The Press Enterprise
RIVERSIDE, Calif. — Longer ambulance rides, more patient helicopter flights and added costs would be the future of emergency health care in southwest Riverside County if two embattled hospitals close, officials said.
Health care, ambulance and county officials are exploring scenarios for the possible closure of Rancho Springs Medical Center in Murrieta and Inland Valley Medical Center in Wildomar, which account for 218 of the area’s 300 or so hospital beds.
While it’s not a given that the hospitals will shut down, some officials said residents needing a hospital might have to travel up to 30 miles farther than they do now. For the critically ill or injured, the longer trip could mean the difference between life and death.
“It’s going to increase that period of time where (trauma victims) don’t have that surgeon or that (operating room) working on them,” said Bruce Barton, Riverside County emergency medical services director. “In some cases, that could affect survivability.”
Assuming the new Loma Linda University Medical Center in Murrieta opens early next year, the region of roughly 500,000 people still wouldn’t have enough hospitals, even if Rancho Springs and Inland Valley remain open.
If they close, “with the number of beds and the services we would offer, it would not be sufficient to meet the needs of the community,” said Bruce Christian, CEO of the new Loma Linda hospital.
The California Department of Public Health this month announced it would start the process to revoke the license of Southwest Healthcare System, which runs Rancho Springs and Inland Valley.
Federal officials want to cut off Medicare and Medi-Cal funding for Southwest after June 1. Southwest relies on Medicare for 40 percent of its net patient revenue.
The state and federal actions are tied to a three-year pattern of rules violations that regulators say endanger patients. Southwest, which employs 1,300 people, has challenged many of the violations and moved to fix others.
State regulators said the revocation process could take as long as two years. Southwest could keep its license if it shows significant improvement, they said. Medicare officials also could change their mind, although a Southwest appeal doesn’t automatically push back the June 1 cutoff date.
In an e-mailed statement Friday, Southwest spokeswoman Teresa Fleege said the for-profit company “is focusing all its energies and resources toward addressing the current issues and delivering quality healthcare to the residents of Southwest Riverside County.”
Soaring costs
American Medical Response, a private company that provides ambulance service to southwest Riverside County, transports about 1,300 patients a month to Rancho Springs and Inland Valley, said Thomas McEntee, the company’s general manager in Riverside County.
Should the hospitals close, patients would have to go to Corona, Menifee or Hemet, he said. Barton mentioned Riverside County Regional Medical Center in eastern Moreno Valley as another destination.
The potential closures likely would lead to more helicopter airlifts of trauma victims, Barton said. While the bill to take someone by ambulance is usually $1,500 to $2,000, airlift bills can approach $30,000, he said.
Murrieta Fire Chief Paul Christman said traffic backups on local freeways would make more airlifts a necessity. End-of-the-day gridlock on Interstate 215 would make it impractical to drive an ill or injured patient to Riverside, he said.
A matter of time
The county requires McEntee’s company to arrive at a call in fewer than 10 minutes. That requirement wouldn’t end if the Southwest hospitals close, but the company might need more ambulances because they would be traveling farther to hospitals, Barton said.
“We can attempt to pass that (cost) along to the customers, but our rates are regulated by the county so we’d have to ask for some special relief,” McEntee said. “Even though we increase our charges, it doesn’t guarantee we’re going to collect the money.”
Then there’s distance. It is roughly 31 miles from Inland Valley, the southwest area’s only trauma center, to Corona Regional Medical Center. About 32 miles separate Rancho Springs from Riverside County Regional Medical Center in Moreno Valley.
“It’d be more than double the transport time” if Rancho Springs and Inland Valley close, Barton said.
The local hospital situation will be a topic Thursday for Lake Elsinore Mayor Melissa Melendez and other local officials meeting in Canyon Lake. She said her city already has been fielding calls from residents worried about where they’ll go if Southwest closes its hospitals.
‘In all good conscience’
“The state in all good conscience cannot shut these hospitals down without a contingency plan in place,” Melendez said.
Kathleen Billingsley, deputy director of the state Center for Healthcare Quality, said a region’s level of hospital coverage isn’t a factor in the decision to revoke a hospital’s license. The state last moved to de-license a hospital three years ago.
“The decision to revoke a license is based on the performance of the hospital,” Billingsley said. “The number one thing I can reiterate is that our focus is on quality of care and patient safety, and our decisions have to be based on that.”
Southwest has several options if it loses Medicare certification. Billingsley said that, in previous cases, hospital owners have chosen to close, sell or suspend their license. A hospital would have to reapply for its license and Medicare certification if it chose to suspend, she said.
90 days notice
A hospital must give local officials 90 days notice if it decides to close its emergency room, Billingsley said.
Jerri Randrup, a spokeswoman for the Hemet-based Valley Health System, which operates hospitals in Menifee and Hemet, said her company is working with the Hospital Association of Southern California and other hospitals to come up with a backup plan.
“In the meantime, we would hope that Southwest is successful in resolving its issues with both the state and federal agencies,” she wrote in an e-mail.
“I hope that they can resolve their issues, for the best interests of the community,” Christian said.
Copyright 2010 The Press Enterprise, Inc.
All Rights Reserved