing centers feared would further politicize the approval process.

The decision is a real setback to the argument that increasing the number of trauma centers will result in fewer seriously injured patients in each facility, leading to less experience for doctors and nurses and a subsequent drop in the level of care. This also comes at a time when competition is highest for the best medical talent. In addition, duplicate services could drive up costs, they said.

Representatives of Tampa General and UF Health Shands said they would decide on what will be their next step. They have 30 days to appeal the decision with the Tallahassee First District Court of Appeal.

McKibben’s ruling is a major victory for HCA Healthcare, a hospital chain that opened six Florida trauma centers since 2009, with plans to add more.

Peter Schorsch is the President of Extensive Enterprises and is the publisher of some of Florida’s most influential new media websites, including,,, and Sunburn, the morning read of what’s hot in Florida politics. SaintPetersBlog has for three years running been ranked by the Washington Post as the best state-based blog in Florida. In addition to his publishing efforts, Peter is a political consultant to several of the state’s largest governmental affairs and public relations firms. Peter lives in St. Petersburg with his wife, Michelle, and their daughter, Ella.