Hospital May Close Its ER
Downey facility says care of uninsured is too costly. Closure would be a blow to the county's strained system.
latimes.com : California
By Jack Leonard, Times Staff Writer
August 3, 2005
www.latimes.com/news/local/la-me-downey3aug03,1,538109.story?coll=la-headlines-california&ctrack=1&cset=true
Downey Regional Medical Center has told Los Angeles County officials it might close its emergency room, threatening to become the 10th hospital to cut those services since 2003 as they struggle with the cost of treating the uninsured.

If the medical center follows through, it would be the largest emergency room to close in recent years, further straining the county's already overstretched emergency medical system.
 
The county has lost emergency rooms that treated nearly 136,000 patients a year, but state figures show that the Downey facility alone saw 46,307 emergency patients last year.

If the hospital closes, already crowded hospitals in Whittier and Bellflower would have to absorb those patients, county officials said.

"It's going to be horrible," said Carol Meyer, the county's head of emergency services. "Our emergency system is falling apart."

On Tuesday, the private nonprofit hospital appealed to the county Board of Supervisors for financial aid to help cover the cost of treating poor patients. But supervisors rejected the idea and expressed concern that paying Downey could lead to a run of other hospitals looking for help. The county is facing its own financial crisis in healthcare, stemming from the cost of treating the uninsured. The Department of Health Services is expected to plunge into the red by nearly $1 billion in three years.

"I don't know how you could ask us to subsidize a private nonprofit," Supervisor Gloria Molina said. "Every single hospital would line up, because they have the same situation as you do."

A closure or significant reduction in emergency services at the 199-bed center could be catastrophic for some patients, said Dr. Jack Kennis, associate director of the hospital's emergency care center.

Two weeks ago, he said, an ambulance brought in a 6-year-old boy who had choked on a hot dog. His heart and breathing had stopped, but doctors and nurses were able to resuscitate him because he had arrived quickly, Kennis said.

"If this facility were not here, the patient might have died," he said.

The issue facing the hospital is one that has hit private medical centers throughout the region as jammed public hospitals turn patients away. A recent study commissioned by the Hospital Assn. of Southern California found that the number of uninsured patients visiting the county's private emergency rooms has risen by a third in the last five years. About 2.25 million residents lack health insurance in the county, which has one of the highest percentages of uninsured of any major U.S. metropolitan region. Most are employed but work at jobs that do not provide health insurance. Illegal immigrants account for about 20%.

Emergency rooms are often hit hardest because more of those patients don't have insurance and because they are generally sicker and need longer treatment, often being moved to other areas of the hospital for follow-up care.

Downey Regional lost between $7 million and $11 million last year because of its emergency room services, said Robert Fuller, the hospital's chief operating officer. In the last five years, the independent nonprofit hospital has eaten up a surplus of $60 million, with half going to treat the uninsured, he said.

Fuller blamed the county's 2002 decision to cut costs by shutting several nearby clinics, leading many uninsured patients to turn to Downey for emergency care.

In addition, the hospital has had to treat emergency patients diverted from the county's troubled Martin Luther King Jr./Drew Medical Center in Willowbrook, he said. Downey is just minutes away via the Century Freeway.

"The county has solved its problems on our backs," Fuller said.

The hospital, which has been looking at closing or downgrading its emergency room for a year, is also reviewing other options, such as stop taking patients brought by ambulance from outside Downey's city limits.

The hospital has also appealed to the state to raise its reimbursement payments for treating the indigent. State officials are expected to announce a decision within the next few weeks. Without the increased funding, a closure or downsizing of the emergency room looks likely, said hospital President Allen Korneff. "It's a very serious, real threat," he said.

Korneff begged the supervisors Tuesday to approve a financial aid package that would have provided up to $900,000 to the Downey hospital for treatment of indigent patients who live near King/Drew.

That proposal was part of a $14.7-million spending plan for county trauma and emergency services that would also have bought new equipment for paramedics to detect heart attacks sooner and provide incentives for hospitals to open new trauma centers.

