For all of their professional careers, Drs. Pejman and Pedram Salimpour--following their father's example--could never resist helping a sick child.

So it wasn't totally startling that one of the San Fernando Valley's best known physician families decided to take the case of Tenet Healtheare Corp.'s ailing Alvarado Hospital, which the brothers purchased for $22.5 million on Jan. 1.

Never mind that the pediatrician brothers have never owned a hospital before, or that San Diego-based Alvarado is more than 140 miles from the medical practice their father established in the Valley when the family fled Iran in the early 1980s after the revolution there.

"If it closes it will affect thousands of people, so its success will not only be a business success for us but a personal one," said Pejman Salimpour, 45, a former clinical chief of pediatrics at Cedars-Sinai Medical Center, who juggles a patient load and a teaching role as a professor of clinical pediatrics at UCLA David Geffen School of Medicine.

The brothers won't find it easy to turn around the 306-bed Alvarado, which lost more than $3 million in 2005 and was the subject of a three-year federal probe into charges that some doctors were paid kickbacks for referring patients to the hospital. Two trials related to the case ended in hung juries, but Tenet was forced to sell the hospital as part of a government settlement.

Every other major hospital operator in town passed on making a serious bid when Tenet put it on the market last June. The Salimpour brothers made a few casual inquiries and believed it was a potential diamond in the rough.

They formed Plymouth Health and came forward with their offer, backed by group of private investors led by Los Angeles-based Omninet Capital LLC., whose co-founder Parviz Nazarian is Pejman Salimpour's father-in-law.

"I think Tenet knew that not only did we have the resources to keep the hospital open but also have the sophistication," said Pedram Salimpour. "As physicians who have lived in hospitals all our lives, we understand what doctors need in order to practice medicine."

Plymouth is the first health care industry investment for Omninet, which is better known for its early investment in the San Diego-based wireless communications giant Qualcomm Inc. But Ben Nazarian, Parviz Nazarian's son and another Omninet principal, said the Salimpours had more to offer than family ties when they approached his firm.

"They're both doctors and businessmen and we believe that gives them a unique perspective," Nazarian said. "We also have a special relationship with the San Diego area, and believe that with the right owners and management, Alvarado has the opportunity to become a premier hospital again."

Whether they can succeed in turning around the hospital is, for now, an open question. One complication is that the hospital serves a high percentage of Medicare and Medi-Cal patients, which means low reimbursements. Furthermore, the hospital has long suffered from below-average reimbursement rates from private payers, too.

Nathan Kaufman, managing director of San Diego-based health care consultant Kaufman Strategic Advisors, said that with Medicare proposing to slash its budget by $17.4 billion next year and consolidation in the health insurance industry increasing the bargaining leverage of insurers, this is not an easy time for a stand-alone hospital.

"How is the hospital industry going to make up the Medicare cuts? By getting more out of Blue Cross," Kaufman said. "And good luck with that if you're not a market leader like Cedars-Sinai."

For their part, the Salimpours note that Plymouth has hospital consultants advising them and they worked closely with Tenet after the deal was announced to bring an experienced hospital administer on board after the hospital's chief executive quit before the deal closed.

Significantly, the final sale price was well below the $36.5 million announced last October and less than half the reported $50 million that Tenet originally sought for the hospital. The money saved will help the Salimpours as they work with the post-Tenet management team to determine what capital improvements need to be made at the hospital, in addition to an estimated $70 million in earthquake retrofitting.

The brothers also believe that the relationships that they have built with HMOs through other businesses have helped in negotiating new reimbursement contracts.

Another advantage: While many Los Angeles hospitals have more licensed beds than they can afford to staff, San Diego has a bed shortage, Pejman Salimpour said. That works in Plymouth's favor during negotiations with third-party payers that can't afford to lose another network hospital in the region.

"No hospital can survive if it continues to lose money, so in order for this to work, we need fair, reasonable reimbursement rates," Pejman Salimpour said, noting that Plymouth won modest contract increases with all but two of the hospital's main third-party payers, where negotiations continue. "We have a ways to go, but this is a good start."