Hospitals Work to Cope With Closure By BRAD SMITH Staff Reporter The decision by San Francisco-based Catholic Healthcare West to close the San Fernando Valley’s oldest hospital by the end of the year will increase the patient load on neighboring hospitals, but the facilities are trying to make the transition as smooth as possible and the closure could actually help nearby Valley Presbyterian Hospital. CHW, which has owned the Sherman Way campus of the Northridge Hospital Medical Center, the former Valley Hospital in Van Nuys, for a decade, will transfer some of its business to Northridge Hospital Medical Center, also a CHW facility. Likewise, Valley Presbyterian, an independent non-profit that is run as a 501(c)3, is working to ramp up its staff and facilities to meet the expected increase once the CHW facility closes. “The thing is, we’re still going to be here, there’s a CHW facility that’s close by that’s still going to be here, and so there’s a greater emphasis on making sure the transition is carried out correctly,” said Robert Bills, president of Valley Presbyterian. Valley Presbyterian (which does not have any significant ties to the Presbyterian Church), is located on a 17-acre campus at 15107 Vanowen Street in Van Nuys. It has about 1,000 employees, with approximately 850 full-time equivalents, and an operating budget of $340 million annually. The hospital is licensed by the state for 290 beds, with an average of 185 occupied every day. The total will go up to 380 beds when a new 127,000-square-foot, six story building currently being finished opens this month. The CHW Sherman Way Campus is located on a four-acre parcel at 14500 Sherman Circle in Van Nuys, less than two miles from Valley Presbyterian. It has 209 licensed beds, with , typically 124 occupied. The CHW facility has 830 employees, with about 610 full-time equivalents, and a budget of about $156 million. Founded in 1929, the hospital’s fortunes have changed with changes in demographics and increases in poverty in the East Valley. “We’ve been operating at a deficit for a little over two years,” said Jerry Conway, president of the hospital. “It’s been almost a million dollars a month most recently.” CHW also faced a costly reconstruction of the hospital to meet state earthquake standards toughened after the 1994 Northridge earthquake. The facility’s newest buildings date to the 1970s, Conway said. “We would have had to spend $16 million to be seismically compliant, and we just can’t afford to do it,” he said. Valley Presbyterian has also run at a deficit that reached about $3 million in 2003. Both hospitals serve a largely uninsured and under-insured population; about 86 percent of the CHW patient load is on MediCal or Medicare, while about 85 percent of Valley Presbyterian’s patients use public insurance programs. Both hospitals also have a relatively high percentage of completely indigent, or uninsured, patients, managers said. “We’re doing over $13 million a year in what we call charity care,” Conway said. “It’s been pretty dramatic over the past few years.” Volume is key Those realities have left both institutions weaker financially than they would be otherwise because of their proximity, managers said. “We make it up with philanthropy and hopefully better negotiating clout with the payers, and volume is key,” Bills said. “We will be about it in the mid-San Fernando Valley the bottom line is we are what amounts to an adjunct to the county system.” Bills said the addition of MediCal patients that currently go to CHW’s facility will allow Valley Presbyterian to actually get more revenue. “We’ll absorb that MediCal load, which will give us a greater percentage of MediCal, which hopefully allows us to negotiate better rates with the state,” Bills said. “The more volume we can get, as long as the state continues to pay for it, the better off we are.” The California Department of Health Services will oversee the transition to insure patients’ rights and care standards are respected, officials said. “We can’t force a hospital to stay open,” said Robert Miller, with the state DHS in Sacramento. “What we can do is require that the standards for patients’ care are met, so there’s an orderly transition.” Likewise, Los Angeles County Emergency Medical Services, part of the county Public Health Department, will review the impact of the closure on the emergency services network. A public hearing on the closure has yet to be scheduled, county officials said. Hospital meetings Representatives from CHW and Valley Presbyterian have met for several months to discuss options for the hospitals; the agreement to coordinate the CHW facility’s closure with improvements at Valley Presbyterian is the product of those discussions, officials said. “We realized that two hospitals, in the same competitive market, offering similar services so close to each other meant that neither of us could operate viably,” Conway said. “This consolidation means that improved health services will continue to be available to people in our community.” Valley Presbyterian will buy about $1.5 million worth of equipment from CHW’s facility to help outfit the new building at Valley Presbyterian. In addition, Valley Presbyterian which already provides privileges to most of the physicians at CHW is likely to pick up additional doctors, nurses, and support staff from the CHW hospital. “We will offer people jobs but not until the facility closes down or a given department transitions,” Bills said. The hospitals expect to coordinate so a given department will not close at CHW until the same unit at Valley Presbyterian is ready to receive additional patients. The emergency room at CHW, for example, will stay open for 90 days. CHW reported 24,689 visits to the hospital’s emergency department in 2003, although only 651 of those were deemed critical and another 7,022 urgent; 17,014 could have been treated in a doctor’s office. “We are very concerned about the closure of this emergency department and the effects it will have on the rest of the system,” said Cathy Chidester, assistant director of the EMS agency. Valley Presbyterian plans to accommodate the growth by creating a set of four specialized units, including the actual emergency department. Set to be added as the new building opens, and staffed based on demand, is a new observation ward and new, separate urgent care units for adults and pediatric cases. “We can stand the increases in volume,” Bill said. “We believe we can do it.”
