By Jim Shilander
The future of Saddleback MemorialCare’s San Clemente campus—Dana Point’s nearest hospital and emergency room— has either been decided or has not, depending on what side you were listening to Tuesday, as the San Clemente City Council heard from a number of stakeholders during four hours of testimony.
MemorialCare announced in August that it was studying a proposal to raze the current facility and rebuild it as an urgent care center with increased capabilities for out-patient care. However, that proposal would eliminate the emergency room and acute care, since the state does not allow for an ER without an attached acute-care center. The proposal has drawn strong opposition from residents, who have said they fear potentially
Saddleback doctors told the council that the hospital’s parent company is already offering employees termination packages. They also charged that equipment, including hospital beds, is being moved to the company’s Laguna Beach campus in preparation for a move.
Steve Cullen, a physician, charged that the company “made a promise they did not keep,” when they purchased the hospital, to upgrade it and keep it viable.
Company officials denied any decision to close the hospital had been made, saying it was making efforts to retain doctors during the uncertainty. Any move of beds or equipment was reflective of a lower patient population in San Clemente and the need to allocate resources where they would be better used, officials said.
The proposal is not a fait accompli, said Steve Geidt of MemorialCare. The hospital’s board had only authorized a study, he noted. The proposal did, however, reflect a “new reality” for small hospitals nationally, he said, due to fewer patients being admitted into acute care. He and Emergency Department director Dr. Mark Todd said many patients already bypass San Clemente due to a lack of equipment or specialists in certain specialties, such as cardiac care and obstetrics. Geidt himself said he had a friend in San Clemente who suffered a stroke. When the friend’s wife called Geidt for advice, he told her to give the man an aspirin and take him to Mission Hospital, where specialty care could be found.
A number of city officials also spoke at the meeting. Chief of Police Services David Moodie said he was concerned about potentially losing officers from the field due to longer commutes taking deputies out of the area for extended periods if they had to accompany suspects or victims for hospitalization. He was also concerned that sergeants would lose investigative time for the same reason.
Julie Puentes of the Hospital Association of Southern California said there were serious financial issues facing many hospitals, especially with recent changes in health insurance, with many coming into emergency rooms who weren’t facing actual emergencies. The state currently prohibits standalone emergency rooms without an acute care facility.
Many residents told the council about their own experiences at the hospital, where they said their or loved ones lives had been saved.
Peter Curran, a former paramedic said he’d brought many people to the hospital where they’d been saved.
“This will cost lives,” Curran said.
Warren Vidrine said the proposal did not deal with the “non-negotiable” reality presented by nature, and that urgent care facilities would not help people in the most dire need.
A few speakers voiced positive sentiment about the proposal, saying it could be a model for future care elsewhere.
Saddleback officials said the board will decide the hospital’s future at a March meeting. Should it opt to close the acute-care facility, the county would then examine the impact on emergency services within 90 days of the notice of closure. Part of the study could include potentially sending patients in south San Clemente to Tri-City Hospital in Oceanside.
The council, while not taking formal action, did indicate a willingness to join an ad hoc committee facilitated by the South Orange County Economic Coalition. The hospital will also be an agenda item for the council through the remainder of the year. Assistant City Manager Erik Sund said there had been interest from both the cities of Dana Point and San Juan Capistrano in discussing the issues related to the hospital.