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Los Angeles Times -- 5/30/02, Thursday
Tenet to Close Hospital in Marina del Rey

* Health care: County officials say the shutdown of Daniel Freeman facility will add to the burden on area emergency rooms.

Home Edition, California, Page B-3
Metro Desk

By CHARLES ORNSTEIN, TIMES STAFF WRITER

Tenet Healthcare Corp. said Wednesday that it will close Daniel Freeman Marina Hospital, just six months after acquiring the Marina del Rey facility from a Catholic hospital chain.
The closure of the 166-bed hospital and its emergency room--by August at the latest--will add to the burden on nearby ERs, county officials said. Nearly all of the county's 80 remaining emergency rooms are crowded, and patients often are forced to wait hours before they are seen by a doctor.

But Tenet officials said they would keep Daniel Freeman Memorial, the main 358-bed campus in Inglewood, open, and are seeking to expand urgent-care services at a clinic at Los Angeles International Airport.

Daniel Freeman Marina's closure is the second hospital shut by Tenet in Los Angeles County this year. In January, Tenet announced it would close St. Luke Medical Center in Pasadena, along with its emergency room, citing financial problems. St. Luke had 165 beds and 442 full- and part-time employees.

"The net effect will be additional waits and longer transfer times for paramedics," said Virginia Hastings, director of the Emergency Medical Services Agency at the Los Angeles County Department of Health Services.

Hastings acknowledged, though, that Daniel Freeman Memorial is far more important to the county's emergency network than the Marina campus.

"We recognize that all these hospitals are not going to stay open," she said. "For us, it becomes a game of prioritizing."

Daniel Freeman Marina handled about 4,400 ambulance runs in 2001. In the future, patients will have to be taken to five neighboring hospitals, Daniel Freeman Chief Executive Harris Koenig said.

Tenet, based in Santa Barbara, plans to put the Marina facility up for sale in the next few days. At the same time, the firm will try to find jobs within the Tenet system for the hospital's 350 employees or help them find work elsewhere, Koenig said.

Tenet acquired the two Daniel Freeman hospitals in December for $55 million from Carondelet Health System, based in St. Louis. The two hospitals were losing $23 million a year, Koenig said, and the Marina hospital treated only 40 acute-care patients per day.

"This hospital has not been as successful as a lot of people would like for it to be or thought it might be," Koenig said. "There are not enough patients now, and there won't be enough patients in the future to allow us to afford or attract the capital to do the necessary upgrading of this hospital."

Consumer advocates who fought Tenet's acquisition of Daniel Freeman said the hospital chain has done exactly what they feared--close the Marina hospital to sell the valuable land beneath it.

"The other shoe drops," said Maura Kealey, a health-care coordinator with the Service Employees International Union, upon learning of Marina's closure.

"Marina hospital, while it's small, has an emergency room that is vital-- vital to the people living in Marina del Rey, in Venice," said Kealey, whose union has frequently locked horns with Tenet. The union fought to block the sale but does not represent Daniel Freeman employees.

"Under the previous owners as a nonprofit, Marina was one of the few places where the poor working people in Venice could go for care," Kealey said. "This is a major loss for them."

In approving the sale of the Daniel Freeman hospitals, California Atty. Gen. Bill Lockyer required that Tenet operate the emergency room at the larger Daniel Freeman campus in Inglewood for five years and maintain the ER at Centinela Hospital Medical Center, which it already owned, for the same period.

Tenet is spending $7 million to enhance the Inglewood facility, and has no plans to close it, even after its five-year obligation ends, Koenig said.

The attorney general did not require Tenet to keep the Marina campus open. Tenet is required, however, to provide Marina-area patients with transportation to other facilities until June 2005 to ensure that they have continued access to health services, said Sandra Michioku, the attorney general's spokeswoman. Details on how that would work were not released Wednesday.

"We're obviously disappointed about the closure," Michioku said. "The concerns about possible closure did prompt us in our review to require that residents in the area would continue to have access to health facilities."

Meanwhile, Tenet also said Wednesday that it is working with the county Emergency Medical Services Agency to begin accepting some ambulance patients in stable condition at the Centinela Airport Medical Clinic at LAX. If a final agreement is reached, the airport facility would be the only urgent-care center in the county licensed to accept 911 patients.

