Hospital Spurns County Cash to Delay Cutback

California Medical Center officials Thursday refused an offer of about $500,000 from the county to postpone imminent cutbacks in the center’s busy downtown Los Angeles emergency room.

The hospital also objected strongly to a surprise attempt by the state’s top health official to delay the cutbacks, but nevertheless agreed to meet with him to discuss the matter next week.

The director of health services for Los Angeles County, Robert Gates, said that he is hopeful that a “compromise” can be worked out to temporarily delay cutbacks scheduled to take place Wednesday at both California and at Hospital of the Good Samaritan. French Hospital of Los Angeles, a much smaller facility, has announced emergency room cutbacks effective June 15 and three other central Los Angeles hospitals have indicated that they may follow suit.

Good Samaritan officials stated without elaboration Thursday night that they will “cooperate with any request of the state for short-term delay in implementing changes in provision of emergency service, if any agreed-to delay will not cause a service crisis.”

Public interest attorneys said they would, nevertheless, seek a court order today preventing cutbacks at all three hospitals.

The three nonprofit hospitals plan to downgrade their emergency rooms to “standby” status--meaning that doctors need be “on call” rather than on the premises and that rescue ambulances carrying about 1,200 patients a month will have to be diverted elsewhere.

Heavy Financial Losses

California Medical Center officials said the cutbacks were prompted by heavy financial losses from their emergency room, where increasing numbers of patients are being treated who can not or will not pay their bills. They estimated that the hospital is losing $500,000 a month on “uncompensated care” to patients entering the hospital through the emergency room.

California Medical Center’s board of trustees was offered about $500,000 Thursday by a county health department representative to continue emergency services at full force for two months through the end of July, according to Samuel J. Tibbits, president of the Lutheran Hospital Society, which owns the medical center. Of the offer, he said: “That wouldn’t help us any.”

Early this month, California and Good Samaritan notified health officials of their intention to downgrade their emergency room service.

“We expected no problem with getting permission,” said Tibbits.

But on Wednesday, he said, Dr. Kenneth Kizer, director of state health services, informed hospital officials that they cannot “down-license” until they receive written permission from the state.

“This is unprecedented,” Tibbits said of Kizer’s statement.

“It’s strange,” he said, and comes “absolutely” as a surprise.

Duty to Review Changes

Kizer’s spokesman explained that the state has a duty to review licensing changes requested by hospitals. He said Kizer has determined that his review of the California Medical Center application for changing the status of the emergency room will not be completed by June 1, thereby delaying the cutbacks.

“I can not tell you by when we will reach a decision,” the spokesman said. He said that Kizer ultimately has the power to deny the application, but was unable to say on what grounds.

Stan Roman, assistant chief of licensing for state health services, said that Kizer may consider whether the proposed cutbacks pose “a hazard to the health and safety of the community.”

Tibbits said hospital officials have not yet decided whether to fight Kizer in court, but said that in any event, they will meet with Kizer on Tuesday in Los Angeles to discuss solutions to the looming emergency-services crisis in Los Angeles.

California Medical Center’s executive director, William Haug, said in a statement:

“The delay of the state to respond to our notification has placed the hospital in an extremely untenable position in terms of being able to provide an appropriate level of clinical service” in the emergency room.