MemorialCare CEO says hospital closure is unavoidable but that residents and leaders are misunderstanding actual consequences

Five days after nurses and community leaders hosted a press conference to speak out against MemorialCare’s handling of the closing of Community Hospital, John Bishop, chief executive officer of MemorialCare Long Beach Medical Center, MemorialCare Miller Children’s & Women’s Hospital Long Beach and MemorialCare Community Medical Center Long Beach, told the Signal Tribune that there is much misunderstanding within the community as to the implications of the impending closure.
MemorialCare has included Community among its hospitals for seven years, but, last December, the healthcare system announced that the site would have to close because it sits on an active fault line. Local leaders and healthcare workers have since rallied and formed a task force to explore ways to keep the hospital open.
However, on Friday, March 16, Community Hospital staff and elected officials used a press conference outside the facility to “demand Memorial Health System stop artificial moves, including the design to fast-forward an immediate emergency-room diversion, to hasten its unwarranted decision to close” the hospital, according to a press release from the California Nurses Association and National Nurses United announcing the event.
Long Beach Mayor Robert Garcia was among the leaders at the press conference, and he emphasized the numbers of residents who rely on the hospital located in the 4th council district, just west of the traffic circle.
“Thousands of patients come to this hospital for important service and the best level of care,” Garcia said. “And to keep this hospital open, to keep this emergency room open, is incredibly important to us here in Long Beach, and we stand with all of you today in this effort.”
Seventieth District Assemblymember Patrick O’Donnell, who once represented the 4th District on the city council, also attended the press conference and called the closure of the hospital “a win for Memorial, but a loss for Long Beach and the greater community.”
“The closure of this hospital puts lives in threat,” O’Donnell said. “We need an emergency room on the east side of Long Beach. MemorialCare, keep this hospital open, keep this emergency room open.”
After thanking the hospital’s nurses and doctors for their work, the assemblymember was critical of MemorialCare’s timing.
“I get that this is a business decision, but the fact of the matter is— the mayor alluded to it— MemorialCare should have given us more notice,” O’Donnell said.
In a phone interview Wednesday, however, Bishop said the move to close Community has nothing to do with business and everything to do with following the law.
“I know Pat has come out and said that he thinks that we are doing this in a manner that’s designed to effectively eliminate a competitor, but nothing could be farther from the truth,” Bishop said. “If we wanted to eliminate a competitor, we would have allowed the hospital to close back in 2011. This is simply and purely about the ability to comply with seismic law, and we do not think that the services— particularly the behavioral-health services— going away is a good thing at all. It’s very unfortunate that we’re in this position where neither we nor any other acute-care provider can continue to run it as an acute-care facility. So, we will be doing our best to mitigate the impact. We are expanding our emergency department, as is St. Mary’s and College, and we will be continuing to try to collaborate with the City to find a way to take care of the members of our community. The notion that we are stepping away and intentionally imperiling the health of our community is just absolutely not true.”
One of the concerns expressed by residents is that not having an ER at Community will mean longer ambulance drives to hospitals on the west side of the city. However, Bishop explained that Community Hospital currently does not treat trauma patients and has not done so since MemorialCare acquired the hospital.
“They’re not a stroke-receiving center. They’re also not a cardiac-receiving center, so, most acute patients have, since we acquired Community back in 2011, gone to St. Mary’s in Long Beach,” Bishop said. “So, there is no change there. So, the notion that there is going to be a significant impact on the ability to serve the community because they’re going to have to drive three miles farther is simply not accurate.”
He added that Community does not have obstetric services, so mothers in labor are not taken there, nor does the hospital receive patients who have been in car accidents or are victims of gunshot wounds, or stroke patients, since Long Beach Memorial is the stroke-receiving center in the area.
“If you are having a cardiac event that requires intervention, whether it’s a bypass or a stint, you cannot go to Community,” he said. “The only cardiac services Community has are what are called medical cardiology, whether it’s something that can be managed by a medical process and not an interventional one. So, [patients needing] the more acute services— for stroke, trauma, cardiac and all pediatrics and obstetrics— already do not go there and have not gone there since 2011.”