If patients needed additional medical treatment in a hospital, they would be transferred to the Daniel Freeman hospital in Inglewood or Centinela Medical Center.

Hastings said the airport facility would not play a major role in the county's emergency network because it would only be able to receive ambulances carrying patients with minor, non-life-threatening injuries or illnesses. These conditions include minor cuts, broken bones, nausea and diarrhea.

"We don't expect 911 to be using it very much because these patients are so minor that often they're not transported," Hastings said, adding that she envisions only five patients a day being taken by ambulance to the airport clinic.

But Koenig said the urgent-care facility could help alleviate some congestion at emergency rooms. The clinic, opened in late 1986, sees nearly 25,000 patients a year, but has the capacity for double that.

BY CINDY FRAZIER

A coalition of community activists and healthcare interest groups are banding together to try to keep the Daniel Freeman Marina Hospital and its emergency room from being closed in August by the new owner, Tenet Healthcare Corp.

The group called Save Our Marina Hospital is being spearheaded by Julie Inouye, of the Vista del Mar Neighborhood Association of Playa del Rey, and other community activists.

Others involved in the campaign are the Community Health Councils, Inc., a nonprofit healthcare interest group; and the Service Employees International Union, which is involved in a labor dispute with Tenet at the Tenet-owned Queen of Angels-Hollywood Presbyterian Medical Center.

"The closure of the Marina hospital will have disastrous effects on this community," Inouye said.

"We cannot have a lack of an emergency room or hospital. The public must be served," she said.

Inouye said she hopes to pressure Tenet to keep the Marina hospital intact until another entity can purchase the hospital.

"We have no answer on how to save it, but they can't close the facility until we know" whether it can be salvaged, Inouye said.

"My neighbor had a massive heart attack and he would be dead today if not for the Marina hospital," she claimed.

"We are all concerned about where we will go" for emergency medical services, she said.

URGENT CARE SITE — Tenet is planning to upgrade its Centinela Airport Medical Clinic on Sepulveda Boulevard near Los Angeles International Airport with an "urgent care" facility that would be able to take emergency patients, Tenet officials say.

The Emergency Medical Services County Commission will hold a public hearing on the issue of the closure of Daniel Freeman Marina hospital at 6 p.m. Wednesday, July 17th, at a location to be announced, according to Maria Iacabo, a spokeswoman for the Los Angeles County Health Department.

The location of the meeting will be posted on the department's website, www.ladhs.org/ems

FINANCIAL STRAITS — Tenet purchased the two non-profit Daniel Freeman Hospitals — the Marina area site and a larger Inglewood facility — for a reported $57 million in December from the Sisters of St. Joseph of Carondelet.

The hospitals had lost $23 million in the previous year and the Catholic order of nuns had used up a $100 million endowment to keep the hospitals in operation, Tenet officials claimed.

Tenet — a Fortune 500 company that recently posted a two-for-three stock split — also owns Centinela Hospital Medical Center in Inglewood, Brotman Hospital in Culver City and the Centinela Airport Medical Clinic near Los Angeles International Airport.

On Wednesday, May 29th, Tenet announced that the Marina area hospital would be put up for sale and would close on or before Monday, August 26th.

The Community Health Councils (CHC) recently wrote a letter to Senator Dianne Feinstein and other legislators criticizing Tenet's plans to open an "urgent care" facility for some emergency patients at the Centinela clinic.

Lark Galloway-Gilliam, executive director of CHC, said she is concerned that Tenet will be able to use the purchase of the two Daniel Freeman hospitals to control the health care market in the area.

Among other concerns, CHC is asking the legislators to determine the value of the Lincoln Boulevard property on which the Marina area hospital and an adjacent medical building sit, which are now for sale by Tenet.

Information, Inouye, (310) 306-1487, or by e-mail:

ino@cyberverse.com

The Argonaut -- 6/27/2002
Daniel Freeman Marina Hospital to close month earlier than planned

BY CINDY FRAZIER

Due to a loss of medical personnel, Daniel Freeman Marina Hospital will now close Monday, July 22nd, one month earlier than previously announced, according to county officials.

The hospital stopped admitting non-emergency patients "several weeks ago," according to Dave Langness, a spokesman for Tenet Healthcare Corp., the new owner of the hospital.

