With the Fallbrook Hospital facing a loss of $6 million that is growing at a clip of $500,000 a month, the directors of Fallbrook Healthcare District voted on Wednesday, October 8, to pull the plug on its emergency room and completely change the way it does business.
The five directors voted to cast the struggling hospital’s fate with Oceanside’s Tri-City Medical Center and Escondido’s Palomar Health hospital districts. Fallbrook Healthcare District will soon join a joint-powers-agreement type of governing body with those two districts, which are each located some 30 miles away. Specifics are to be worked out.
“We have $9 million reserves and if we continue at this rate we will completely deplete our resources at hand,” said board of directors president Stephen Abbott at the October 6 meeting attended by some 80 citizens. The directors are negotiating the termination of a 30-year agreement with Tennessee-based Community Health Systems, which has run the hospital for the past 16 years.
The Fallbrook ER will morph into an urgent-care-type facility. Serious heart attack and trauma care patients from Fallbrook and Bonsall will need to be rushed to Temecula, Escondido, or Oceanside after November 17.
Insiders say it has been at least ten years since a hospital emergency room flat-lined, coinciding with the closures of Mission Bay and El Cajon Valley hospitals.
The ailing Fallbrook Hospital started turning away pregnant moms last month when its obstetrics unit stopped taking patients. And the hospital has seen the exodus of two eye doctors and two gastro-intestinal specialists who were based in Fallbrook but who no longer choose to perform operations at the hospital.
The 47-bed, two-story, 52-year-old hospital has suffered from a decrease in ER use as well as in many other departments. The biggest challenge facing Fallbrook Hospital, admits president Abbott, is that stand-alone hospitals can't survive without affiliating with a larger health-care network like UCSD, Scripps, or Sharp. But is the Tri City/Palomar affiliation merely a rearrangment of the Titanic’s deck chairs?
San Diego–based Nathan Kaufman consults over 80 hospital districts nationwide on how to adapt to the realities of modern medicine. He has been publicly urging Tri-City for years that it absolutely needs to affiliate with a larger provider or it could face realities like a fire-sale of assets or bankruptcy.
“Tri-City has been teetering on financial difficulty for years,” says Kaufman. “Like many public districts that are funded by taxes, they have well-meaning people who have been elected to run them. But that doesn’t mean those who are elected have the competencies to figure out how to make that district survive.”
Kaufman points out that since Grossmont Hospital in La Mesa became Sharp Grossmont Hospital, that operation has “...turned things around. The board that ran Grossmont realized that if they went along with business as usual, they wouldn’t survive. There is no plausible way Tri-City can survive as a stand-alone.”
Scripps, which already is attracting patients from Tri-City's core Oceanside/Carlsbad/Vista service area to its hospitals in Encinitas and La Jolla, is currently building a three-story outpatient clinic in Oceanside at Hwy 78, two miles west of Tri-City, which Kaufman says will put an even greater burden on Tri-City to maintain solvency.
When Fallbrook Hospital director Gordon Tinker was asked in a public meeting if he was aware that Tri-City could also face the same problems of solvency, he responded, “That’s what our consultant told us.” (Fallbrook hired a different consultant besides Kaufman.)
The Fallbrook Hospital District only received one other offer to run the hospital, from Riverside-based for-profit Strategic Global Management, which runs hospitals in Hemet and Victorville. But the directors said that offer left all the financial risks with the district and hence voted to go with the Tri-City/Palomar arrangement.
One item not brought up at Wednesday’s meeting: the entire second floor of the Fallbrook Hospital building can't be utilized by patients because it doesn’t have an elevator, which all California hospitals must have by law. It is currently used for storage.