Attorney General Bonta Conditionally Approves Sale of Madera Community Hospital to Trinity Health

Thursday, December 15, 2022
Contact: (916) 210-6000,

Sale will allow over 150,000 residents living in predominantly rural communities to continue receiving emergency services in their area

OAKLAND — California Attorney General Rob Bonta today conditionally approved the sale of financially distressed Madera Community Hospital to the Trinity Health Corporation. The 106-bed hospital located in the Central Valley offers vital services to more than 150,000 residents living in Madera and its surrounding communities. Many of those residents live in rural areas and rely on the hospital for critical care, as it is the only provider of emergency and lifesaving surgical services within a 30-minute drive. The conditions of Attorney General Bonta's approval will ensure the Madera community maintains access to critical emergency and surgical services in their area. Under California law, any transaction involving the sale or transfer of control of a healthcare facility owned by a nonprofit must secure the approval of the state Attorney General.

“When it comes to accessing emergency healthcare, every minute counts,” said Attorney General Bonta. “Having a hospital in the neighborhood can make the difference between life and death for a patient. Maintaining access to critical healthcare for our communities is always our top priority. Today's conditions seek to protect the welfare of Madera County residents, and ensure they can continue to access life-saving and hospital services when they need them most.”

The sale of Madera Community Hospital was found to be a benefit to the community, the majority of whose residents live in the predominantly rural Madera County area and are from lower-income Latinx communities. Many of them may lack transportation to the nearest alternative emergency or hospital services, which are approximately a 30-minute drive away in Fresno County.

Besides emergency care, Madera Community Hospital also provides other important services to the community, including preventative and primary care services, treatment of chronic conditions, and women’s and maternal health services.

Under the terms of the sale, Trinity has committed to the following:

  1. Making financing available up to $45 million for installing and implementing a new medical records system and providing seismic upgrades to the hospital;
  2. Spending $3 million per year on other necessary investments into the hospital, including equipment upgrades

Under the terms of the conditional approval, the Attorney General has required, among other things, that Trinity:

  1. Use commercially reasonable best efforts in good faith to maintain services at the Madera Community Hospital for 5 years;
  2. Accept price caps to ensure continued affordability for Madera residents;
  3. Ensure continued certification of the hospital as a Medi-Cal and Medicare facility;
  4. Provide charity care, financial assistance to patients, and community benefits;
  5. Comply with nondiscrimination rules in the provision of healthcare services; and
  6. Provide emergency reproductive healthcare services, notice and information to the public about nonemergency reproductive healthcare not provided, as well as information about alternative licensed providers and transport

These conditions will benefit the Madera community by: 

  • Helping to ensure essential emergency care, acute hospital, and outpatient services continue for the Madera community and its rural populations, and for low-income and Medi-Cal recipients for at least five years;
  • Advancing public health and welfare for the Madera community by allowing the hospital to raise rates and revenue to stabilize its financial status;
  • Allowing improvements and upgrades for the hospital and its services along with recruitment of specialized medical professionals;
  • Ensuring emergency reproductive healthcare continues;
  • Saving lives by helping prevent the loss of the only GACH and emergency room in the county;
  • Curbing excessive prices for Medi-Cal Managed Care and Medicare Advantage, in a highly concentrated rural-like market for at least five years; and
  • Curbing excessive pricing for commercial out-of-network emergency services in a highly concentrated rural-like market with no alternatives for emergency care for at least five years

The California Department of Justice’s Healthcare Rights and Access Section (HRA) works proactively to increase and protect the affordability, accessibility, and quality of healthcare in California. HRA’s attorneys monitor and contribute to various areas of the Attorney General’s healthcare work, including nonprofit healthcare transactions; consumer rights; anticompetitive consolidation in the healthcare market; anticompetitive drug pricing; privacy issues; civil rights, such as reproductive rights and LGBTQ healthcare-related rights; and public health work on tobacco, e-cigarettes, and other products.

A copy of the conditional approval letter is available here.

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