When asked for his reaction to O’Donnell’s calling the closure a “business decision” on MemorialCare’s part, Bishop said such a move would have been unwise from a business and public-relations standpoint.
“When we first became aware of the severity of the seismic concerns, I met with many of the elected officials, including Patrick O’Donnell, to tell them that, at a minimum, it was going to have a different footprint,” Bishop said. “And it was only after we got the second independent seismic study— and that was [the Office of Statewide Health Planning and Development] and their conclusion that there was no way to have an acute-care facility there— that we then proceeded to make the announcement. But the City knew back in 2011 that there was a fault there. We have been very transparent throughout the process that the facility was going to need to look different because it was on a fault, and we wanted to do our due diligence to make sure that we exhausted all options to continue as acute-care. There is nothing about this that is a business decision. It would be a terrible business decision, a terrible public-relations decision. There’s nothing about this that actually is a decision, unless you consider whether we comply with seismic law to be a decision, and I don’t. We are going to follow the law.”
Information that MemorialCare provided Wednesday evening indicated that an independent study looked at local emergency departments and determined that Community’s emergency-room visits represent only about 10 percent of total ER visits in the area.
“Over half the area’s ER visits are considered low acuity, and these patients can be seen in other settings such as at more than two dozen urgent-care centers and federally qualified health centers located in Long Beach,” according to an email from Richele Steele, a spokesperson for MemorialCare. “The study also revealed an excess of 800 licensed hospital beds in the area each day and low occupancy among hospitals. The study found that Community Medical Center’s service area has seven acute care hospitals within a short travel distance, all with large numbers of available patient care beds and excess capacity. It showed a low combined occupancy rate of only 56 percent of licensed inpatient beds. This means, on average, area hospitals have about 800 licensed hospital beds vacant and available for additional patients each day.”
The information Steele provided also indicated that the study found it likely that the need for acute-care inpatient hospital beds will decrease even more because of an industry-wide shift from inpatient settings to outpatient care settings, continued reduction in the average length of hospital stays and increasing population health initiatives that are meant to improve the overall management of individual patients.
“Therefore, the conclusion is that nearby area hospitals could absorb the number of acute-care hospital patients currently served by Community Medical Center,” Steele’s email concluded.
Despite those figures, Bishop said MemorialCare is creating an additional nine emergency-department observation beds, which are expected to be ready by late 2019.
“We’re also increasing the size of what we call an observation unit on one of our patient floors, so what it effectively does is it takes patients that would otherwise be in the emergency department for an extended period of time and moves them up to a patient floor, thereby creating more capacity in the emergency department,” Bishop said. “We have already done that. We’re also creating a prioritization process to get patients that are brought in by the Long Beach Fire Department and EMS prioritized patient placement so they can get the paramedics back out in the field more quickly, and we are also going to be performing community education around the appropriateness of an emergency-department visit versus urgent care, because half of our current emergency-department visits could go to an urgent care.”
Bishop said the car accident that occurred in the traffic circle just hours after the press conference at Community is a perfect example of the misunderstanding that exists.
“That was a traffic accident that never would have and never will go to Community,” he explained. “That is a trauma case that would go to Long Beach [Memorial] or St. Mary’s. There is zero impact to the potential closure of Community Hospital related to that traffic accident. People assumed that they would go to Community. Never have and never will.”
Nevertheless, Bishop expressed disappointment in losing the site.
“We’re also very saddened by the fact that Community cannot meet seismic laws,” he said, “and we will continue to work with the City and the other stakeholders— and not only find the best path forward and the highest and best use for that facility— but to continue to educate folks to understand that this was not a decision, but it is effectively the fact pattern that is before us— that we all need to make the collective best decision as to how to move forward.”
When asked if, at this time, there is any chance that Community Hospital could remain open, Bishop was straightforward and clear in his response.
“No,” he said. “There is no chance.”