FREMONT -- Washington Hospital may be changing the rules that allow only two doctors to practice in its state-of-the-art joint replacement center. But it appears to be keeping quiet about it.
At least a half-dozen patients of surgeons who do not meet the hospital's stringent criteria for access to the $42.7 million Center for Joint Replacement were allowed to recover in the building last week, doctors said. The move comes as state investigators acknowledged that federal officials have joined them in investigating the hospital's practices, which were the subject of a report last month in this newspaper.
Dr. John Jaureguito said he was told by a nurse last week that two of his joint-replacement patients could not be guaranteed private patient rooms on the sixth floor of the main hospital, so his patients would recover in the new building, the first time any of his patients had been allowed such access.
"I think it is a step in the right direction should it continue, but the criteria for inclusion should still be revised," Jaureguito said. "However, if my patients get access to the same treatment, that is the most important factor."
Washington Township Health Care District officials have not responded to requests by email and in person since Monday for clarification about whether last week's decision signals an overhaul of their joint center policies, or if it was a decision based solely on space constraints.
Last month this newspaper highlighted the concerns of excluded doctors and patients who said the policy created a "two-tier" system of care at the public health care district in southern Alameda County.
For the past year, physicians who did not meet 24 criteria for participation in the hospital's new Institute for Joint Restoration and Research -- which included quotas for joint replacement surgeries -- were not granted access to the new building. Instead, they and their patients were relocated from the soon-to-be-demolished Whitaker Pavilion to the sixth floor of the main hospital tower with only a hallway to use for physical therapy sessions, risking exposure to infectious patients walking the halls nearby, doctors and patients said.
In an email Wednesday, Dr. John Dearborn, co-medical director of the institute and one of two surgeons that qualified for access, told Newark resident Sumeet Batra that six non-institute patients were welcomed to the building last week, "because the Institute volume that week did not fill the unit. Most weeks the CJR beds are full." Dearborn has acknowledged helping to write the criteria that excluded the other doctors.
Batra, whose mother is scheduled for knee replacement by Dr. Barry Rose on April 22 at Washington Hospital, had emailed Dearborn's medical office Tuesday, asking if there was a reason his mother could not recover in the new building.
Dearborn's email detailed the benefits of his "minimally invasive" surgery techniques and called the differences in facilities "purely cosmetic."
"Conceivably, if the hospital administration felt that the best place for Dr. Rose's patients from an operational standpoint was the CJR, they would make the decision to put his patients there," he said.
The segregated care sparked a discrimination complaint filed with the state on Sept. 4. Since then, federal officials have become involved. Both they and state officials have declined to identify which federal laws were being examined and when federal officials got involved.
Officials did say they are investigating whether the joint center policies comply with federal laws governing hospitals that participate in federal Medicare and Medicaid programs.
Hospital officials said last month they were cooperating with the probe.
"We want to state clearly and for the record, the legal structure for the Institute was created on the advice of qualified legal counsel and designed to meet all applicable legal requirements. ... Any physician who meets the requirements for participation may apply for acceptance," wrote hospital Administrator Kimberly Hartz on March 20. "The legal structure does not constitute an 'illegal kickback' or any other violation of law."
On Thursday, hospital spokeswoman Gisela Hernandez declined a Jan. 28 request for the costs and revenues associated with the operation of the institute, writing in an email that "providing such detailed data would be providing competitive service-line information; the data is a valuable trade secret. ... Our competition would benefit significantly by having access to the detailed revenue and expenditure information that you are requesting."
Ashly McGlone covers San Leandro, San Lorenzo and the Washington Township Health Care District. Contact her at 510-293-2463. Follow her at Twitter.com/AshlyReports.