hospital - Hagai Frid - August 17 2011
Haifa’s Elisha Hospital. Photo by Hagai Frid
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Two Haifa rehabilitation hospitals may be shuttered due to a conflict between the Health Ministry and Clalit Health Services.

Health Ministry officials threatened not to renew the license of the privately owned Elisha Hospital after inspectors found problems in May. The ministry said no new patients should be sent to the facility until the problems were fixed.

The 150-bed facility has rehabilitation wards and is also used by surgeons for private operations.

The inspectors determined that two hospital departments lacked licenses: a long-term ward housing 35 patients with severe head injuries, and a private ward with 15 beds for patients recovering from heart operations and major plastic surgery. The inspectors also found an acute shortage of geriatricians, rehabilitation physicians and nurses. In addition, the hospital's three rehab wards held 52 patients, although they were licensed to have only 32.

Hospital administrators were summoned to an urgent meeting on Monday with Health Ministry officials.

Elisha had been receiving a growing number of patients in recent months after signing an agreement with the Clalit health maintenance organization. That agreement was precipitated by a dispute between Clalit and the Health Ministry over the second Haifa rehab facility, the ministry-owned Fliman Hospital.

Fliman's occupancy declined from 170 in March to between 70 and 100, when Clalit stopped sending it geriatric rehab patients. Clalit insures around 75 percent of Israel's elderly population.

Clalit's move was a blow to Fliman, which recently spent NIS 30 million on a new respiratory support ward and other projects. It is the only hospital in northern Israel specializing in geriatrics, a field with an acute personnel shortage. In an effort to stem the financial crisis, employees have been forced to take vacations, and some wards were merged.

Officials at Elisha Hospital dismissed the Health Ministry's findings, saying they were aimed at forcing Clalit to send rehab patients to Fliman Hospital.

"The inspection in May was part of a routine biennial inspection. It found shortcomings even though the hospital has undergone a dramatic change, including renovating all six operating rooms, which increased the number of operations to around 1,000 a month; opening a new recovery ward; introducing dental care under full anesthesia for children; and relocating the dialysis ward," said Elisha's medical director, Dr. Moshe Person.

Person said the head injury ward has been operating without a license for 22 years, caring for patients in vegetative states. "This is a home for the patients' families. The ward is not listed on the license, but until now it has been a source of pride and was lauded during previous inspections," he said.

Last month Haaretz published an investigative report on geriatric rehabilitation hospitalization in the north and the ministry's policy of not permitting private facilities to add beds, despite the ministry's own figures showing that many adult stroke and orthopedic patients do not receive the inpatient rehabilitation they are legally entitled to.

Haaretz has learned that in the past two weeks Fliman reduced what it was charging Clalit to NIS 600 per patient per day, comparable to the NIS 550 to NIS 570 charged by private rehabilitation hospitals. However, it demanded that Clalit commit to having 80 of its customers at the hospital at any given time. Clalit rejected the demand.

Clalit officials attributed the dispute with Fliman to the ministry's decision to raise the per diem rate for geriatric inpatient care, canceling an agreement with Fliman that would have expired at the end of the year.

In a statement, the Health Ministry said it found the professional staff at Elisha not up to par. As for Fliman, according to the statement the hospital agreed to Clalit's demand for a significant discount but could not provide it without a guaranteed minimum purchase. The negotiations are continuing.