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

  1. Duarte Hospital to Close Its ER
    By Stephanie Chavez
    Times Staff Writer

    January 9, 2004
    http://www.latimes.com/news/printedi...-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.
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  3. by   PMHNP10
    How unfortunate. So not being from CA, I wonder what kind of hospital this is. Were they fighting the ratios since 1999, until the bitter end on 12.31.03 or did they really put out the effort to hire? Are they pulling a Tenet? I can't help but think that in a large area like LA that there would be ample resources to recruit from, but admittedly, this is only an educated guess. I'd certainly love to hear what some CA nurses have to say about this. Logic also tells me that these type of things result in public favor switching away from the ratios, because the avg person only get to see that another place they get care at is closing, not as a way of hospitals fighting the govt and CNA. I'd love to know what people are saying out there.
    Last edit by PMHNP10 on Jan 10, '04
  4. by   purpleyoda
    i think we will start seeing this across the country as the nursing shortage grows. no one seems to know what to do to improve the situation. it is great for travelers like myself, with many more choices, but i am concerned about no solution . the geriatric population is growing and growing, and many of those are nurses with no one to replace them. i have four children and six grandchildren, and only one is a nurse and one is thinking about it. the younger generation does not look at nursing the way we did, as something proud to be a part of. if they are interested at all, it is for job security. there is also a huge shortage of nursing instructors. something has to change, soon.california er closing
  5. by   -jt
    <California Hospital Closes "Due to Ratio Law">

    No big surprise there. Its one of the industry's tactics to reverse the staffing ratio law by creating public panic. Hospital and healthcare corps (like Tenet) in California are conducting seminars all over the state to train hospital executives and management in how to evade and reverse the new staffing ratio law. The tactic you mention is right there in the "playbook" theyre giving out at these seminars. It's designed to create public panic and get the law reversed.

    <Hospital industry seminars advise administrators on how to EVADE RN safe staffing ratios

    excerpt:

    * 'Close beds and cry wolf'
    Voluntarily close or downsize beds or units, citing an inability to "find" sufficient RNs to meet the ratios. The goal is to fan hysteria in hopes of softening public support for the ratios, winning regulatory exemptions to compliance, and generating political support for legislation to repeal or suspend the ratios.

    * Delay elective surgeries, declare healthcare "emergencies," - both to force RNs on staff to work more hours and to engage in a PR war to subvert the ratios. To ratchet up public pressure, some hospitals may close units or suspend operations every day, and will meet with legislators to place the blame on the ratio law.The officials concede that hospitals may, in some cases, have difficulty receiving permission to reopen beds or units that have been temporarily or permanently shut down.

    Seminar packets provide:
    1. Detailed information on obtaining temporary and permanent closures of units and suspensions of beds
    2. Sample letter to DHS requesting bed suspension
    3. Sample letter to employees and medical staff announcing unit closures
    4. Sample press release for participants headlined: "(Facility/System Name) Closes XXXX Unit Because of Lack of Nurses. Despite Recruitment Efforts, Hospital Unable to Hire Enough Nurses to Meet New State Law.">>

    We'll be seeing more hospital closings announced as more facilities follow that game plan to get the public to call for a reverse of the law. You have to wonder what that hospital has been doing since 1999, when the law was first passed, to prepare for the day it would be implemented. If they waited until the last minute to take actions to meet the ratios, its seems THEY - not the law - would be to blame if their facility really had to close. I have no sympathy for them. If they dont have adequate staffing, they SHOULD be closed.

    Full article: http://www.calnurse.org/102103/hospindustry.html
  6. by   teeituptom
    So is this going to turn into another Pro unionist rhetoric thread, or what. Thats what it sure sounds like. Im sure the hospital had very good reason to close some beds and change thrie focus to elsewhere in health care. And maybe not necessarily as an attack against nursing and ratio laws and unions. It just might be good solid business for them without and ulterior motive. However I dont see the prounionist segment seeing it that way.


    Not evrything in life is a conspiracy

    by

    Samuel Clements
  7. by   oramar
    It occured to me that moves like this are in the pipe line long before they are carried out. This plan was probably first brought up maybe five years ago. Nurse/patient ratio laws are mostly a small factor if any at all.
  8. by   pickledpepperRN
    1. A forty bed hospital minutes away from the larger hospitals Methodist, Huntington, and City of Hope makes little sense to me.

    2. The above mentioned hospitals and others a short drive away will probably hire any displaced nurses.

    3. There are plenty people in this tate on waiting lists for admission to nursing school.

    One young person I know is attending an LVN program and working weekends as a monitor tech, clerk, and EKG tech having taken all prerequisites and earning an AD in biology. There are MANY others.
  9. by   PMHNP10
    Originally posted by teeituptom
    So is this going to turn into another Pro unionist rhetoric thread, or what. Thats what it sure sounds like. Im sure the hospital had very good reason to close some beds and change thrie focus to elsewhere in health care. And maybe not necessarily as an attack against nursing and ratio laws and unions. It just might be good solid business for them without and ulterior motive. However I dont see the prounionist segment seeing it that way.
    Being that I'm just a few miles south of you, I have no experience with unions whatsoever, so I can't make an intelligible decision on whether I'm for them or not based on anything other than what I read on this board. I do know a union was instrumental in starting the ratios in CA, and while ratios might not be the perfect remedy for bedside nursing, it is one heck of a start.

    As I understand your post, you believe these hospitals closing and siting inability to hire staff is merely coincidence. So here is the question I pose: These hospitals closing...was there any talk of them closing prior to the implementation of the ratios? There are exceptions to the rule, but things like this typically don't get formulated and carried out overnight. I don't expect you to know given that you live 1600+ miles away from them, but I would sure like to hear from people associated with the hospital. They would certainly have an interesting insight.