The plan, recommended by county health officials, relied upon a property tax hike of a quarter-cent for every improved square foot of property — or $3.75 for a 1,500-square-foot home. Under Measure B, approved by county voters in 2002, supervisors can raise the property taxes allocated for trauma care each year as much as inflation for medical services.

But supervisors rejected the plan, citing the $20.8 million the county's health department has set aside for trauma and emergency care. In addition, they said an increase would hit taxpayers at a time when property values are skyrocketing, seriously affecting the property taxes already being paid by recent home buyers.

"I just can't explain to my neighbor, or quite frankly to my wife, why we're raising the tax when we have a $20-million surplus," said Supervisor Zev Yaroslavsky.

Supervisor Yvonne Brathwaite Burke noted that Downey Regional's emergency room visits actually declined last year, from more than 53,000 emergency patients in 2003.

Hospital officials replied that ambulance drop-offs have increased, resulting in the need to treat sicker patients longer.

The average stay for emergency patients, they said, has also gone from two hours to four or five hours.

When President Clinton passes her universal healthcare program this will all go away.

Good the more that close, the better, till people start throwing out the Illegals themselves they can expect more and more.

I'm not suprised with the number of illegals in the Los Angeles area. I went to the ER in Glendale last year after cutting my hand. 6 of 8 patients were illegals with no ability to pay. Only me and a woman suffering from diabetic shock had insurance. I had to wait 3 hours, dripping blood on their floor, before getting 5 sutures. It's a wonder the hospitals can stay in business when 75% of their walk-in traffic cannot pay their bills.

Phhht... emergency room expenses.

Who cares as long as the cost of a head of lettuce is less than a gallon of gas and there's a fresh bar of soap in the shower stall at the Super-8.

Keep'em coming over the border.

We can absorb the flow.

It seems like the new mayor of Los Angeles would be right on top of this problem.
I guess it sucks not to have health insurance. I know it sucks to be a taxpayer(cash cow, atm, etc)

Quoted: I'm not suprised with the number of illegals in the Los Angeles area. I went to the ER in Glendale last year after cutting my hand. 6 of 8 patients were illegals with no ability to pay. Only me and a woman suffering from diabetic shock had insurance. I had to wait 3 hours, dripping blood on their floor, before getting 5 sutures. It's a wonder the hospitals can stay in business when 75% of their walk-in traffic cannot pay their bills.

Problem?.............just raise taxes..........that is how they solve those problems
if you can afford a house\apt you are obviously blessed and should support your community MORE

Doctors at a private hospital told me that they send the illegals across the street to the funded hospitals because they CANNOT turn them away. And since this is happening at the poor communties the poorer community hospitals are falling out of the system.

Quoted: Good the more that close, the better, till people start throwing out the Illegals themselves they can expect more and more.

bush is going to make them all legal, twice as many are going to come here
and who do you think is going to pay for their health care, schools and
don't forget the outrageous prison numbers, we will have to make them
exempt from any\all prison sentences because we will never be able to build enough prisons.........

"The issue facing the hospital is one that has hit private medical centers throughout the region as jammed public hospitals turn patients away. A recent study commissioned by the Hospital Assn. of Southern California found that the number of uninsured patients visiting the county's private emergency rooms has risen by a third in the last five years. About 2.25 million residents lack health insurance in the county, which has one of the highest percentages of uninsured of any major U.S. metropolitan region. Most are employed but work at jobs that do not provide health insurance. Illegal immigrants account for about 20%."

sounds like the other 80% of the NON ILLEGALS without health insurance is straining the system as well.  

Not that I have any particular wish to defend illegals, but the problem is much bigger than that.  

Quoted: "The issue facing the hospital is one that has hit private medical centers throughout the region as jammed public hospitals turn patients away. A recent study commissioned by the Hospital Assn. of Southern California found that the number of uninsured patients visiting the county's private emergency rooms has risen by a third in the last five years. About 2.25 million residents lack health insurance in the county, which has one of the highest percentages of uninsured of any major U.S. metropolitan region. Most are employed but work at jobs that do not provide health insurance. Illegal immigrants account for about 20%." sounds like the other 80% of the NON ILLEGALS without health insurance is straining the system as well.   Not that I have any particular wish to defend illegals, but the problem is much bigger than that.

