What to do with Edgemoor Geriatric Hospital is one of those issues that pits an undeniable need against an unavoidable shortage of money.
Everyone involved agrees that the 323-bed county hospital's physical plant, parts of which are 50 years old, needs major improvement if Edgemoor is to continue to operate. One estimate puts the cost of those improvements at $4 million. Additional staff also is needed.
The Board of Supervisors has begun a comprehensive review of the hospital and whether the county should continue to operate it. Edgemoor serves patients--not all of them elderly--who suffer from the most severe physical and mental impairments, and it is the only county-owned hospital of its type in California.
The current examination was triggered in part by two incidents that led to large fines being imposed by the state Department of Health Services. In December, a paralyzed woman drowned in a bathtub while unattended, and the next month a legless man fell out of his bed and later died of a heart attack.
But even if those regrettable accidents had not occurred, the day of reckoning for Edgemoor could not have been postponed long. County officials believe the state will eventually require the upgrading of the facility as a condition of continued operation.
It might seem that, given that the county is not required to keep Edgemoor open, a rational decision would be to close it, and the supervisors seem open to that possibility. But finding other satisfactory beds for the 310 patients normally at Edgemoor would be difficult.
Some came to the Santee facility from state mental hospitals and could return there, although it would mean being further away from families. Others need "skilled nursing beds," and there are not enough of those in the county to absorb Edgemoor's patients.
As the board begins to decide what Edgemoor's fate will be, supervisors will have to be most cognizant not only of the financial considerations and the future needs of Edgemoor patients, but also of their responsibility to operate an efficient, safe facility as long as it remains open.