After announcing last month that the Marina area hospital would close Monday, August 26th, hospital officials recently notified the Los Angeles County Emergency Medical Services Agency that the hospital will stay open only until Monday, July 22nd, at the latest.

A public hearing must be held prior to a hospital closure and one is scheduled for 6 p.m. Wednesday, July 17th, at the Boys and Girls Club of Venice. (See related story.)

SHORT ON STAFF — The hospital emergency room now has only one anesthesiologist, who has agreed to work at the site until Monday, July 22nd, according to Virginia Harms, director of the county's Emergency Medical Services (EMS) Agency.

"For all 911 purposes, we will redirect paramedics to other hospitals" after that date, Harms said.

Other hospitals that are likely recipients of emergency patients from the Marina-Venice-West-chester-Playa del Rey areas are Brotman Hospital in Culver City and two hospitals in Santa Monica — Santa Monica-UCLA Medical Center and Saint John's Hospital and Health Center, Harms said.

Without an anesthesiologist, the Daniel Freeman Marina Hospital emergency room cannot function and paramedics cannot take critically injured patients to the facility, Harms said.

"If the anesthesiologist cannot stay until that time, then the hospital will close even earlier," she said.

The hospital was purchased by Tenet Healthcare in December, and the Lincoln Boulevard property where the hospital is was put up for sale Thursday, May 30th.

Hospital staff were informed of the closure Wednesday, May 29th.

HOSPITAL PURCHASE — Tenet purchased the Marina area hospital and its sister facility, Daniel Freeman Memorial Hospital in Inglewood, from the Sisters of St. Joseph of Carondelet, which had operated it as a nonprofit entity.

Tenet, as a for-profit entity, was required to obtain approval of the acquisition from the state attorney general, which stipulated that the Daniel Freeman Memorial Hospital in Inglewood would have to remain in operation for five years. But there was no requirement to keep the Marina area hospital open.

Harms said that it is common for such hospital closures to take place earlier than the planned closure date.

"People look for other jobs and they can't keep a facility open without staff," she said.

Thursday, June 6th, the hospital sent letters to all patients stating that the Daniel Freeman Marina Hospital would soon "begin the process of closing the hospital" over the following 30 days, and would discontinue patient care services during that time.

The letter states, "Effective Monday, July 3rd, 2002, we will no longer be able to provide non-emergent [emergency] patient services."

The Argonaut, 6/20/2002
County panel plans hearing on Marina area hospital closing July 17th

BY CINDY FRAZIER

The Los Angeles County Emergency Medical Services (EMS) Commission will hold a public hearing on the impending closure of the Daniel Freeman Marina Hospital. The meeting is scheduled at 6 p.m., Wednesday, July 17th, at the Boys & Girls Club of Venice, 2232 Lincoln Blvd., Venice.

The 15-member commission was asked by the County Board of Supervisors to conduct a required public hearing regarding the hospital closure and the loss of the hospital's emergency room facility, according to Virginia Harms, EMS Agency director.

The commission will also take testimony on other issues — such as the loss of the hospital psychiatric ward — to forward to the supervisors, she said.

The commission acts in an advisory capacity to the Board of Supervisors.

The Daniel Freeman Marina Hospital on Lincoln Boulevard in the City of Los Angeles is located in Yvonne Brathwaite-Burke's Second Supervisorial District.

Supervisor Don Knabe, who represents most of the Marina area and coastal areas to the south, is also concerned about the Marina area hospital closure, according to John Musella, Knabe spokesman.

"That hospital serves many people in our district," Musella said.

The commission, however, cannot ask that the hospital be kept open, nor can the supervisors intervene to halt a closure, according to Harms.

It is a privately owned hospital, she noted.

Harms said that a state statute requires a public hearing to be held prior to a hospital's closing, in order "to notify people of the closing."

"Before the statute, hospitals would announce on a Friday that they were closing and we would be left in the lurch," without a plan for emergency response for the area, Harms said.

However, a similar hearing in Long Beach recently resulted in saving Long Beach Community Hospital, which was slated for closure, she claimed.

"The public outcry from the hearing resulted in the Board of Supervisors asking the hospital owners not to surrender the hospital license and another entity purchased the hospital," she said.