That's a good point.  There are two issues here.

1.  The most obvious is that 20% shouldn't even be here and are just leaching off taxpayers.  This should be addressed first and quickly.

2.  Medical costs continue to rise and there are people without insurance.

I know of ways to bring medical costs down, but I have no solution as far as the insurance issue is concerned.

Wow, what a misleading title.  Looks like it is primarily citiznes or legal residents with no insurance that is closing the hospital.  Still, don't let the facts get in the way of your tirade.

Quoted: That's a good point.  There are two issues here. 1.  The most obvious is that 20% shouldn't even be here and are just leaching off taxpayers.  This should be addressed first and quickly. 2.  Medical costs continue to rise and there are people without insurance. I know of ways to bring medical costs down, but I have no solution as far as the insurance issue is concerned.

I have pondered that also.  Most insurance compaines are for-profit and accountable to stock holders.  

So how do you have a non-greedy for-profit company?  I don't think it is possible.

Supposedly, a number of studies just came out that refute the argument that the main culprit in the escalation of health care premiums is sky rocketing malpractice insurance premiums.  As evidence, they cite the states that have capped lawsuit payouts already, with no let up in the growth of monthly premiums.  According to the studies, it's the cost of the care itself...new machines, state of the art treatment, etc., that' s the problem.  

I've said this before, but somewhere, when there are 60 to 70 million working Americans w/o health insurance, there will be a huge crisis...and it's gonna come in the next 5 years.  

I'm not advocating socialized medicine...but we're gonna have to figure something out.  Right now, I'd be willing to see every dime I've paid into social security go to *something* that will keep me insured for the next 20 years.  I'm 53, and I pay $378 a month for individual health insurance through Kaiser.  What the fu** is that monthly premium gonna be in 10 years?  $1,000?  $1500  What if I had a family...that amount would likely be doubled.  

Consider what the burden is gonna be on the hospitals in 10 years, if it's already forcing closures.  

Not a pretty picture.  

Quoted: Supposedly, a number of studies just came out that refute the argument that the main culprit in the escalation of health care premiums is sky rocketing malpractice insurance premiums.  As evidence, they cite the states that have capped lawsuit payouts already, with no let up in the growth of monthly premiums.  According to the studies, it's the cost of the care itself...new machines, state of the art treatment, etc., that' s the problem.

The machines certainly are a cost incurred, although they are more productive than ever. Note that the medical equipment manufacturers also incur the costs of relentless (and often frivolous) litigation.

PA specialists are leaving in droves, thanks to Fast Eddie Rendell being in the pocket of the trial lawyers (his "reforms" are classic big D doubletalk)

Look at the number of malpractice attornies in your local phone book and understand that they would not be in that business if they were not making a profit at the expense of Doctors, Hospitals, and ultimately, patients.

(and yes, the AMA also needs to do a better job with weeding out bad Docs)

Quoted: Quoted: That's a good point.  There are two issues here. 1.  The most obvious is that 20% shouldn't even be here and are just leaching off taxpayers.  This should be addressed first and quickly. 2.  Medical costs continue to rise and there are people without insurance. I know of ways to bring medical costs down, but I have no solution as far as the insurance issue is concerned. I have pondered that also.  Most insurance compaines are for-profit and accountable to stock holders.   So how do you have a non-greedy for-profit company?  I don't think it is possible.

Wow!  NimmerMehr, you're pretty insightful.  I've pondered the same thing.

Way back when, insurance companies were created for the sole purpose of diminishing risk.  They weren't necessarily for-profit ventures.  However, as with any business dealing, insurance companies quickly evolved into profit motivated, publicly held corporations.

I'm not a big fan of government intervention into business institutions, but I can see an argument for forcing insurance companies to be non-profit organizations where profits are put back into the reserves for the express purpose of reducing premiums.

