Another California ER bites the dust; blame is "nursing shortage"

[NRSKarenRN]

Duarte Hospital to Close Its ER

By Stephanie Chavez

Times Staff Writer

January 9, 2004

http://www.latimes.com/news/printedition/california/la-me-duarte9jan09,1,7126567.story?coll=la-headlines-pe-california

Santa Teresita Hospital in Duarte is shutting down its emergency room and acute-care facility today, closures that officials blame in part on the state's nursing shortage.

The hospital's 177-bed skilled nursing facility, outpatient surgery center and fertility clinic will remain open, said Sister Michelle Clines, chairwoman of the hospital's board of directors.

The hospital had slowly cut back on its acute-care beds, from a high of 150 in 1987 to fewer than 40 last year. Santa Teresita's emergency room saw about 12,000 patients a year who were not brought in by paramedics in ambulances and approximately 1,700 brought in by paramedics.

The closing of Santa Teresita's emergency room further strains the county's emergency medical services system. More than a year ago, St. Luke Medical Center in northeast Pasadena closed its doors.

"Every ER that closes in L.A. County puts greater pressure on our system, which is already overwhelmed," said Carol Gunter, acting director of the Los Angeles County Emergency Medical Services Agency.

At Methodist Hospital in Arcadia, about five miles south and the closest hospital to Santa Teresita, officials are preparing for a 25% increase in emergency room patients. "It will mean about one more person an hour, about 24 more patients a day," said Lynn Ingram, a spokeswoman for Methodist Hospital.

She said the hospital had been talking to members of the nursing staff at Santa Teresita in the hopes of hiring them.

Santa Teresita was founded in 1930 as a tuberculosis sanatorium by the Carmelite Sisters of the Most Sacred Heart. It became a fully accredited hospital in 1956, and its campus covered 14 acres in Duarte.

Many of its nurses have worked at Santa Teresita for 10 to 30 years because they are committed to working for a Catholic hospital, said the nursing supervisor, Mark Cline.

Although Sister Clines did not have figures on layoffs, she said many of the hospital's 475 employees would stay on because most of its operations are linked with its skilled nursing facility and other clinics.

[-jt]

BUT - the hospitals advertise in the paper.>

Yeah I know. My local paper (theres only one) will not print any letters to the editor that are critical of either one of our hospitals. Not only do both hospitals advertise a lot in that paper, but the hospitals administrators of both are on the newspaper's board of directors. Nice catch-22. Hopefully the information is also being sent directly to the city manager and city health deputy.

At Least Its good to see someone in authority thinking & asking why the hospital waited till the last minute to address how it was going to implement the ratios when they knew since 1999 that the day for implementation was coming.

health deputy for Los Angeles County Supervisor Roman said she does not understand how Santa Teresita officials could not have seen the financial crisis coming. ``How can you not know that you're having this problem?'' she said. ``You have to plan to close; you don't just close overnight.''>>

They may not need RNs if this turns into a new statewide trend. If I knew this a week ago, I could have saved myself the $85 it just cost me to renew my California license.

[pickledpepperRN]

Originally posted by -jt

[b

They may not need RNs if this turns into a new statewide trend. If I knew this a week ago, I could have saved myself the $85 it just cost me to renew my California license. [/b]

LOTS of hospitals have openings!

Kaiser, the University of California System, Catholic Healthcare West, City of Hope, and Cedars Sinai are some BIG chains and facilities that already were staffing pretty well and seem to be making a good effort to increase staffing.

RNs have excellent opportunities here. RNs are struggling with success to keep the LVNs already working.

Little Santa Teresita had been decreasing acute beds while adding skilled nursing for several years.

Huntington is hugh, Methodist and San Gabriel are pretty big too. I guess about 200 + beds. Anyone know for sure?

Anyway, if you want a job you will find one.

