Blog Post

What happens when a hospital closes

April 23, 2015

    Juliette Mullin, senior editor

    On Tuesday, "Amazing Grace" played in the halls of Doctors Medical Center (DMC) as its staff members hugged and talked about the 60-year-old hospital's closure and the end of an era for the city of San Pablo, California, which will now go without a hospital or access to timely emergency care.

    But the moment came as no surprise. In fact, the closure was the culmination of years of efforts to keep the facility open, and then months of work to shut it down.

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    Fighting to stay open

    DMC is the only public hospital serving 250,000 residents between Berkeley and Vallejo.

    According to John Gioia, a member of the Contra Costa County Board of Supervisors, the hospital's payer mix was 88% Medicare and Medicaid patients, and the reimbursement levels for those patients just weren't high enough to cover the services provided. As a result, the hospital had been losing $18 million per year.

    Over the years, DMC managed to stay open through ownership changes, short-term cash infusions, and community support.

    In 1997, Tenet Healthcare took over the struggling hospital. But it decided not to renew its lease in 2004, and the West Contra Costa Healthcare District regained control of the facility.

    In 2006, DMC filed for bankruptcy and closed its inpatient burn unit.

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    After that, taxpayers approved two tax measures to support the hospital. And from 2008 to 2010, Kaiser Permanente, Alta Bates Summit Medical Center, and John Muir Heath System contributed a combined $17 million to help DMC stay afloat.

    But in the spring, the community voted against a third tax measure to sustain DMC. Meanwhile, funding appeals to foundations and companies like Chevron and Republic Services did not succeed. According to the San Francisco Chronicle's Victoria Colliver, "the hospital's fate was all but sealed."

    In March, after months of scaling back, the board of the hospital decided that closing the hospital this week was the only option.

    "This is a very sad day and a huge loss for our community and for all of us who have worked so hard to keep our community hospital open for all our residents in time of need," board chair Eric Zell said in a statement. "We have exhaustively pursued every alternative over the past weeks, months, and years. Unfortunately, we have completely run out of viable and responsible options."

    Shutting down operations

    Staff at the hospital have been shutting down operations one department at a time over the past couple weeks. The hospital had already stopped accepting patients who needed ongoing care, and it transferred patients who needed to be hospitalized to other facilities.

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    On Tuesday, the ED—which began diverting ambulances in August, but continued to see 75 to 100 walk-in patients per day—shut down, effectively ending all patient care at the hospital.

    Some departments, such as those managing medical records, will remain open for a few additional weeks. According to the Chronicle, the hospital has been managing requests from patients who need copies of their birth and medical records before the facility closes.

    To help meet community health needs, Lifelong Medical Care on Monday began offering urgent care services at its Brookside Health Center in San Pablo, located across the street from the DMC building. Even so, the now-former staff of DMC worry about where their patients will receive the care they need.

    "It's a real tragedy. Patients here have nowhere to go," Eileen Scott, the clinical director of oncology services for DMC, told KTVU. "People who have insurance can go anywhere, but for those who don't, where are they going to go?"

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