Quoted: Quoted: Supposedly, a number of studies just came out that refute the argument that the main culprit in the escalation of health care premiums is sky rocketing malpractice insurance premiums.  As evidence, they cite the states that have capped lawsuit payouts already, with no let up in the growth of monthly premiums.  According to the studies, it's the cost of the care itself...new machines, state of the art treatment, etc., that' s the problem.   The machines certainly are a cost incurred, although they are more productive than ever. Note that the medical equipment manufacturers also incur the costs of relentless (and often frivolous) litigation. PA specialists are leaving in droves, thanks to Fast Eddie Rendell being in the pocket of the trial lawyers (his "reforms" are classic big D doubletalk) Look at the number of malpractice attornies in your local phone book and understand that they would not be in that business if they were not making a profit at the expense of Doctors, Hospitals, and ultimately, patients. (and yes, the AMA also needs to do a better job with weeding out bad Docs)

My suggestion.  Right now attorneys take about 40-60% of any payout from medical litigation.  Why not cap the attorney's take to just 10%.  That alone would significantly reduce the incentive for attorneys to pursue the litigation.

Quoted: Phhht... emergency room expenses. Who cares as long as the cost of a head of lettuce is less than a gallon of gas and there's a fresh bar of soap in the shower stall at the Super-8. Keep'em coming over the border. We can absorb the flow.

Labor is 6-10% of the cost of vegetables and <2% of the cost of machine-picked crops.  We could pay lettuce pickers $15/hr and add $.30 to the cost of a head of lettuce.  In Texas, that is a lot of money for young people, the low IQ, the terminally goofy, or whoever else winds up doing stoop labor.  Or, like Europe, we could machine-pick the lettuce.

Quoted: Quoted: Good the more that close, the better, till people start throwing out the Illegals themselves they can expect more and more. bush is going to make them all legal, twice as many are going to come here and who do you think is going to pay for their health care, schools and don't forget the outrageous prison numbers, we will have to make them exempt from any\all prison sentences because we will never be able to build enough prisons.........

Actually, based on the 1986 Amnesty, ever illegal legallized brings over 2.5 other persons through family reunification, so 2.5x, not 2x.  In case you were curious.

Quoted: My suggestion.  Right now attorneys take about 40-60% of any payout from medical litigation.  Why not cap the attorney's take to just 10%.  That alone would significantly reduce the incentive for attorneys to pursue the litigation.

Because like idiots we keep electing lawyers to political office, and they would never cut the economic throat of their brethren.

(Remember that they also have backup in the Judicial Branch (100% non-lawyer free!), should a legislature try to rein them in)

Please stop calling them Illegal immigrants. They are ILLEGAL INVADERS!!!!!!

A bad day is coming. As long as there is plenty of water at the water hole all the animals drink. When it dries up only the lions drink. Welcome to the jungle.

Quoted: Quoted: My suggestion.  Right now attorneys take about 40-60% of any payout from medical litigation.  Why not cap the attorney's take to just 10%.  That alone would significantly reduce the incentive for attorneys to pursue the litigation. Because like idiots we keep electing lawyers to political office, and they would never cut the economic throat of their brethren. (Remember that they also have backup in the Judicial Branch (100% non-lawyer free!), should a legislature try to rein them in)

Oh yeah!  Well I...I...I just can't argue with that.  You're right.

I was born in Downey more than 43 years ago at "Rio Hondo Memorial Hospital"  We lived in Norwalk.  Even back then we were the only white family in the neighborhood.

Quoted: Wow, what a misleading title.  Looks like it is primarily citiznes or legal residents with no insurance that is closing the hospital.  Still, don't let the facts get in the way of your tirade.

I think you were misled by the article(in the leftist liberal media)
look at this paragraph that you reference........

"the Hospital Assn. of Southern California found that the number of uninsured patients visiting the county's private emergency rooms has risen by a third in the last five years. About 2.25 million residents lack health insurance in the county, which has one of the highest percentages of uninsured of any major U.S. metropolitan region. Most are employed but work at jobs that do not provide health insurance. Illegal immigrants account for about 20%."

It says that emergency room patient count has risen by 30% in the last five years
It says that 2.25mil have no heath ins in THAT county
It says that  illegals are 20% of THAT number
It DOES NOT say that only 20% of the emergency room patients are illegals
and I "doubt" that is the case.............
maybe you have some numbers to rufute my "doubt"