Hospital Can’t Limit Emergency Care to Gardena Residents : Medicine: County rules out geographical limits on emergency services. Hospital officials say they can’t afford unrestricted paramedic services.

County health officials have told Gardena city officials and administrators at Memorial Hospital of Gardena that the hospital cannot limit emergency services to Gardena residents only.

The hospital has asked the county for permission to downgrade its emergency room from basic to standby status and to stop accepting paramedic patients. At a meeting Monday, city and hospital officials proposed retaining full emergency services for Gardena residents, but county officials said such selectivity would violate the policies of the county’s Emergency Medical Services system.

“The problem with what Gardena proposed--to carve out a specific service area--is that it sets a precedent,” said Virginia Price-Hastings, who oversees the county’s paramedic operations. “Other hospitals would want to follow suit, but that would leave us with large (geographic) areas uncovered. We can’t permit something to go in that leaves large population bases uncovered.”

In addition, Price-Hastings said, state regulations require ambulances to transport patients to the closest emergency room equipped to handle the emergency, and they also require that paramedics take patients to a hospital with a basic emergency room. If a basic emergency room is open at the Gardena hospital, it must be available to the entire EMS system, not just to local residents, she said.

Memorial Hospital Administrator George Rooth said the number of non-paying emergency cases forced officials to request that the emergency room at the private, 200-bed hospital be downgraded from basic to standby status. Emergency services would still be available for walk-in patients and private ambulances that are not used for paramedic calls, he said.

It could be another 30 to 60 days before the hospital’s request is approved and paramedic service is halted, officials said. Centinela Hospital Medical Center in Inglewood downgraded its emergency room and closed its doors to paramedic services last May.

Memorial Hospital of Gardena “wants to provide service in its own community,” Rooth said, “but we can’t provide services to the indigent population using us as primary care from outside the area. We’re willing to absorb some losses from our community, but not from the broader area.”

The Gardena Fire Department has only one fully equipped paramedic unit, said Administrative Battalion Chief Ralph Mailloux.

A paramedic assessment unit, added last year, can handle most emergencies but cannot administer heart medication or drug therapy, Mailloux said.

Downgrading Memorial Hospital “has the potential to cause our only full paramedic squad to be unavailable due to longer transportation time. . . . Our squad will be unavailable more, so we’ll be relying on our assessment engine,” Mailloux said.

Price-Hastings said it might be possible for the hospital to receive funds under Proposition 99, which provides money from a tax on tobacco for a number of health services, including treatment for patients who are unable to pay.

But Rooth said Proposition 99 money “is not sufficient to make us decide in favor of continuing business as usual.”

After Monday’s meeting, county and city officials said they plan to meet again in two weeks to discuss other possibilities for retaining some emergency services at the hospital.

Rooth said he hopes that “a good solution can be worked out for the city and the hospital.”