    Now when it comes to a tenet hospital, I am going to fully disagree (and I still don't know if the hospital in question is tenet owned). I trust their motives no further than I can throw their largest employee; and on more times than I can count on my toes and fingers they have earned such a reputation. So perhaps (and unfairly) people generalize the unscrupulous actions of tenet and the like to other hospitals, but at the least their timing suggests playing dirty. I reckon the situation in Los Angeles, CA (et. al) remains to be seen.
  10. by   pickledpepperRN
    http://www.pasadenastarnews.com/Stor...892374,00.html
    Hospital's ER closure being investigated
    DUARTE -- County and state health officials have launched an investigation into the abrupt closure of Santa Teresita Hospital's acute-care facility and emergency room, officials said Wednesday.
    Friday's closure of the 73-year- old facility put the community at risk, said Russie Roman, health deputy for Los Angeles County Supervisor Michael Antonovich.
    ``Can you imagine if we just had emergency facilities closing overnight? It's a public-safety issue,'' she said. ``It affects a lot of agencies, fire departments and paramedics.''
    County and state officials are working together on the investigation.
    Roman said officials were alarmed by several things about the closure. For instance, state law requires facilities to give 90 days' notice and hold a community meeting before closing. But Santa Teresita officials gave the county two days' notice and told the public and their own employees less than 24 hours before shuttering the facility.
    ``The way this all went down was not appropriate, in our view of it,'' Roman said.
    Hospital CEO Mike Costello did not return calls seeking comment but said previously the closure was an emergency effort to avoid bankruptcy and save the facility's 150-patient, skilled-nursing operation. A state law requiring higher nurse-to- patient ratios made it too expensive for the facility to remain open, he said.

    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.''

    Duarte City Manager Jesse Duff, who sat on the hospital's board until December, said the closure surprised him. Duff said the hospital had a feasible financial plan in place.

    At least two of the hospital's nurses also questioned the CEO's reason for closing, saying the facility had no shortage of nurses to meet the new state requirements.

    Nurses also questioned the administration's ability to provide quality care. There were allegedly no pediatricians on duty or on call in the obstetrics unit for about 10 births in November and December, the nurses have said.

    The controversy raised by the nurses was also a motivation for a more thorough investigation, Roman said. State health officials said they started investigating the closure Jan. 6, when they were notified of the administration's plans to close. The county's emergency medical services team and state licensing officials visited the hospital Wednesday, Roman said.
    The investigation should be finished in a week or two, she said.
    -- Staff Writer Lisa Faught contributed to this story.
  11. by   -jt
    Space, Is anybody sending those reporters out there the info in the post above about how the industry is telling the hospitals to close beds and units & publicly blame the staffing ratio law for it in an attempt to get the law reversed? It just seems to me that hospitals are following the blueprint they concocted to get rid of that law.

    Full article: http://www.calnurse.org/102103/hospindustry.html
  12. by   pickledpepperRN
    Originally posted by -jt
    Space, Is anybody sending those reporters out there the info in the post above about how the industry is telling the hospitals to close beds and units & publicly blame the staffing ratio law for it in an attempt to get the law reversed? It just seems to me that hospitals are following the blueprint they concocted to get rid of that law.

    Full article: http://www.calnurse.org/102103/hospindustry.html
    I know the nurses I know are very cynical. One nurse on a statewide committee attended one of those CHA classes bringing the handouts refered to in your link.

    It would be unusual for the PR dept. not to sent the press release to the paper.

    BUT - the hospitals advertise in the paper.
  13. by   PMHNP10
    Originally posted by spacenurse
    http://www.pasadenastarnews.com/Stor...892374,00.html
    Hospital's ER closure being investigated

    ``Can you imagine if we just had emergency facilities closing overnight? It's a public-safety issue,'' she said. ``It affects a lot of agencies, fire departments and paramedics.''
    County and state officials are working together on the investigation.
    Roman said officials were alarmed by several things about the closure. For instance, state law requires facilities to give 90 days' notice and hold a community meeting before closing. But Santa Teresita officials gave the county two days' notice and told the public and their own employees less than 24 hours before shuttering the facility.
    ``The way this all went down was not appropriate, in our view of it,'' Roman said.
    Hospital CEO Mike Costello did not return calls seeking comment but said previously the closure was an emergency effort to avoid bankruptcy and save the facility's 150-patient, skilled-nursing operation. A state law requiring higher nurse-to- patient ratios made it too expensive for the facility to remain open, he said.

    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.''

    Duarte City Manager Jesse Duff, who sat on the hospital's board until December, said the closure surprised him. Duff said the hospital had a feasible financial plan in place.

    At least two of the hospital's nurses also questioned the CEO's reason for closing, saying the facility had no shortage of nurses to meet the new state requirements.

    Nurses also questioned the administration's ability to provide quality care. There were allegedly no pediatricians on duty or on call in the obstetrics unit for about 10 births in November and December, the nurses have said.

    The controversy raised by the nurses was also a motivation for a more thorough investigation, Roman said. State health officials said they started investigating the closure Jan. 6, when they were notified of the administration's plans to close. The county's emergency medical services team and state licensing officials visited the hospital Wednesday, Roman said.

    Originally posted by psychrn03
    I reckon the situation in Los Angeles, CA (et. al) remains to be seen.
    I reckon that is no longer the case. How shocking....:stone
  14. by   -jt
    <It would be unusual for the PR dept. not to sent the press release to the paper.
    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.

    <<..A state law requiring higher nurse-to- patient ratios made it too expensive for the facility to remain open, he said.....
    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.
    Last edit by -jt on Jan 18, '04

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