Officials to Shut Valley ER Today

Unable to find surgeons to staff their emergency room, officials at Northridge Hospital Medical Center-Sherman Way said they will close their emergency department today, months ahead of a planned shutdown of the entire facility.

The Sherman Way campus emergency room -- which served about 29,000 patients a year -- was the busiest of the six emergency departments in Los Angeles County that have closed or plan to close this year, healthcare officials said.

Although hospital officials announced in August that the 209-bed facility would close by year’s end, the decision to shut down the emergency room at 8 a.m. today came suddenly.

On Friday, hospital officials realized they could not meet a state law requiring facilities with emergency rooms to have doctors with certain specialized skills on call.

By Saturday, the emergency room was closed to ambulances. A sign on a glass door showed a route to the next-closest emergency room.

The decision to shut down early stunned emergency department Director Dr. Frank Fower. He and his staff were “heartbroken” at the news, he said Sunday.

“Just for financial problems, they want to close it like a store,” he said, shaking his head.

Tracey Veal, a hospital vice president, called the decision very difficult but said officials had little choice, once they realized they did not have doctors available to comply with state law.

The Sherman Way campus in Van Nuys is the oldest hospital in the San Fernando Valley. The hospital has treated about 45,000 people a year, in addition to emergency room patients.

Like other hospitals that have closed down, the Sherman Way campus has struggled to cover the cost of two state-mandated programs: nurse-to-patient ratios that went into effect in January and seismic retrofitting.

And like many hospitals, the Sherman Way campus has faced growing debt, because hospitals are required to treat all emergency room arrivals, regardless of ability to pay. As a result of these factors, the facility has lost about $1.5 million each month -- $13 million a year on charity cases alone, hospital officials said.

“Just like hospitals, physicians don’t get reimbursed for that charity care,” Veal said. That made it difficult to persuade general surgeons to staff the on-call teams required for maintaining an emergency room, she said.

In addition, doctors who specialize in other fields required for emergency room staffing, such as obstetrics and gynecology, had little incentive to work emergency room hours when they could treat a high volume of insured patients in private practice, Veal said.

On Sunday, the halls of the emergency department were unusually quiet. On a wipe-off board near the nurses’ station, staffers counted down the hours to closure.

Despite his disappointment, Fower, the emergency room director, said he could understand why surgeons would refuse to join an on-call panel. “The malpractice insurance for surgeons is one thing. When you’re on-call for an ER, it’s 100 times more.”

Some employees held out hope the hospital could be saved.

Gracia Cahoon, an obstetrics nurse, said a group of physicians and nurses called the Valley Healthcare Alliance was looking for investors.

“It’s like an epidemic; so many hospitals keep closing all the time,” said Cahoon, who said they had gathered more than 6,000 signatures in support of keeping the hospital open.

But hospital officials said they were doubtful a financial bailout would occur.

The decision to close the emergency room early highlights the growing struggle of many area hospitals.

Carol Meyer, the county’s head of emergency services, said she is worried that uninsured patients will continue to strain hospital finances and make it increasingly hard for the county’s remaining emergency rooms to attract required doctors. Since the 1980s, 18 emergency rooms and 10 trauma centers in the county have closed.

Meyer said she was hopeful that Proposition 67, which would add a surcharge to telephone bills to pay doctors and hospitals more money for emergency care, would pass.

“Right now, there are no other programs, except for trauma, for paying the uncompensated cases,” she said. The ballot measure faces opposition from major telephone companies who say the tax is not justified because it would benefit large healthcare corporations without guaranteeing better service.

Meyer said most patients who would go to the Sherman Way campus will be rerouted to Valley Presbyterian Hospital, about a mile and a half away. Valley Presbyterian handles about 22,000 patients annually in the emergency room.

“It’s very concerning that it is going to take on double its ER volume,” Meyer said. Other nearby emergency rooms are at Sherman Oaks Hospital and Mission Community Hospital in Panorama City.

Valley Presbyterian officials worked over the weekend to prepare for an increase in emergency room patients, hiring a doctor and a few additional nurses, said spokeswoman Lisa Chakos-Knapp. She said they had been planning for increased traffic at the end of the year.

Because the two facilities often competed for the same patients, Chakos-Knapp said: “While this is a sad thing for the population in the Valley and Sherman Way [Medical Center], this can be a good thing for us.”