Laguna Beach, Providence agree to explore feasibility of small-scale hospital
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Alarmed Laguna Beach residents rallied for months after learning the town could lose its local emergency room and, this week, those efforts appeared to bear fruit.
Providence Mission Hospital, which operates the South Laguna facility that opened in 1959, informed the city in January it did not intend to continue running an acute care hospital. Officials cited too-costly seismic retrofitting, required by state law, as a reason for the move.
But city leaders intervened, offering to work with the institution on a solution. And on Wednesday, the two parties released a joint statement indicating they will study the feasibility of operating a small-scale hospital on the 20-acre site as a means of potentially preserving in-town emergency services.
“Health and safety is local government’s highest obligation,” Councilman Alex Rounaghi wrote in a social media post. “In 2016, the attorney general’s reviewers called it ‘critical’ that Laguna Beach keep its emergency services, and the state required Providence to keep them for a decade.
“That term ended this summer,” he continued. “The need didn’t. Our ER saw 14,827 visits last year, and six in 10 of our fire department’s ambulance transports go there.”
Rounaghi serves with his council colleague Bob Whalen on an ad hoc committee for the hospital.
Laguna Beach is forming a work plan in response to an update from Providence Mission Hospital that forecasted a future without an emergency room and acute care services.
While Providence agreed to evaluate the “micro-hospital” model, the statement — released after the sides met on Aug. 24 — said the hospital operator was not committed to pursuing the option.
Seth Teigen, the chief executive of the hospital, had told city officials in the January update that the hospital faced estimated costs of $300-350 million if it were to bring the facility into seismic compliance with state regulations by a 2030 deadline.
The hospital’s consideration of transitioning to an outpatient-focused model would mean the loss of the emergency room. Teigen has repeatedly said the state of California does not allow for standalone emergency departments.
Following that news, Laguna Beach sprung into action, launching plans to save its emergency room that included the formation of a 16-member hospital task force.
The panel has met twice, most recently on Aug. 20, when task force members reaffirmed the community’s uncompromising stance that the emergency department must remain, while also questioning hospital leaders about the economics — including recurring revenue systems — and what it would take to facilitate a change in course.
“This community is not the least bit interested in having an outcome that does not provide for emergency department services in this community,” Ron Geisman said at the meeting. “It’s very, very clear that that is our attitude as a community, so we’re going to work from that perspective.”
A care facility without an emergency department cannot accept ambulance traffic, so patients in need of transportation by ambulance are sent to neighboring specialty care facilities, such as Mission Hospital in Mission Viejo or Hoag Hospital in Newport Beach.
Hospital officials said the Laguna Beach campus is designated an emergency receiving center, unable to accept patients with heart attacks or strokes and critically-ill children. Dr. Melanie Wolf, the hospital’s chief medical officer, said in the Aug. 20 meeting that those patients were already being transferred to Mission Viejo, a regional trauma center, via ambulance, which she described as an “ICU on wheels.”
Laguna Beach’s action plan includes input from working groups regarding the healthcare needs of its community and the future of its hospital site in South Laguna.
“One of the things that we have to look at is when the hospital was built, it was built because of the death of Gordon French, a Laguna Beach policeman in 1953 who died in transit going to healthcare in Newport Beach,” Geisman added. “The problem then was pretty bad. The problem today is a lot worse. … The ability to get to emergency care — I don’t care if you call [an ambulance] an ICU on wheels or not — is very difficult.”
The emergency department in Laguna Beach receives about 17,000 visits per year, according to data presented by hospital officials, with approximately 3,400 of those patients requiring admission.
City officials and Providence have agreed to pursue legislation that would allow for a standalone emergency department, both addressing that approach in last month’s public hospital task force meeting.
“We have met with Providence and our lobbying firm to talk about the possibility of state legislation that would allow for a standalone emergency room, which currently is not allowed under California law,” Whalen said.
While the state Legislature has been reluctant to allow standalone emergency rooms, Teigen expressed a willingness during the task force meeting to go down that path.
“Even though it’s not allowed, we really think with our government affairs team, and with the support of the city and community, that there is a real opportunity for us to pursue this, because Laguna Beach is not alone,” Teigen added. “There are hospitals across the state of California that are in the exact same situation, whether it be for activity, their location, they’re rural by nature or the seismic deadline that they’re faced with.
“It’s really multi-factorial, not just one of those things that kind of informs the decision. But I think it’s a great opportunity for us to work together and do something really special, just like the people that came before us in 1959.”
