A 300-bed hospital jointly owned by the City of Las Cruces, New Mexico, and Doña Ana County had seen its performance and financial footing sinking in the face of competition from a new hospital in this small community. By the time a decision had to be made, the hospital was losing $1 million a month.

The Background

The physicians on Memorial Medical Center’s staff were losing confidence and shifting more and more patients to the new private hospital. Institutional bondholders were threatening to act on a bond default. With its back to the wall, the hospital announced it would abandon the only obstetrics program in the county and the only inpatient acute care psychiatric unit in the region, among many other cuts to essential community care. The citizens increased the pressure on their elected officials to do something, yet those same citizens did not want a fire sale of their hospital that would give away local public-sector input into its future. A robust community debate was underway.

The Solution

The City and County jointly engaged an advisor, now Newpoint’s chairman, to lead an open and independent process to seek community involvement in the formulation of objectives for its hospital and the decision making on a solution. The local paper soon reported that “alarming developments in the MMC saga” had created “a train barreling out of control,” but that “Lupica’s involvement in the MMC issue has had a calming influence . . . clarifying the decision-making process.” On his advice, the elected leaders assured their constituents a completely open process with no closed door sessions, a public solicitation of their constituents for binding evaluation criteria, and no decision until the officials had “a full array of options on the table.” The honest outreach to the community – not staged events, but true listening – created a buy-in that not only supported a rational decision for a divisive issue, but also rebuilt a loyal base of support among physicians and their patients for their original hospital. That buy-in also gave several suitors the confidence to make generous offers for this struggling hospital, as County and City officials unanimously voted for a long-term lease to a public company for an up-front payment of $150 million, along with contract commitments to preserve the obstetrics and psychiatric programs for the full 40-year term of the lease and to preserve access for all, regardless of ability to pay. The new partner also added a $2 million chapel and pastoral care center to the hospital, upgraded rural clinic services for $5 million, and added permanent board seats for both the County and City Managers.

The Result

Memorial Medical Center has not only survived, but thrived. A hospital once in danger of closing witnessed ebullient growth. Four years later, the local newspaper reported that surgeries were up 36 percent and outpatient visits jumped by 73 percent. The people of Las Cruces and Doña Ana County had a new confidence not only that their essential services would continue, but also that they would continue with sustainable excellence and access for all. The National Association of Counties recognized the process and result with its Best in Healthcare Award for that year.