Voters will have the final say in whether Tri-City Medical Center executes a long-term lease with Sharp HealthCare, but the question may not appear on a ballot until June 2026.
It is a long wait for major change at the Oceanside hospital, whose governing board chose Sharp as a long-term partner during a public meeting on May 29. Sharp proposes assuming all of Tri-City’s assets and liabilities under a multi-decade lease — likely lasting 30 years — similar to an arrangement it has with Grossmont Hospital in La Mesa. A new 15-member operating board with a majority of its appointed by Sharp would oversee operations.
Sharp would invest $100 million in Tri-City during the first five years of the lease, according to a set of proposed project , and would take over payment of or retire its existing loans. The two parties would work together to a general obligation bond during the lease’s first three years to bring the medical campus into compliance with state seismic requirements, which require closing Tri-City’s central tower in 2030 unless the state Legislature again delays enforcement.
But state law is very specific about the timing of the steps that must be taken before a public health care district, such as Tri-City, can lease or otherwise transfer 50% or more of its assets to a nonprofit partner.
A full 88 days must after the Tri-City’s board gives its final approval of a lease with Sharp, and that vote can only occur after “at least five properly noticed open and public meetings” occur to educate residents on the details of the agreement.
There is no general election in November, making the primary on June 2, 2026, the next regularly scheduled opportunity on the Registrar of Voters’ calendar. Tri-City directors could use their authority to call a special election before next June, though doing so would come at its expense.
Dr. Gene Ma, Tri-City’s chief executive officer, said Friday that the North County hospital has reached out to the county Registrar of Voters to nail down the details of holding a special election. The 88-day requirement means that Tri-City and Sharp would need to complete a definitive agreement by early August in order to hold a referendum this year.
Due diligence, the process of Sharp digging into the details of Tri-City’s operations and ing its current condition, is the main obstacle to achieving such a timeline.
A previous partnership with UC San Diego Health bogged down during this phase, eventually leading to the entire agreement falling apart in late July 2024.
“The window for a special election gets tight since it’s not ideal to have one over the holidays,” Ma said in an email. “After that, it starts getting pretty close to June, in which case I think the question at hand will be whether or not it’s worth the resources to hold a special election a few months before the general election in June.”
Giving the public time to weigh in, he added, will be the priority over moving as quickly as possible.
“It’s really important that we’re out hearing the community during this process and that we ensure that their input, what they’re asking us for, is incorporated into what Tri-City and Sharp focus on.”
But given that Tri-City first started searching for a large health care system to partner with in 2023, waiting another year to finally get underway seems long, especially for employees who have looked forward to ing up with a partner capable of helping to bring in additional patients served under a more competitive wage scale.
There is also significant hope, both at Tri-City and in the community, that having Sharp take over day-to-day operations will allow the resumption of sidelined services, especially the mother and newborn services, which the hospital’s board suspended mid-2023, citing severe budget difficulties.
Ma said there is less need to execute the lease quickly than there was 18 months ago. Since then, Tri-City’s finances have gradually improved. Closing labor and delivery provided enough financial breathing room for the organization to start paying off its creditors and now, according to the latest budget report presented to the Tri-City board last month, the picture is vastly different.
Through April, Tri-City’s operations, taking into public tax revenue, yielded $3.8 million more revenue than expenses. It’s a slim margin, but it is much better than budget projections, which had Tri-City losing $3 million on its bottom line over the first 10 months of its fiscal year.
Still, employees and the public might wonder if there is something, anything, that could be done to get started on the deal with Sharp more quickly.
Scott Evans, chief strategy officer and market CEO at Sharp, said Friday that the region’s largest medical provider is open to finding ways to perhaps accelerate the relationship, though exactly how that might be done remains to be seen.
Regular discussions between the two parties, he said, are expected to begin next week.
“My understanding is that they’re in a better (financial) situation than they were in, but, certainly, if there was an opportunity in the interim that needed Sharp to help in some way we would have to take a serious look,” Evans said. “What I don’t want to happen is for us to distract ourselves from the main issue that they really want to solve, which is a lease partnership.”
Ma said that there may be a way for Sharp and Tri-City to get started on some improvements that obviously need to be done, such as upgrading Tri-City’s electronic medical records system, by creating a t powers authority during the interim. But that idea, he said, would need further vetting by the medical providers’ legal teams.
