City/County/Federal hospitals

[4fill]

I am in the "September "of my career. (Well maybe mid-August.)

When I began, it was a "given" that teaching hospitals were the forefront of modern medicine.

At least in this area that doesn't seem to be the case. USC & UCLA are linked at the hip with the Los Angeles County Hospitals.

This is probably a simplified view, but it seems that the cost of health care equipment and service has risen so dramatically that the only way to support county hospitals is to raise taxes, and probably substantially. The L.A. County Board of supervisors can't/won't do that.

Consequently, what we are left with is partial service teaching hospitals. UCLA/Olive View does have a cardiac cath lab. But they are unable to perform any heart surgeries.

The hospital is not even in the trauma network, there is no Neuro-Surgery service.

Recently, King/Drew, with its 530 beds, was shut down by JCAHO... for incompetence at all levels. Some one died in their waiting room after being triaged for treatment Harbor/UCLA is now being looked at. A patient died in their parking lot. He could not stay for the 16 hours, which is the average wait in their ER.

High Desert Hospital was one of the smaller hospitals, in northern L.A. County. It was closed because it would have been too expensive to retrofit the building to bring it up to current building codes. Initially licensed for 170 beds it served not only the county clients but also prisoners from adjacent Ca State Prison.

A clinic building does not require the same physical stability as a hospital so the main building is now a few clinical services and the primary clinics Adult Urgent Care, Peds are now in temporary buildings that are 10 - 20 - 30 years old.

Now we have learned, in order to save money, that at least eleven clinics spread throughout LA County may be closed and their services either contracted out or shunted to the reaming county hospitals.

I realize that this may be just in this area, and that some of the Ivy League schools or the better-known schools must have their endowment programs to keep them at the top of the field.

Are City/County/Federal hospitals across the country in the same situation?

[fizz2Nurse]

Welcome to public healthcare. The problem is one of accountability. While you listen to all the bandwagon jumpers talk about "Universal" healthcare these facilities have no incentive to be better or profit. No desire for competition and that's the type of service you get.

[newsguy]

JCAHO did not shut down the hospital. Indeed, JCAHO had withdrawn its accreditation for the hospital some years ago. As was widely and extensively reported (many front-page stories in the Los Angeles Times, among others) the hospital failed two surveys by the Centers for Medicare and Medicaid Services (CMS), the Federal agency that provides about half the funding for the hospital. With that money gone, the Los Angeles County Board of Supervisors, the hospital's governing board, elected to transfer many of the hospital's functions to other LA County facilities whose licenses were intact. "Incompetence at all levels" had little or nothing to do with the findings of the surveyors or the closing.

Nor is the government looking to shut down Harbor, as you claim. The incident to which you refer -- a patient who walked out -- was not a result of his unwillingness to wait 16 hours to be admitted. He had been admitted to the hospital. Federal inspectors issued an "Immediate Jeopardy" finding but withdrew it when the hospital quickly issued a plan of correction that addressed the conditions that led to the "walkout." Immediate Jeopardy findings are rather common and are certainly not an indication that the hospital is in danger of being shut down.

It would be good if you would get your facts right. If you're a nurse, I'd want you to have a better command of facts if you were taking care of me.