Healthy Signs

Bucking a statewide trend toward consolidation and downsizing, Los Robles Regional Medical Center is rapidly expanding instead.

As hospitals struggle to survive throughout California, the medical center in this affluent community is opening new specialty buildings and hoping to add another wing at its main Janss Road campus.

It has set aside $6.5 million to triple the size of its crowded emergency room, is moving toward construction of a $4-million intensive care unit and is talking with its parent company about a new multistory tower of patient rooms.

In addition, Los Robles plans to reopen the former Westlake Medical Center seven miles away as an urgent care and outpatient center on Dec. 1. Los Robles’ corporate owner, Columbia/HCA, bought the competing general hospital several years ago and closed it in 1997.

As the Conejo Valley’s only remaining general hospital, Los Robles has already expanded by 70 beds to 255 through the purchase of the old Charter Hospital building in mid-1997.

Los Robles has been able to expand even as health maintenance organizations and state and federal programs have cut payments for patient care over the past decade. That is partly because the hospital has little competition, executives said. And the expansions are meant to keep that virtual monopoly intact.

“Anybody who runs a hospital looks at us with envy. You couldn’t be in a better position than Los Robles is right now,” said spokeswoman Kris Karraway. “Because the competition isn’t there, we don’t have to spend money on advertising and buying duplicative equipment. We can truly concentrate on bringing in health-care services that people now leave the area for.”

Los Robles’ expansion is also fueled by continued growth in the Conejo Valley.

“The community is growing and we can look down the road and see major developments coming in like the Dos Vientos project,” said Bill Nolan, associate administrator. “So we are looking at expanded needs, and we’re doing everything we can to meet the needs.”

Regional hospital officials said Los Robles also has been able to withstand industry cutbacks partly because it has so few indigent patients--those without insurance who cost other hospitals dearly.

Los Robles made a 12% profit on its operations last year, while about half of California’s hospitals lost money, according to state reports. Locally, Santa Paula Memorial Hospital, Simi Valley Hospital and the public Ventura County Medical Center lost money on operations for the reporting year ending March 31.

“We’re delighted to see what Los Robles is doing even in a time like this,” said Monty Clark, regional vice president for the hospital industry association in Southern California.

“It’s one of Columbia’s flagship hospitals,” he said. “And it’s gratifying to see that they have seen the necessity to continue building for that community.”

Critics maintain, however, that Los Robles’ ambitious building program is driven by competition.

Tenet Health Care, the nation’s second-largest hospital chain behind Columbia, announced plans to move into the Conejo Valley in 1997 after Columbia closed the Westlake hospital. But Tenet abandoned its plans this summer as it became clear the Westlake facility would be reopened as a satellite of Los Robles.

“It’s very interesting the way the whole delivery of service has gone in the Conejo Valley,” said Tenet spokesman Brandon Edwards. “The interesting part to me is that they contracted their services, and now they’re expanding them again. And it’s all happened in a short period of time.”

Regardless of Columbia’s motivation, Edwards said, Tenet finally decided not to open an urgent care center to handle minor emergencies for a variety of reasons other than fear of competition with Columbia.

He said Tenet had trouble leasing an adequate building, enrolling sufficient numbers of doctors and did not like depending on a general hospital 20 miles away. The closest of Tenet’s 32 general hospitals in Southern California is its Encino-Tarzana facility.

“It was a fluid situation to start with,” he said. “And combined with the geographical difficulties, it didn’t make sense.”

Karraway said Los Robles intended to set up its own urgent care and outpatient center in the Westlake area regardless of what it did with the old Westlake hospital. That just made sense in competitive terms as well as for the community good, she said.

“From an economic standpoint, you can say, ‘I want to monopolize the entire valley here,’ ” she said. “Or you can look at it another way and say, ‘I have a responsibility to provide the best care possible.’ We look at it both ways.”

Precisely what the Conejo Valley has gotten or will get from Los Robles’ projects is this:

* A new open-heart surgery suite that was built at the 208,000-square-foot main hospital, at 215 W. Janss Road, in 1995.

* The 1997 conversion of the old Charter Hospital into a 55,000-square-foot Los Robles extension on Via Merida, five miles from the main campus. It has 43 beds for long-term patients who need skilled nursing, 16 beds for elderly patients with behavioral problems and 11 beds for patients recovering from surgeries.

* The expected $2.5-million December reopening of the 76,000-square-foot Westlake facility on Lakeview Avenue as an urgent care center for noncritical patients and a clinic for patients receiving speech and physical therapy and rehabilitation treatments. Los Robles expects the new center to draw about 30 of the 100 patients a day who now go to the emergency room at the main hospital.

* The Christmas 1999 opening of a $6.5-million expansion of the Los Robles emergency room. It will be expanded by three trauma rooms and a fast-track area for less ill patients. Its square footage will increase threefold to 11,000. Patients now sometimes wait for hours to be seen. Construction should begin in January, Nolan said.

* The mid-2000 opening of a 6,750-square-foot intensive care unit at the main hospital. The 10 new beds will augment 10 in the current ICU and another 10 for acutely ill heart patients.

* A possible new patient tower at the main hospital that would be several stories high and provide private rooms for Los Robles patients for the first time.

“We got a gift in the circumstances here,” Karraway said. “And we can sit back on our laurels and let another company come in, or we can be proactive and take steps to be better. We choose the second. We want to be the Cedars-Sinai of the Conejo Valley.”