Los Robles to Break Ground Today for an Expanded ICU


Los Robles Regional Medical Center kicks off a project today to double the size of its intensive care unit, aiming to prevent the kind of patient diversion experienced firsthand recently by Ventura County Supervisor Frank Schillo.

Despite being the county's most profitable hospital, Los Robles diverted patients to other medical centers because of a packed ICU on 130 days last year--more than any other hospital in the county, according to statistics from the Ventura County Emergency Medical Services Department.

The situation was highlighted last week when 67-year-old Schillo, suffering from a heart condition caused by blocked arteries, had to be sent to St. John's Regional Medical Center in Oxnard--20 miles from his Thousand Oaks home--for triple-bypass surgery.

"They just didn't have any more beds," Schillo said Wednesday while recovering at home, a day after being released from St. John's.

While his experience at the Oxnard hospital was good, Schillo said he would have preferred being closer to home to make it easier for family members who visited.

"I don't think I'll be at the ground-breaking, but I certainly commend them for expanding their services," he said.

Expansion at Los Robles has been in the works the past two years, even as hospitals throughout California struggle to survive. Last year the Thousand Oaks medical center completed a $6.5-million, 12,000-square-foot emergency room with private rooms.

But Schillo's experience is "a perfect case in point" illustrating the need for more ICU beds, hospital spokeswoman Kris Carraway-Bowman said. The $4.5-million project will add 10 intensive care beds and 5,500 square feet to the existing 10-bed ICU, she said.

The project is part of a larger expansion plan to eventually add a new wing to the front of the hospital with dozens of private rooms.

The expansion also calls for a multilevel parking structure as well as possible additions still being designed, Carraway-Bowman said.

Specific details on the ambitious plan--the cost of which is not yet known--should be released in two to six months. After that, Carraway-Bowman said, it will take about 18 months to secure approval from the city of Thousand Oaks and the Office of State Health Planning and Development.

Los Robles has been able to grow even as health maintenance organizations and state and federal programs have cut payments for patient care over the past decade, forcing the closure or consolidation of more than 100 California hospitals since 1990.

"As the population expands, we are going to see a need to expand services at our hospitals," said Monty Clark, regional vice president for the Health Care Assn. of Southern California. "We just don't know at the moment where they're going to get the money. More than 60% of our hospitals are operating in the red."

The difference at Los Robles is due in part to the hospital having little competition, and in part to an increasing demand for health services in the Conejo Valley's growing white-collar communities.

Carraway-Bowman said Los Robles' corporate owner, Tennessee-based HCA-Healthcare Corp., is committed to the facility's growth plan, including providing any necessary funding.

"We don't have to plead and beg corporate to agree with us that we need to expand," she said. "They are behind us 110%."

Los Robles' operating profit in 1999--the most recent figures available from the state--was $16.3 million, or 12.6%. Elsewhere in the county, operating margins are either minuscule or nonexistent, according to the state.

When Los Robles was built in 1968, the Conejo Valley was home to roughly 30,000 people, Carraway-Bowman said. Today, as the suburban area's population has swelled to 155,000, hospital personnel see 30,000 people in the emergency room each year, officials said.

That surge of potential patients--particularly the unknown demand that will be added as the population ages--is what led hospital officials to pursue a large-scale expansion.

Two years ago the idea was to simply build a new wing that would protrude halfway into the front parking lot, housing 43 patient rooms. The latest plan, however, calls for eventually using all of the hospital's undeveloped land--about three acres--to shore up its position as the only general hospital between the Conejo Grade and Agoura Hills.

"We really need it," Carraway-Bowman said of the extra space, especially private rooms for noncritical patients. "If I could wave my magic wand, I'd put it in right now."

Although all areas of the hospital have been busy, the effects of the space crunch have been most obvious in the ICU and critical care unit--small spaces where patients are the most critically injured.

"We're jam-packed full every day--it's very rare when we get a break," said Jennifer Rech, the hospital's critical care manager. "We're holding our own, but anything extraordinary is potentially problematic."

Today, hospital officials will host a ground-breaking ceremony for the new ICU building, which will take up to a year to complete.

It promises to make a big difference for those patients who have found themselves diverted to medical centers farther from their homes.

Carol Ramirez of Agoura Hills was visiting her father, 88-year-old Lou Cataldo, in the Los Robles ICU on Wednesday after he underwent surgery for bleeding on his brain. She said she was grateful there was room for him when they arrived.

"It would have been miserable" to have been diverted, she said. "I have two kids and a busy schedule. I don't want to be spending 20 minutes on the freeway when I could be spending it with him."

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