In the case of the Marina area hospital, Tenet Healthcare Corporation, a Fortune-500 company, purchased the financially ailing hospital and its sister facility in Inglewood from a Catholic order of nuns in December for $57 million.

While the Inglewood facility is required under the terms of the sale to remain open for five years, no such stipulation was made for the Marina area facility, which was put up for sale Thursday, May 30th.

Some local residents, who have been organizing to try to save the hospital, hope that a buyer can be found to purchase the Marina area facility separately from the Inglewood hospital.

Hospital officials claim that together, the two Daniel Freeman Hospitals lost $23 million in the last year that they were operated by the Sisters of St. Carondelet.

Hospital officials also alleged that the Sisters used up a $100 million endowment keeping the facilities in operation.

Tenet — which owns a number of hospitals in the Los Angeles region — has said that it cannot afford to renovate or replace the Marina area facility to improve the hospital to state seismic requirements for hospitals.

Harms said that the commission "may well make a recommendation" to the supervisors because of the high level of concern about the closure of the Marina area facility.

Los Angeles Times -- 6/28/02, Friday

Group Fighting to Save Hospital
Health care: State orders owner of Daniel Freeman in Marina del Rey
to prove it is fulfilling agreements to serve the community.

By NERISSA PACIO, TIMES STAFF WRITER

In a last-ditch effort to save the nonprofit Daniel Freeman Marina Hospital, a coalition of community and labor groups asked the state attorney general to stop the hospital's closure while his office investigates whether Tenet Healthcare Corp., which owns the facility, has violated its commitments.

Atty. Gen. Bill Lockyer gave Tenet until today to provide documents that prove the company has complied with the conditions it agreed to when it purchased the Marina del Rey hospital in December, a spokesman for the attorney general said.

The coalition says the hospital is an essential neighborhood resource and that Tenet has not lived up to its commitments. It says Tenet agreed in December that by now the company would have established a local governing board to oversee continued care of patients.

The agreement also included maintaining a nearby urgent-care facility, providing free transportation to surrounding medical centers and establishing an outreach program to let residents know about their options after the hospital closes.

"If I have a heart attack, where will I go?" asked the president of the Vista Del Mar Network, Julie Inouye, whose husband is a physician at the hospital.

"Doctors are being displaced. Patients are being displaced. This is about our region right now.... It's about life and death."

Company officials say Tenet will have those services in place before the hospital closes in August.

"We are under no obligation to have these services prior to the closure," said Harris Koenig, chief executive officer of Daniel Freeman Marina Hospital.

The hospital has consulted community physicians and health-care organizations in the area to find out the community's needs, and urgent care and transportation to nearby hospitals will be provided closer to the time of the hospital's closure, Koenig said.

Tenet has also signed a letter of intent with the county to upgrade the Tenet-owned Centinela Hospital near Los Angeles International Airport to a high-end urgent-care center with basic life support services, said Tenet spokesman David Langness.

The hospital's psychiatric and chemical dependency unit has closed. Medical staff refer those patients to Tenet's Brotman Medical Center in Culver City. The Marina hospital emergency room is to close at the end of next month, Koenig said.

Tenet also owns Daniel Freeman Memorial in Inglewood, which will remain open. The Marina hospital's closure will be the second hospital shut by Tenet in Los Angeles County this year.

The hospital planned to launch a public awareness campaign this week notifying residents of nearby medical facilities and how to get to those places, Koenig said. Some residents think that's not enough.

"Demographically, we are a graying neighborhood," said Terry Conner, president of the Villa Marina Council. "The other Tenet properties are 13 to 19 minutes away.... Time is of significance."

The Los Angeles County Emergency Medical Services Commission will hold a public hearing July 17 on the closure of the hospital, which community members said serves many low-income residents of Venice and the Marina.

The Argonaut, 7/11/2002
Marina area: Attorney general says Tenet didn't comply with conditions to buying Marina hospital

BY CINDY FRAZIER

The impending closure of Daniel Freeman Marina Hospital and its emergency room (ER) Monday, July 22nd, may have been halted, at least temporarily.

California attorney general Bill Lockyer sent a letter to Tenet Healthcare Corporation Wednesday, July 3rd, claiming that the firm had failed to meet several conditions required in order to close the formerly non-profit hospital.

The letter states that the July 22nd closure of the hospital and its ER cannot take place because there will not be enough time for Tenet to make corrections.