I suggest calling the unit you are interested in on a weekend or night shift and asking to talk to a staff nurse. You are likely to be given the truth/

[oramar]

CNA site has an article addressing the abruptness of the closure. There is an investigation going on folks. One interesting subject brought up is the fact that they were reported to the state. It almost appears as if the closure was an attempt to lash out at the nurses involved. PS they were NOT reported for nurse/patient ratios, other patient safety issues were involved.

[pickledpepperRN]

http://www.pasadenastarnews.com/Stories/0,1413,206~11851~1905864,00.html

Article Published: Wednesday, January 21, 2004 - 1:32:20 PM PST

Hospital lobby would undermine state's patient protection law

EXECUTIVE insiders at the lobbying arm of the state's hospital industry are waging a high- stakes gamble in their drive to roll back a landmark patient protection law that if properly enforced almost certainly will save the lives of thousands of Californians.

In an announcement widely disseminated by the industry lobbyists, officials at Santa Teresita Hospital in Duarte recently announced plans to close, blaming the new safe staffing law.

The announcement failed to point out that the hospital has reported losses in six of the past nine years, an aggregate total of $11.1 million, and that the facility has been downsizing for years, all long before the new rules to protect patients were in effect.

At best, the timing of the hospital's announcement six days after the operative date of the minimum registered nurse ratios raises questions that cry out for a broader context.

Last fall the California Healthcare Association (CHA), the industry lobby group, held seminars across the state for local administrators, ostensibly to inform them about the law. But there was a hidden agenda as well, laying the groundwork for a strategic campaign to erode public support in hopes of persuading the governor and Legislature to repeal or weaken the safe-staffing law.

In the seminars, the CHA handed out sample press releases with blanks to fill your name in here announcing a unit closure due to the reputed inability to adhere to the law. If hospital industry opponents of the law are encouraging hospitals to shut down or restrict access to care as a strategy for achieving political ends, that bears investigation by our elected leaders.

Closures are just one apparent tactic. Some hospitals are also canceling or delaying elective surgeries and using lesser-licensed staff who do not have the professional expertise of registered nurses to meet the requirements of the law. The CHA has reportedly also been holding meetings of member hospitals in an effort to keep everyone in line on their interpretation of the law and coordinating common responses.

Additionally, the industry has filed a lawsuit challenging the requirement that hospitals comply with the law at all times, apparently concluding that your loved one who has suffered a heart attack or been seriously injured in an auto accident should have safe care for only part of the day.

Regrettably, promoting patient safety seems to be the theme missing from most of the industry's economically motivated campaign, not surprising for some who have long profited off the pain and suffering of patients when they are gravely ill or badly injured.

As the debate heats up, it's worth recalling the reason for this commonsense law, which requires minimum, safe, registered nurse staffing, similar to the standards we have come to expect for our air, water, airlines, day care centers and other areas of critical public importance. And don't forget the fact that hospitals have had more than four years to get ready.

The law was no accident.

It was enacted in 1999 following years of erosion of patient care conditions in our hospitals, prompted by the abuses of managed care and an industry more focused on cost cutting and business priorities than on patient safety.

Consider the consequences. The Institutes of Medicine of the National Academy of Sciences has estimated that avoidable medical errors kill up to 98,000 people in U.S. hospitals every year and, most recently, that nurse staffing levels affect patient outcomes and safety.

They are not alone.

A 2002 Journal of the American Medical Association study found that for each additional patient assigned to an RN, the likelihood of death within 30 days increased by 7 percent. Four additional patients increased the risk of death by 31 percent.

Even the industry-funded private agency that accredits hospitals, the Joint Commission on Accreditation of Hospital Organizations, said last year that inadequate staffing precipitated one-fourth of all sentinel events unexpected occurrences that led to patient deaths, injuries, or permanent loss of function reported to JCAHO the past five years.

California is not unique in unsafe conditions and grim statistics. But California did become the first state in the nation to take meaningful, corrective action in response. The Safe Staffing Law, which was sponsored by the California Nurses Association, is a major step forward, offering real progress for California patients.

