Another Hospital Leaves County’s Trauma Network

In the second major defection of its kind this year, Queen of the Valley Hospital in West Covina said Tuesday it will abandon the county’s beleaguered trauma care network and leave a major sector of the east San Gabriel Valley without the specialized emergency services.

Citing annual trauma care-related losses of more than $4.5 million over the last two years and a projected $3-million shortfall in 1988, Queen of the Valley President James Haden said Tuesday that the nonprofit community hospital could no longer justify remaining in the network. Queen of the Valley is the fourth hospital to leave the network this year, and the second that will leave a gap in trauma care service in a large part of the county.

“While we believe in the trauma system, Queen of the Valley can no longer sustain the burden of these increasing financial losses since they restrict our ability to serve other equally vital community needs,” Haden said. Among the major concerns he cited were financial losses suffered by trauma physicians who were not reimbursed for caring for indigent patients.

Maintain Emergency Room

Haden said the 272-bed hospital will continue to maintain its 24-hour emergency room after it withdraws from the network on Dec. 21.

Queen of the Valley’s pullout is one of the network’s most significant losses because it will leave a wide swath of the east San Gabriel Valley, an area of 130 square miles and containing more than 80,000 people, without specialized trauma care. During the first six months of 1987, the hospital treated 361 trauma patients, according to county officials.

The hospital’s withdrawal will leave the communities of Covina, West Covina, Pomona and Claremont most vulnerable because they are the furthest from other trauma centers, network officials said.

The unprotected area will be the second created this year due to a network defection. When Daniel Freeman Memorial Hospital in Inglewood left the system in June, its departure left a similar breach in the county’s western region.

Network Created 4 Years Ago

The county’s trauma network was established nearly four years ago to guarantee victims of serious accidents or wounds a maximum 20-minute ambulance ride to a highly specialized emergency room with a specially trained staff. When the network was forming, private hospitals strongly competed to become designated center.

The troubled system has lost two other hospitals since Jan. 1--Hollywood Presbyterian and Santa Monica--for similar financial reasons. Once Queen of the Valley leaves, 17 hospitals, including three major county facilities, will remain in a system once boasting 23 members.

Haden said the hospital gave the county no specific ultimatum, and decided to pull out at this time “because we wanted to get out of the ballpark of speculation.” Haden held open the door for the hospital’s possible return to the network, but would not offer any specific ways the county could lure it back.

Haden said the governor’s recent veto of trauma care bailout legislation made it clear that there is little chance that new money will be found to keep the hospital in the network. Gov. George Deukmejian has maintained that the trauma network is a county, not a state, responsibility.

Assemblyman Burt Margolin (D-Los Angeles), who sponsored the trauma care legislation, said Tuesday that Queen of the Valley’s action came as a surprise, but he blamed it on the veto by the Republican governor.

‘A Slow-Motion Disaster’

“We’re watching a slow-motion disaster play itself out in Los Angeles County,” said Margolin, who will chair hearings Thursday in Los Angeles on the network’s funding crisis.

County officials, meanwhile, echoed Haden’s pessimism.

“I need money to work with,” Health Services Director Robert Gates said in an interview. “I just finished making $6.8 million in cuts in our own (county) programs.” Gates was referring to an action earlier in the day when the Board of Supervisors voted 3 to 1 to slash mostly outpatient services at 11 county facilities because of budget constraints.

Chief Administrative Officer Richard Dixon told the supervisors that “I cannot allow a great deal of hope that (Queen of the Valley’s) withdrawal can be halted.” Dixon is expected to recommend soon that nearly $9 million of newly found property tax money be pumped into the network, but added that even some of those funds would not be enough to avert the hospital’s withdrawal.

Began Losing Money

But in recent years, mostly inner-city trauma hospitals began losing hundreds of thousands of dollars when they were called upon to treat indigent trauma patients whose long-term care went largely unreimbursed. Aggravating the situation for the private hospitals was a lack of beds at county hospitals to which stabilized trauma patients could transfer.

As the losses mounted, one by one the private hospitals began dropping out.

As a result of most trauma network defections, other nearby trauma hospitals have been able to fill the resulting service gaps. In fact, Queen of the Valley agreed to take on most of the area once served by Pomona Valley Hospital’s trauma center, which left the network a year ago.

The West Covina hospital’s announced departure triggered predictions that two other San Gabriel Valley-area trauma hospitals--fearing financial losses if forced to accept indigent trauma patients no longer handled by Queen of the Valley--will follow suit. Officials from Presbyterian Intercommunity Hospital in Whittier and Methodist Hospital, Arcadia, will remain in the system for now. But they warned that if the county tries to force them to accept any of Queen of the Valley’s service area, their continued participation could be jeopardized.

Will Not Be Easy

Virginia Hastings, coordinator of the county’s trauma network, said that in the next two months alternative facilities will be identified to handle those patients destined for Queen of the Valley. She indicated that will not be easy, and suggested that officials may even need to approach a hospital in San Bernardino County for help.

After the Board of Supervisors vote to impose $6.8 million in county health cuts, health Director Gates said that most of the eliminated services are available at other county facilities. But he said patients would probably experience longer waits for appointments. Specifically, the cuts include:

- Los Angeles County-USC Medical Center. Outpatient services affecting cardiac, eye and prosthetic valve care; Pediatric Pavilion outpatient care involving dermatology, tuberculosis and failure to thrive services; Women’s Hospital outpatient care involving abortions.

- Martin Luther King Jr./Drew Medical Center. Outpatient services involving general medicine, cardiology, dermatology, gastroenterology, chest and dental specialty clinics.

- High Desert Hospital. Outpatient ophthalmology clinic.

- El Monte Comprehensive Health Center. Surgical clinics involving general surgery, ear, nose, throat and orthopedic services.

- H. Claude Hudson Comprehensive Health Center. General surgery, abortion, dermatology, podiatry and sterilization services.

- Rancho Los Amigos Medical Center. Drug detoxification and rehabilitation services.