3 More Hospitals in L.A. Act to Cut Emergency Care

Three more private hospitals in downtown Los Angeles have picked up applications to dramatically curtail their emergency room service, it was disclosed Tuesday.

A fourth was feared to be considering doing so as well.

“We may be looking at 2,000 ambulances a month that will have to go someplace else,” said Virginia Price Hastings, a county health official. “I don’t know what we’ll do.”

On Monday, the busiest private emergency room in the county, California Medical Center in downtown Los Angeles, announced that because of financial losses, the center will downgrade its busy emergency room to standby status effective June 1. This means that doctors will be “on call” rather than on the premises, and that about 800 rescue ambulances a month will have to be rerouted to other hospitals.

But three of those facilities in the line of fire--Hospital of the Good Samaritan, Linda Vista Hospital and French Hospital of Los Angeles--have indicated their reluctance to take up the slack. Hastings said the three have obtained applications from the county to change their emergency room status.

Handle 550 Cases

The three hospitals combined now accept about 550 rescue ambulances per month, with most of them going to Good Samaritan.

If Hollywood Presbyterian Medical Center were to downgrade its emergency room service too, as some officials fear, another 600 ambulances would have to be rerouted. This would amount to a total of about 2,000 ambulances monthly that would have to be absorbed by the rest of the county’s emergency network. Countywide, there are about 80 hospitals with emergency rooms that accept rescue ambulances.

Hastings predicted that the problem will “boomerang” into longer paramedic response times and more-crowded emergency rooms.

Compared to the recent trauma center crisis, Hastings said, “This is much more serious.”

In the last two years, seven area hospitals, including California Medical Center, have closed their trauma centers.

Trauma patients account for only about 15,000 of the 400,000 annual paramedic runs by the Los Angeles City Fire Department, she said. “Trauma is an important but very small subset of all the emergency cases handled by paramedics--the drug overdoses, heart attacks, seizures and so on,” she said.

Financial Crunch

County and hospital officials agree that the source of the problem for trauma centers and for private emergency rooms is a financial crunch caused by the cost of providing medical care to increasing numbers of indigent patients--many of whom enter a hospital through its emergency room. By law, a hospital must treat and stabilize all emergency room patients without regard to their ability to pay.

At the Hospital of the Good Samaritan on Witmer Street, which receives about 450 rescue ambulances a month, spokeswoman Heather Hutchison said the emergency room is “losing money.” She confirmed that officials there recently obtained an application from the county to downgrade emergency services, but said that no firm decision has been made, pending “a special session of the trustees” scheduled for Thursday.

She said the emergency room has recently been filled to capacity “19 days out of each month” and will be hard-pressed to handle a “20% to 40% increase” in patients due to curtailed emergency services at nearby California Medical Center on South Hope Street.

At California Medical Center, officials figure that the center’s emergency room is losing about $500,000 a month. Compounding the hospital’s financial problems is its $60-million debt from a recent rebuilding campaign, as well as stricter government controls on hospital charges to public health care programs such as Medicare and Medi-Cal.

Reacting to California Medical Center’s announcement, county supervisors declared Tuesday that the hospital’s action will “leave an area twice the size of San Francisco with inadequate emergency health care.” In an emergency motion, they asked health officials to study the possible “domino effect” on other hospitals.

May Downgrade Service

At French Hospital in the Chinatown area, spokeswoman Roselyn Smith said the hospital has suffered financially from the large percentage of indigents brought to the emergency room by paramedics. Of about 50 ambulance patients a month, she said, about half do not pay their bills. “There’s a good chance we will downgrade” the hospital emergency room, she added.

Officials at Linda Vista Hospital in Boyle Heights, which also accepts about 50 rescue ambulances a month, could not be reached for comment.

Times staff writer Rich Connell contributed to this story.