The attorney general must sanction the hospital closure because the Marina facility was formerly operated on a not-for-profit basis and its purchase by Tenet — a publicly traded Fortune 500 company — was subject to approval by the state.

Lockyer's letter was released to the public Tuesday, July 9th, the same day that hospital supporters staged a protest and rally at the Lincoln Boulevard facility.

The Los Angeles County Emergency Medical Services Commission will hold a public hearing on the hospital closure between 6 and 8 p.m. Wednesday, July 17th, at the Boys & Girls Club of Venice, 2232 Lincoln Blvd., Venice.

Information, County Emergency Medical Services Commission, (323) 890-7539.

TENET ‘SURPRISED' — Tenet spokesman David Langness said his firm still hopes to close the hospital ER July 22nd.

The hospital will remain open to treat patients already at the facility but will accept no new patients, he said.

"We were surprised by the attorney general's letter," Langness said.

"We are in discussions now to find out what stipulations and conditions they want and we will do whatever they ask us to do.

"We feel we are in compliance with the spirit and intent of the letter of agreement we signed," the hospital spokesman said.

Langness said that no buyer has yet been found for the hospital property and he debunked rumors that a hotel chain had already purchased the property.

"It is not sold yet, but a number of people have expressed an interest in the property," Langness said.

RALLY — The attorney general's letter heartened some 100 persons — many elderly and some in wheelchairs — who gathered Tuesday morning in front of the hospital with picket signs protesting the closure.

Hospital patients, doctors and healthcare workers, as well as community members, marched, chanted slogans and shouted as numerous passing drivers on Lincoln Boulevard honked their vehicle horns in support.

Some marchers wore black armbands to signify the pending loss of the hospital and its emergency room.

Organizer Julie Inouye, a Playa del Rey resident whose husband is a physician at the Marina area hospital, was exultant after the letter was announced.

"Tenet thought they could ramrod a closure in less than two months," Inouye said. "We will not let that happen. It is a matter of life and death."

Physicians said they want to keep working at the Marina area facility.

"This community deserves high-quality emergency serv-ices," said Dr. Bob Slay, chief of the emergency room.

"Twenty hospitals have closed in the Los Angeles region in the past ten years and fewer ERs means fewer beds and longer waits for patients," Slay said.

The rally was organized with the assistance of the Los Angeles Metropolitan Alliance, a consortium of labor, anti-poverty and consumer groups, and was joined by members of the Service Employees International Union, which is involved in a labor dispute with Tenet at another hospital.

Some speakers alleged that the hospital property will be sold to a hotel developer and many picketers carried signs saying, "Hospitals, not hotels."

Labor organizers want to keep healthcare jobs, which they say pay better than hotel jobs.

"We don't need to promote the tourism industry," said Gloria Camarillo of the Los Angeles Metropolitan Alliance.

"Hotels pay poverty wages," she alleged.

Assemblyman George Nakano said that he is concerned about the closure and conditions of the sale.

"I will continue to be in contact with the attorney general's office to ensure the safety and welfare of my constituents," Nakano said.

CONDITIONS — Tenet purchased two Daniel Freeman Hospitals — Memorial Hospital in Inglewood and the Marina facility — in December from the Sisters of St. Joseph of Carondelet.

On May 30th, Tenet put the Marina facility up for sale.

Tenet is required under the terms of its purchase of the two hospitals to keep the Inglewood hospital open for five years, but no such stipulation was put in place for the Marina hospital.

Lockyer cited two conditions placed on Tenet prior to closing the Marina hospital with which Tenet has allegedly failed to comply.

One condition calls for a "comprehensive planning process" including solicitation of public input and "consultation with community based healthcare organizations" and the County of Los Angeles Emergency Medical Services Agency, the letter states.

The planning process was supposed to include representatives from the hospital board, medical staffs, community leaders, local elected officials and hospital employees, as well as members of the public.

The letter states:

"The materials that you [Tenet] provided do not show any consultation or advisory process involving the Marina governing board, community leaders, local elected officials, or hospital employees prior to the decision to close Marina.

"Contrary to the requirements of Condition IX, Tenet has made no effort to solicit public input or consult with community-based healthcare organizations.

