REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF SAN BERNARDINO COUNTY
AND RECORD OF ACTION
October 20, 2026
FROM
ANDREW GOLDFRACH, ARMC Chief Executive Officer, Arrowhead Regional Medical Center
SUBJECT
Title
Non-Financial Transfer Agreement with Hospital of Barstow, Inc. dba Barstow Community Hospital for Transfer of Patients Requiring Specialized Hospital Services
End
RECOMMENDATION(S)
Recommendation
Approve non-financial Transfer Agreement, including non-standard terms, with Hospital of Barstow, Inc. dba Barstow Community Hospital, for the transfer of patients requiring specialized hospital services, for the five-year period of October 20, 2026 through October 19, 2031.
(Presenter: Andrew Goldfrach, ARMC Chief Executive Officer, 580-6150)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Provide for the Safety, Health and Social Service Needs of County Residents.
FINANCIAL IMPACT
Approval of this item will not result in the use of Discretionary General Funding (Net County Cost) as the Transfer Agreement with Hospital of Barstow, Inc. dba Barstow Community Hospital (Barstow Community) is non-financial in nature and does not include any associated costs. Each facility will be responsible for billing the applicable third-party payors for the costs associated with patient care provided at the respective facilities.
BACKGROUND INFORMATION
Approval of the Transfer Agreement (Agreement) with Barstow Community will allow for the transfer of patients requiring specialized hospital services from Barstow Community to Arrowhead Regional Medical Center (ARMC) when the appropriate level of care is not available at Barstow Community. The Agreement also provides for the return transfer of patients to Barstow Community after specialized hospital services are completed, as appropriate, with all patient transfers conducted in accordance with applicable federal and state requirements, including the Emergency Medical Treatment and Active Labor Act (EMTALA) and applicable provisions of Title 22 of the California Code of Regulations.
The Agreement establishes the responsibilities of each facility, including coordination between transferring and receiving physicians, confirmation of available beds and appropriate staff and services, transfer of patient medical records, and arrangements for safe patient transportation. Each facility will bill and collect for services it provides from Medicare, Medi-Cal, private insurance, or other responsible payors, as applicable.
The Agreement with Barstow Community was negotiated by the parties and deviates from the standard County contract terms as follows:
1. The Agreement does not require Barstow Community to meet the County’s insurance standards as required pursuant to County Policies 11-05, 11-07 and 11-07SP.
• County policy requires contractors to carry appropriate insurance at limits and under conditions determined by the County's Risk Management Department and as set forth in County policy and in the County standard contract.
• Potential Impact: The County has no assurance that Barstow Community will be financially responsible for claims that may arise under the agreement, which could result in expenses to the County.
2. The Agreement does not require Barstow Community to indemnify the County, as required by County Policies 11-05 and 11-07.
• The County standard contract indemnity provision requires the contractor to indemnify, defend, and hold County harmless from third party claims arising out of the acts, errors or omissions of any person.
• Potential Impact: Barstow Community is not required to defend, indemnify or hold the County harmless from any claims, including indemnification for claims arising from Barstow Community’s negligent or intentional acts. If the County is sued for any claim, including claims based on Barstow’s negligent or intentional acts, the County may be solely liable for the costs of defense and damages.
ARMC recommends approval of the Agreement, including non-standard terms, to ensure patients have timely access to specialized hospital services that may not be available at Barstow Community.
PROCUREMENT
Not applicable.
REVIEW BY OTHERS
This item has been reviewed by County Counsel (Charles Phan, Supervising Deputy County Counsel, 387-5455) on October 7, 2026; Risk Management (Noel Cantrell, Administrative Supervisor, 386-8890) on September 25, 2026; ARMC Finance (Chen Wu, Finance Budget Officer, 580-3165) on September 28, 2026; and County Finance and Administration (Jenny Yang, Administrative Analyst, 387-4884) on September 29, 2026.