We dare not abort that hope for our families now.

-- Deborah Burger is a registered nurse and president of the 55,000-member California Nurses Association.

[pickledpepperRN]

http://www.pasadenastarnews.com/Stories/0,1413,206~22097~1946268,00.html

Article Published: Monday, February 09, 2004 - 9:56:19 PM PST

Nurses file suit over fast layoffs

By Marshall Allen , Staff Writer

DUARTE -- Seventeen nurses have sued Santa Teresita Hospital, claiming they were sacked without notice when the maternity unit and acute care facility were abruptly shut down in early January.

The nurses claim CEO Mike Costello broke labor laws by providing no notice before a mass layoff. The hospital is already under county and state investigation for possibly failing to follow legal guidelines before closing.

Chris Sayler, a maternity nurse on the night shift, said she initiated the lawsuit after she applied for unemployment benefits. On investigating the labor code, Sayler said, she realized that institutions with more than 75 employees must give 60 days' notice before a layoff of more than 50 employees.

In all, more than 100 employees were laid off when Santa Teresita closed Jan. 9. No one got more than one day's notice and some weren't notified until afterward, Sayler said. Under the provisions of the labor code, the employees are entitled to 60 days' severance pay, plus compensation for benefits they would have accrued during that time period, said Charles Zetterberg, the plaintiff's attorney. He called it a "clear-cut case.'

Sayler said she was off duty when the maternity nurses were laid off Jan. 2, so she received no notice. According to Sayler, the on-duty nurses said it never was clear they were being laid off someone just took their timecards and issued final checks. Of 26 maternity nurses laid off that day, only 10 received any severance, and no one was paid more than two weeks salary, she said.

The next layoffs occurred a week later, when Costello who's also named in the lawsuit announced that a financial crisis forced him to close the 73-year-old hospital's 39-bed acute treatment facility the next day.

Costello said the crisis was caused by a new law mandating higher nurse-to-patient ratios, which would have been too expensive for the hospital. The closure was the only way to save Santa Teresita's 150-patient skilled nursing facility and stave off bankruptcy, Costello said at the time.

Sayler, who worked at the hospital for more than three years, said some nurses had been at Santa Teresita for more than 30 years and never had a chance to say goodbye.

"It was very hard, it came as a shock,' Sayler said. "There were people in tears, people very distraught. Very depressed.'

Sayler is entitled to $19,000, according to the complaint filed Wednesday in Los Angeles Superior Court. Zetterberg said Sayler's compensation was average for the nurses, which would mean they are asking for roughly $323,000 combined. Zetterberg emphasized that anyone laid off is entitled to be part of the lawsuit, so the amount will increase.

A county health department investigation said Costello violated state law by closing the emergency room without providing the community with a public hearing and 90 days' notice. County investigations continue to determine the truth of allegations by nurses that pediatricians weren't on staff or on call for 10 births in November and December in violation of state law.

A Santa Teresita official said Monday that Costello was sick and out of the office.

Previous calls to Costello at least five in the past weeks have not been returned. In addition to running Santa Teresita, Costello operates two other companies, Regis Real Estate Holding Co. and 120-employee Apollo Healthcare Corp.

Apollo is named in the lawsuit because the company and Costello are essentially one and the same, Zetterberg said. Costello used assets of Apollo for his personal use, and carried on Apollo business without the holding of directors' or shareholders' meetings, without maintaining records or minutes of corporate proceedings and without gaining the approval of other directors or shareholders prior to entering into any personal transactions, the complaint said.

Zetterberg said further discovery is necessary to determine how Apollo was connected to Santa Teresita. Costello has said previously that there is no connection between the organizations.

The Carmelite Sisters of the Most Sacred Heart of Los Angeles, the order of Catholic nuns that owns the hospital, are also named in the lawsuit.

-- Marshall Allen can be reached at [phone], Ext. 4461, or by e-mail at [email protected] .