The San Joaquin County Board of Supervisors on May 13 unanimously voted to extend San Joaquin General Hospital’s management services agreement with Dignity Health — a division of Chicago-based CommonSpirit — for three more years. The agreement, valued at $5.74 million, will span from July 1, 2025, through June 30, 2028.
The board initially entered into the MSA with Dignity in May 2022, after determining that hospital services could be delivered “more efficiently, effectively and economically” under the partnership. The original agreement included an 18-month term with an option for a 10-year extension. It was first renewed for an additional 18 months in October 2023 and is currently set to expire on June 30, 2025.
“Since the agreement began, the hospital has made great progress in improving patient care and its finances,” Paul Canepa, chair of the San Joaquin County board, said in a news release. “We’re excited to keep working together to build a strong, unified healthcare system that provides excellent care to everyone — no matter their ability to pay.”
Quality improvements
Since the MSA’s inception, San Joaquin General has implemented several initiatives aimed at improving quality, safety and operational performance. Among the key accomplishments:
- The hospital successfully completed a Joint Commission Accreditation Survey with no critical findings.
- Its CMS Leapfrog Hospital Safety Grade improved to a high “C” in spring 2024, marking a significant turnaround after seven consecutive years with an “F”.
- Hospital-acquired infections have declined, and the implementation of the Midas Quality Reporting System has replaced manual processes, improving the hospital’s ability to review post-discharge data.
- Participation in the Culture of Safety survey surged from 20% to 80%, with staff education around Leapfrog standards continuing.
- Regulatory surveys on reportable events and patient grievances were cleared without violations, and previously fined late reporting issues have been fully resolved.
- Incomplete patient records dropped from over 15,000 to fewer than 200.
- A new deputy director of nursing was appointed to lead continued improvements in compliance and quality performance.
Financial gains
San Joaquin General has also improved its financial performance by about $50 million since the agreement began, driven by revenue enhancement and cost containment strategies:
- The hospital appointed a new CFO and key revenue cycle leaders to lead efforts beyond traditional volume-based growth.
- Nurse recruitment and retention efforts reduced dependency on travel nurses, saving about $14 million and decreasing the nursing vacancy rate by 16.4%.
- A clinical documentation program improved coding accuracy, while a revenue integrity program has increased revenue through pricing strategy and charge capture improvements.
- Optimization of the Cerner revenue cycle platform strengthened cash collections via automated workflows and improved financial metrics.
- Additional gains have come from increased collections on small-balance accounts and leveraging the CommonSpirit Group Purchasing Organization, which has yielded an estimated $10.8 million in supply chain savings.
“Since the implementation of the Management Services Agreement, CommonSpirit Health and St. Joseph’s Medical Center have had a profound impact on both financial and quality measures at San Joaquin General Hospital,” BJ Predum, market president of Dignity Health Central Valley, said. “By improving and standardizing processes, I am proud of all that we have accomplished together to enhance the health and wellbeing of the San Joaquin County community.”