"In short, Tenet made no effort to engage in the kind of collaborative process regarding the Marina facility required by the Asset Purchase Agreement and one of the conditions of the Attorney General's consent to the sale."

The attorney general also accused Tenet of failing to provide the state with reports created as part of the planning process, as required.

URGENT CARE — Another condition requires Tenet to establish an urgent care or ambulatory care facility within two miles of the Marina site, or provide free transportation to nearby clinics and hospitals for "qualified" area residents if Tenet closes the Marina hospital's 24-hour emergency room.

Tenet has only begun the process of upgrading its 24-hour "urgent care" facility at its Centinela Medical Center on Sepulveda Boulevard near Los Angeles International Airport for basic life support to serve critical patients, according to Langness.

"We don't know when the upgrade will be completed," he said. "It depends upon approvals from the county."

The Lockyer letter states that, "One of the options must be in operation before the emergency room at Marina ceases operation."

The letter also criticizes Tenet's outreach program, stating that it will not reach patients who rely on Medi-Cal or Medicare.

Langness disputed the allegations of non-compliance, stating that the Centinela clinic already operates 24 hours a day —thereby fulfilling the requirement for a 24-hour urgent care facility — and that community meetings were held prior to the closure decision.

"We are giving the attorney general a list of the meetings that were held," he said.

The Argonaut, 7/25/2002
Daniel Freeman Marina Hospital pending closure already impacting other area hospitals

BY CINDY FRAZIER

Emergency room staff in area hospitals are bracing for an influx of patients because of the impending closure of Daniel Freeman Marina Hospital on or before Monday, August 26th.

The emergency room of one Santa Monica hospital is already feeling the impact of the pending Daniel Freeman Marina Hospital closure.

Daniel Freeman Marina Hospital was due to close Monday, July 22nd, but state attorney general Bill Lockyer last week sued to halt the closure and has now obtained an agreement from the Daniel Freeman Marina Hospital owner, Tenet Healthcare Corp., to keep the Marina area hospital open longer.

A hearing is scheduled Tuesday, August 13th, on Lockyer's attempt to obtain a preliminary injunction against the hospital closure.

But even without the pending closure of Daniel Freeman Marina Hospital, other area hospitals have been hard-pressed to keep up with demand for emergency services.

From June last year through May this year, 20,693 emergency room patients visited the Daniel Freeman Marina Hospital, hospital officials say.

That represents 1,725 emergency room visits per month — nearly 60 a day.

Of these visits, 15 percent were listed as major or extreme in terms of level of severity.

SATURATION — Saturday, July 20th, as sun-seekers swarmed the coastal areas from Santa Monica to Playa del Rey, area hospital emergency rooms reached a saturation point, says Dr. Wally Ghurabi, director of Santa Monica-UCLA Medical Center emergency center.

One by one, area emergency rooms closed to new patients brought by paramedics, until all were closed because the emergency rooms had reached capacity.

At that point, all of the emergency rooms were ordered by county health officials to reopen to ambulances, Ghurabi says.

Between ten and 15 "overflow" patients then filled Santa Monica-UCLA's emergency room and medical staff began to triage in order to treat the most serious conditions first, he says.

"First we treat the ones who are having difficulty breathing or those who are bleeding," he says.

Ghurabi says that, during the summer, the emergency rooms fill up with people as the number of coastal visitors swells.

"A lot of these people are drinking [alcohol] and there are many accidents," he says.

AREA ‘UNDER-BEDDED' — Even with the Marina area hospital still in operation, cities in the coastal area have too few hospital beds to serve those who need them, Ghurabi says.

"The closure of Marina puts a criticality on the bed situation," Ghurabi says.

"The whole Westside is under-bedded and we all fill up when we have a heavy flu season, as we did last winter."

When the Marina area hospital emergency room closes, "all the Westside ERs will be impacted," Ghurabi says.

The lack of a hospital located in the Marina area will have a negative impact on the community, he says.

"If somebody has [a cardiac] arrest in the Marina, there will be a longer travel time to an ER," he says.

"There is no question that lives will be lost if a patient in arrest has to wait four more minutes to get into a hospital," Ghurabi says.

"Critically ill people have a much better chance [at survival] with an ER nearby," he says.

MORE PATIENTS — The Santa Monica-UCLA Medical Center emergency room is already seeing four to six more ambulance patients a day who would otherwise be going to the Marina area hospital, Ghurabi says.

