Emergency Care Cut at Downtown Hospital

The trustees of the Hospital of the Good Samaritan in downtown Los Angles issued a terse statement Thursday night announcing drastic curtailment of the hospital’s emergency services. The disclosure came three days after cutbacks in an even busier downtown emergency room.

The announcement came even as victims from the city’s worst downtown high-rise fire were recovering at the hospital after being rushed to the emergency room by ambulance only hours before.

The only explanation given by the trustees for their action was a reference to recent overcrowding in the hospital.

“During January and February of this year, the hospital’s emergency room was closed over half the time because of the hospital’s overburdened critical-care facilities,” the trustees stated.

However, the move was the latest in a series of trauma and emergency care cutbacks prompted by complaints that most emergency room patients lack medical insurance and cannot pay for their care.

Large Void in Service

The curtailment will leave a large void in emergency services for many people, especially heart attack victims in the downtown area, health care officials said.

“St. Vincent (Medical Center at 2131 3rd St.) is the only other hospital nearby to provide high-quality cardiac care and it has no emergency room, so patients will get shunted miles away,” said cardiologist Dr. Joseph Ruggio, who practices at Good Samaritan.

Good Samaritan, a nonprofit hospital with 411 beds at 616 S. Witmer St., has been receiving about 450 ambulances a month, and these will all have to be rerouted to other facilities when the emergency room is downgraded to “standby” status June 1. Another 800 ambulances a month that are now handled by nearby California Medical Center will also have to be rerouted, because that hospital also is downgrading its emergency room to “standby” on June 1.

Linda Vista Community Hospital and French Hospital of Los Angeles--two small downtown hospitals--and Hollywood Presbyterian Medical Center have given strong indications to county officials that they too may curtail their emergency services to head off ambulances that bring in substantial numbers of people who cannot pay their bills, but who, by law, cannot be refused treatment.

Officials at California Medical Center, a nonprofit hospital with 327 beds at 1414 S. Hope St., cited large amounts of non-paying emergency patients as a principal reason for their decision to cut back emergency service. Financial disclosure reports for the year ending in June, 1987, show that the hospital lost $4.3 million on uncompensated care, or 5.1% of its total operating expenses.

This compares with about a $3.5-million loss for the Hospital of the Good Samaritan, or 3.5% of its total operating expenses, records show.

In their statement, the trustees of Good Samaritan made no mention of their uncompensated care costs--that is, costs run up by patients unable or unwilling to pay their bills--other than to say that “the hospital, as always, remains committed to providing charitable care to its community.”

Line of Fire

Good Samaritan was generally considered to be first in the line of fire to accept ambulances rerouted from California Medical Center.

Dr. Philip Fagan, head of the medical group that provides doctor services for Good Samaritan’s emergency room, said that this additional load could sink the hospital, financially.

Founded in 1885 by an Anglican nun, the hospital opened its emergency room about three years ago, coinciding with the build-up of its coronary care unit that now handles about 3,500 in-patients a year.

In 1985, the hospital unexpectedly received a $40-million donation from Beverly Hills recluse Liliore Green Rains. A spokesman at the time said that the money would be put in endowment funds drawing 5% interest, yielding an annual income of about $2 million. Hospital officials declined Thursday to say whether any of this money was being used to offset the cost of providing medical care to the poor. They also declined comment on the hospital’s plans to build a 12-story heart hospital on land next to the main structure.

“We are limiting all comments to this statement,” spokeswoman Heather Hutchison said.