A Tumultuous Year for Local Health Care

Many people in Los Angeles County are having a harder time getting medical care in life-and-death situations. In just over a year, two Southland hospitals shut down their emergency rooms. KPCC's Patricia Nazario says, given the state's budget crisis, public health officials suspect the situation will get worse before it improves.

Patricia Nazario: First to go was Inglewood's Memorial Hospital. Last December, Centinela Freeman HealthSytem CEO Michael Rembis told reporters that meant one less emergency room for south L.A. County.

Michael Rembis: We have made the decision today to consolidate our two emergency rooms at the Centinela Campus...

Nazario: Less than two miles separated Ingelwood's Centinela and Memorial hospitals. Rembis said that closing one was the best way to protect his company's investors and effectively serve people who live in Inglewood. Then eight months later came this.

Yvonne Burke: When you pass a test, everyone's with you. When you fail a test, everyone's always against you.

Nazario: L.A. County Supervisor Yvonne Burke reacted last August after federal regulators failed King/Harbor Medical Center in a "make or break" inspection. Its problems had more to do with serious lapses in care than with money. Flunking the inspection stripped King/Harbor of about half its annual budget and shut down its emergency room. L.A. County supervisors hope to reinstate King/Harbor as a full-service hospital by next fall, but for now it's an ambulatory care center.

Dr. Lee Weiss: Approximately a week before King closed, we were already seeing a change.

Nazario: Dr. Lee Weiss runs the Emergency Room at Inglewood's Centinela Hospital. He walked me around the facility days after King/Harbor closed. Centinela Hospital is one of 73 remaining emergency rooms in L.A. County. Weiss says its daily patient count is up to 170. That's 20% more than a year ago.

Weiss: Right now, on average, the waiting time is about seven hours before you see a doctor. We can certainly see that doubling, if not tripling, as the emergency rooms become more congested.

Nazario: The Hospital Association of Southern California's Jim Lott says nearly half the hospitals in L.A. County aren't meeting their budgets. Fewer of them, he says, can cover uninsured or underinsured emergency room patients. And when another ER closes, that breaks a link in the Southland's fragile critical care chain.

Jim Lott: We forecast that we're probably going to be looking at two closures coming up within the next 60 or 90 days, or at least the announcement of two closures.

Nazario: When hospital administrators decide to shut down an ER, state law requires three steps: A hospital must give three months notice, county public health officials must hold a public hearing, and they must complete an impact report forecasting what the closing would mean to nearby hospitals.

Marty Gallegos: Well, I was the author of that bill...

Nazario: Marty Gallegos is a chiropractor and the chief Sacramento lobbyist for the State Hospital Association.

Gallegos: Well cleary, the bill serves one purpose, and that's to get the public notified of any changes in the services at the hospital. But, no, it's not the solution.

Nazario: Gallegos says one solution would be to insure everyone.

Gallegos: So that providers can get reimbursed at some adequate level, and be able to maintain these services.

Nazario: State universal health care is likely out of reach now that Governor Arnold Schwarzenegger's threatening cuts in state services to help close a projected 14 and a half billion dollar budget gap. But the governor is giving hospitals one break. He's extending an imminent deadline for them to strengthen their buildings against earthquakes. That may not be enough to keep Culver City's Brotman Medical Center afloat. In a cost-cutting move, executives at that for-profit hospital filed for bankruptcy protection two months ago.