Ghurabi attributes this to a dwindling number of medical staff at Daniel Freeman Marina Hospital as the hospital winds down its operation.

Tenet announced the hospital's closure Wednesday, May 29th, and gave hospital staff a 90-day notice.

"Nurses are like gold and they can go anywhere," Ghurabi says. "Why would they stay at a hospital that is closing?"

Ghurabi is philosophical about the Marina area hospital closure, saying, "It is another sign of smaller hospitals having problems."

NUMBERS SERVED — While Daniel Freeman Marina Hospital, with 166 beds, is a smaller hospital, its emergency room serves about the same number of patients annually as larger hospitals in the area, according to statistics released by the Los Angeles County Emergency Medical Services (EMS) Agency.

When the Marina hospital and its emergency room close for good, patients seeking "urgent" or emergency treatment will probably seek that treatment at the three nearest remaining hospitals, Ghurabi says.

These are Santa Monica-UCLA Medical Center and St. John's Hospital and Health Center, both in Santa Monica, and Culver City's Brotman Hospital.

Each of those hospitals is 4.8 miles from the Marina area hospital, County Emergency Medical Services officials say.

But traffic considerations on Lincoln Boulevard are likely to affect decisions about where ambulances will go, Ghurabi says.

"The ambulances probably will take most of the critical patients [from the Marina area] to Brotman, rather than the Santa Monica hospitals, because it will take less time," Ghurabi says. "We will probably split the rest [of patients] evenly between us."

Daniel Freeman Marina Hospital has only eight emergency room beds — compared with 18 at Santa Monica-UCLA Medical Center — but each bed had a much higher ratio of patients seen in a year by comparison with other hospitals, according to an impact analysis from the county health services department.

Ghurabi says that his Santa Monica-UCLA emergency room treated 28,000 patients last year, mostly from the Santa Monica area.

Patients from the Zip Code 90291 area (Venice) accounted for five percent of total patients; while Zip Code 90066 (Mar Vista and Del Rey) area patients accounted for six percent; and those from the 90292 Zip Code, (Marina del Rey area), and the 90045 Zip Code (Westchester) each accounted for just one percent of patients, he says.

The Santa Monica hospital is now undergoing a major redevelopment project, and a new, expanded ER will open next year, he says.

Ghurabi says he expects 15 to 20 more emergency room patients a day at his Santa Monica-UCLA Medical Center after Daniel Freeman Marina Hospital closes its doors.

The Argonaut, 7/25/2002
County hearing on closure of Daniel Freeman Marina Hospital draws large crowd

BY CINDY FRAZIER

A public hearing on the impending closure of Daniel Freeman Marina Hospital and its emergency room drew a standing-room-only crowd of more than 200 people — including paramedics and state and local elected officials — Tuesday, July 17th.

The hearing was conducted by the 15-member Los Angeles County Emergency Medical Services (EMS) Commission and the county's Emergency Medical Services Agency at the Boys & Girls Club of Venice.

The commission listened to more than two hours of sometimes-emotional testimony from community members and Daniel Freeman Marina Hospital patients and employees, most of whom begged the panel to halt the closure.

Commissioners, however, insisted that they did not have the power to stop the hospital's owner, Tenet Healthcare Corporation, from shutting down the Marina area hospital.

The commission will prepare an impact evaluation study that will be presented to the County Board of Supervisors.

PARAMEDICS WORRIED — Paramedics from various agencies testified that, without the resources of the Marina area hospital and its emergency room, they will be strained to provide adequate emergency response.

"We expect an increase of eight percent a year" in demand on paramedic services, said Culver City Fire Capt. Mike Bowden.

"Emergency medicine will be severely impacted, with longer distances and longer waits.

"It is irresponsible to close an ER (emergency room) in a community that desperately needs it without a replacement."

A member of the Los Angeles County Fire Department told the panel that the closest hospital, Brotman in Culver City, is "12 to 15 minutes away."

The other two local hospitals, Santa Monica-UCLA Medical Center and St. John's Hospital and Health Center, are "20 minutes away," he said.

"There will be an operational impact and a cascading impact that is yet to be measured," he said.

Jeff Kovar of Loyola Marymount University (LMU) said that LMU Emergency Services provides volunteer paramedic services to the university campus and that it transported "a record number" of cases last year, many to Daniel Freeman Marina.

