County: No harm in delay of ER work

Santa Rosa Memorial Hospital's decision to postpone a $68 million expansion of its emergency room and intensive care unit won't have an immediate effect on the delivery of medical services in Sonoma County, healthcare officials said Thursday.

Enough capacity exists at Memorial and a half-dozen other hospitals, where total emergency room visits dropped 6 percent and trips to intensive care declined 2 percent from 2006 to 2007, according to statistics from the Office of Statewide Health Care Planning.

"The current number of beds appears to be adequate," said Mary Maddux-Gonzalez, the county's public health officer. "We are in the process of looking at projections over time. In general, as the population and the age of population increases, the need for beds tends to increase."

Memorial announced Wednesday it would suspend work to double the size of its emergency room and add a dozen beds to the ICU, citing the poor economy.

Destabilization in the credit markets, reduction in Medi-Cal reimbursements and difficulty raising $10 million in donations during tough economic times all prompted the decision, the hospital said.

Memorial CEO Kevin Klockenga said the project would be re-evaluated in a year, when officials have "a better picture of where the economy will end up."

It's the second major construction project to be postponed by the hospital this year. In April, the hospital halted plans to expand its parking garage and canceled plans for a new urgent care center after rival Sutter Medical Center decided not to close its Chanate Road hospital.

Memorial had been negotiating to take over Sutter's patient load, but the Sonoma County Board of Supervisors refused to sign off on the deal, forcing Sutter to remain open despite steep losses. Sutter operates the Santa Rosa hospital under a contract with the county that guarantees medical care for indigents and other forms of public health service.

Dr. Gary Greensweig, Memorial's chief medical officer, said Thursday that postponing the emergency room and intensive care expansions had nothing to do with Sutter.

Greensweig said the decline in emergency room visits was caused in part by encouraging patients with less serious conditions to go to urgent care clinics. As a result, visits to Memorial's urgent care facilities are up, he said.

Another reason for the shift is that people are realizing how much more expensive it is to be treated in an emergency room than almost any place else, he said.

"What we said to people is, 'If you've got a little earache, probably the ER is the not the best place for you,' " Greensweig said.

Dr. Ralph DiLisio, director of intensive care at Memorial, attributed the decline of activity in his unit to Kaiser Permanente's increased market share and procedural changes that send patients to other hospitals.

DiLisio said halting the expansion will have no effect on patient treatment.

"We're going to be fine," DiLisio said. "We have more than enough ICU beds."

Currently, there are 83 emergency room treatment bays spread among seven hospitals, and 76 intensive care beds among six hospitals, according to a report county officials received from the state.

There were 123,557 emergency room visits in 2007, down from 131,905 visits the year before, the report said.

Six intensive care units together logged 15,867 patient days in 2007, down from 16,150 in 2006, according to the report.

The sharpest declines were at two hospitals owned by St. Joseph's Healthcare System -- Petaluma Valley Hospital and Memorial -- although Kaiser and Sutter both saw a drop.

Meanwhile, health care officials said they were not surprised by Memorial's decision given the global financial crisis, exacerbated by new billing requirements.

Lisa Amador, a spokeswoman for Sutter in Santa Rosa, said her hospital will lose $10 million in 2009 because of reduced Medi-Cal reimbursements.

The hospital has offset the loss with layoffs and by reducing other operational expenses, Amador said.

"Basically, the current financial crisis worldwide will adversely effect all categories of business," Amador said. "Health care will not be able to escape that."

You can reach Staff Writer Paul Payne at 762-7297 or paul.payne@pressdemocrat.com.