Fountain Valley’s Trauma Center in Danger of Closing

The trauma center at Fountain Valley Regional Hospital and Medical Center is becoming so costly that hospital officials said they may close it unless the county agrees to subsidize the unit.

Fountain Valley hospital officials said their problems are similar to those encountered by Los Angeles, where the high costs of trauma care and the inadequate reimbursement for indigent patients has combined to create a crisis in the emergency facilities.

About a half-dozen trauma centers in Los Angeles have already closed, forcing the Los Angeles County Board of Supervisors to pass an $11-million bail-out last week.

Fountain Valley is the first of the Orange County’s four trauma centers to request money from the county government. The other facilities reported that their trauma centers are generally breaking even and are not in jeopardy of closing.

But Fountain Valley officials said their problems are different because they are in an urban area and handle more trauma patients than the other county facilities.

“If you’re losing on each patient, then the more patients you have, the more you lose,” said Mari Toth, spokeswoman for the Fountain Valley hospital. “We do get a disproportionate share of the loss.”

Toth said that the hospital was planning to submit a request for money to the Board of Supervisors next month and that it has not yet been determined how much will be requested. The hospital would also not disclose its losses on the trauma center.

Without the subsidy, “the hospital will have to perform some sort of analysis to determine whether it is worth our staying in the program,” said Mike Gonzales, the hospital’s controller. “(The costs) are increasing now to a level that we have to be concerned about because it affects our plans for the future.”

County officials in the Health Care Agency and at the Board of Supervisors said they do not know about financial troubles at the hospital and could not tell whether a government bail-out is possible. They said they would wait until a request for money is made before they decide on a subsidy.

Trauma centers in the county are about seven years old. It is a designation that means a hospital has the equipment and staff members to handle multiple critical injuries. A trauma center, for example, must have specialists in varied medical conditions on call round the clock.

The county’s other three trauma centers are the UCI Medical Center in Orange, Mission Hospital Regional Medical Center in Mission Viejo and Western Medical Center in Santa Ana.

Beth Groves, spokeswoman for Mission Regional, said: “Trauma is not a service that hospitals make money on and, at this point, we’re holding our own. Part of it is numbers. (The other trauma centers) have a lot more violent crime-type patients than we do in southern Orange County. We have severe patients, but it is more vehicle or beach accidents.”

William Drozda, financial officer at UCI Medical Center, said his hospital’s trauma facility is “actually at a bit of a loss, . . . but it’s very minor.”

“Our situation is a bit different than Fountain Valley,” he said. “More of the patients that come to our trauma center are insured.”

Wayne D. Schroeder, president of Western Medical Center, said about a subsidy: “At this time, I don’t see it. I don’t want to be the maverick, but I think if they think they have a financial need, then we should present it together and not get into the panic situation (such as the one in) Los Angeles.

“When the time comes when we can justify the need (for more money), I think the community will rise to it,” he said.

Fountain Valley’s Gonzales said about 52% of the trauma center’s 1,000 patients per year pay by means other than insurance. That includes MediCal, cash and the county’s reimbursement for Indigent Medical Services.

In addition, the county reduced its payments under the Indigent Medical Services program by 5% over last year. And Fountain Valley’s situation was intensified because its staff is paid more than at other county facilities, Gonzales said.

He said the average payment from trauma patients is 30% below the average for the hospital.

“What it becomes is a more common sense business management,” Gonzales said. “We would like to add additional services and additional beds to the hospital . . . and all of that means cash flow.”