Los Angeles County Might Face Additional Hospital Service Reductions, Emergency Department Closures
Los Angeles County, which has lost six emergency departments and the capacity to serve 75,000 patients in the last 14 months, is "on the brink of a far more serious problem," the Los Angeles Times reports. The county may face "more closures among larger, more heavily used EDs at private hospitals that "could jeopardize emergency care for tens of thousands of residents," according to the Times. If anticipated service reductions at private hospitals are made, they will further reduce the county's ED capacity by 10% to 15%, according to hospital and county health officials.
Hospital officials declined to publicly name specific facilities considering service cutbacks or closures, but officials familiar with the situation said that Good Samaritan Hospital, California Hospital Medical Center and Downey Regional Medical Center are among those facing "severe economic crises" and considering such options, according to the Times.
Good Samaritan's ED is losing $10 million annually. Andrew Leeka, president of Good Samaritan, said he "can't guarantee that we won't close our [ED] doors by the end of the year."
California Hospital's financial losses were not disclosed, but one hospital industry official familiar with the figures said they are "significantly higher than Good Samaritan's," the Times reports.
Downey's ED is losing $2 million per year, so it might downgrade its status, which would result in the diversion of about 5,000 ambulances each year, according to the Times.
Although several factors have contributed to the ED service cuts and closures, hospital officials and health care economists say the "overwhelming" reason is the county's large uninsured population. Of all ED visits in the county, about one-third involve uninsured patients.
Until last year, when the county changed its policies to limit private hospitals' abilities to transfer uninsured patients to the public health care system, about two-thirds of uninsured patients were treated at four county-run hospitals and clinics. Since then, the number of uninsured patients transferred to public hospitals has decreased by 40%.
In addition, the county in 2002 closed 16 clinics to reduce costs, limiting public health care options for the uninsured. As a result, the number of uninsured patients at private hospitals in the county has doubled or tripled. Hospital officials say other factors contributing to the service cuts and ED closures include the costs of complying with new seismic retrofit regulations -- for which 109 of 122 hospitals in the county have submitted plans or requested extensions -- and the new state nurse-to-patient ratio rules implemented in January. Industry officials say that each new ED closure "compounds the problem and makes it more likely that other hospitals will follow," the Times reports.
"It's very precarious for every single one of us. Whether you have insurance or not, if there's not a bed for you, you're not going to get in," county Supervisor Gloria Molina said (Felch, Los Angeles Times, 8/24).