"Daniel Freeman [Marina] needs to be open," Kovar said.

CLOSURE SOON — Tenet purchased the financially struggling Daniel Freeman Marina Hospital and the Daniel Freeman Memorial Hospital in Inglewood in December and put the Marina area property up for sale at the end of May.

The Marina area hospital is due to close Monday, August 26th, or sooner, if medical personnel are not available.

The Inglewood hospital will remain open for five years under a purchase agreement signed with the California state attorney general.

The purchase of the Daniel Freeman hospitals was subject to the approval of the attorney general because the hospitals were formerly operated on a nonprofit basis by an order of Catholic nuns.

Tenet — a Fortune 500 company that recently posted a stock split — owns a number of other hospitals in the Los Angeles area.

Critics of Tenet accuse the company of purchasing hospitals in order to close them to keep corporate profits high.

But Tenet officials say the two Daniel Freeman hospitals had lost $55 million in recent years, with most of the losses coming from the Marina area hospital operation.

DOCTORS TO PURCHASE? — County Supervisor Yvonne Brathwaite Burke delighted the hearing audience by saying that she is trying to negotiate a possible purchase of the hospital by a doctors group.

"I will find people to purchase the hospital, but I hope you [Tenet representatives] are not pricing the property out of hospital use," Burke said.

"This [sale of the hospital] should not be a business decision, it should be a healthcare decision," the supervisor said.

Burke said she recently was playing tennis in Marina del Rey with a man who had a heart attack.

"The only reason he survived is the Marina hospital," she said. "There are many people in the area involved in strenuous activities and thousands come in every weekend, and there are boating and bicycling accidents.

"This [Marina area hospital] is a regional facility and we have to protect what we have."

‘REPREHENSIBLE' — State Senator Debra Bowen — who also lives in the immediate area — called Tenet's decision to close the hospital "reprehensible" and accused the healthcare company of breaking "promises" to work out a closure of the Marina facility with community members.

Bowen was especially concerned that another major hospital — Harbor-UCLA — is also slated for closure as county supervisors seek ways to cut county costs in the wake of county budget cuts.

"With the state budget deficit at $24 billion, which will hurt the poor more than most, now is not the time to be closing health facilities," Bowen said.

"I'm no longer shocked at greed and bad faith in energy, but I didn't expect it in the healthcare field," the state senator said.

Bowen was a key player in legislative attempts to resolve last year's energy crisis, now blamed in part on energy companies manipulating energy prices to boost profits.

"Tenet can't close the hospital or ER because they have not met the conditions," Bowen said.

HMO's BLAMED — During the hearing, Harris Koenig, Daniel Freeman Hospitals chief executive officer, said that Marina area hospital is not financially viable because 80 percent of its primary patient base goes elsewhere for medical services.

Koenig also blamed the hospital's financial problems on health maintenance organizations (HMOs), which he said do not pay enough to keep the hospital solvent.

"Marina has 166 beds but very few patients because the population of the Marina is not a significant user of the hospital's services," Koenig said.

He said the Daniel Freeman Marina Hospital facility is 32 years old and would require significant upgrading to bring the facility in compliance with new, stringent seismic standards for hospitals and to compete with newer hospitals.

Koenig also defended Tenet's actions in deciding to close down the hospital, saying that the announcement Wednesday, May 29th, that the hospital would close Monday, August 26th, was in keeping with a 90-day advance notice requirement.

Koenig said that his firm is complying with requirements for a transportation program for Marina-area patients, and is assisting the Venice Family Clinic in determining "how to meet the increased patient load" resulting from the Marina hospital closure.

HOSPITAL ‘THREATENED' — But Tim Riley, executive director of the Marina del Rey Lessees Association — an organization of lessees of the county-owned Marina — accused Tenet of reneging on a promise to keep the hospital open.

"A year ago, Tenet was eager to meet with the community to discuss plans to purchase the hospital and said the hospital was threatened if it was not purchased by Tenet," Riley claimed.

"We supported the purchase on the condition that it would remain a health care facility.

"Representations were made and not followed. You [commissioners] need to put pressure on Tenet to keep the hospital open."

Following the hearing, commissioners adjourned the meeting without comment.

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