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Study Finds High Quake Risk for Hospitals

Disaster: More than a third of such buildings in the state could collapse in a strong temblor, report says. Industry sees need for huge infusion of public money.


More than a third of California's hospital buildings--and more than half of Los Angeles County's--are vulnerable to collapse in a strong earthquake, according to a new state study.

The report, released Wednesday, also found that one out of three hospital buildings in Orange and Ventura counties poses "a significant risk of collapse and a danger to the public after a strong earthquake."

The ratio is even worse in San Francisco, where, as Assemblywoman Dion Aroner (D-Berkeley) put it, two out of three hospital buildings would "just go kaboom."

The state officials who issued the report said a strong earthquake generally has a magnitude of 6.0 to 6.9. But the authors, from the Office for Statewide Health Planning and Development, noted that many other factors, such as the depth of a quake, proximity to the epicenter and whether a hospital building rests on bedrock or fill will determine if it remains standing.

By hospital industry estimates, it will cost $12 billion to make initial repairs at a time when two-thirds of the state's hospitals are losing money on patient care.

Industry officials say that without a huge infusion of public funds, many facilities will not meet seismic safety deadlines set by state law after the 1994 Northridge earthquake and that some will have to close.

A few already have, citing the earthquake safety tab as at least part of the reason.

"The bottom line for L.A. is that over half of the buildings on hospital grounds will have to be completely replaced or significantly retrofitted to meet . . . standards" due to take effect in 2008, said Jim Lott, executive vice president of the Healthcare Assn. of Southern California.

"The price tag for L.A. is conservatively $7 billion to $8 billion," he said. "That is more than the assessed value of all hospital property in Los Angeles."

The magnitude of the problem has emboldened the industry to ask for help. The California Healthcare Assn., the statewide hospital trade group, is calling for issuance of $4 billion to $5 billion in general obligation bonds to help hospitals meet the 2008 deadline.

Another deadline, with even tougher standards, looms in the more distant future. The hospital industry estimates that the cost of complying with standards set for 2030 is $24 billion.

State officials and legislators, however, say they are not yet certain of the costs and will know more when hospitals submit their detailed construction plans beginning next year. Rand Corp., a Santa Monica think tank, is also attempting an independent cost assessment.

Industry spokesmen consider a bond measure a "public-private partnership" rather than a bailout.

Assemblywoman Aroner is urging flexibility, suggesting, among other possibilities, that the Legislature could allow hospitals to skip the 2008 retrofitting deadline if they are willing to rebuild in time to meet the 2030 rules.

The 2008 standards require that hospitals be able to remain standing in a strong quake. The 2030 standards require hospitals be capable of maintaining all of their services.

So many hospital buildings are in bad seismic shape because they date from a construction boom between the 1950s and 1970s, when there were no special seismic safety standards. The boom was a response to new government programs such as Medicare and Medi-Cal that paid for patient care.

The same construction standards that applied to city halls or any other public buildings applied to hospitals, said Roger Richter, the California Healthcare Assn.'s expert on earthquake issues.

Then came the 1971 Sylmar earthquake, in which two hospitals collapsed and 58 people died.

The Legislature reacted in 1973 by passing special seismic standards for hospitals.

It toughened standards again in 1994 after the Northridge quake caused 23 hospitals to suspend at least some services and three to close. And, as a first step, the state commissioned the hospitals to assess their own seismic safety. The report released Wednesday chronicles the hospitals' self-assessments.

"The really important point here is that, until today, California did not have any awareness at all of the seismic integrity of its hospital infrastructure," said Dr. David Carlisle, director of the Office for Statewide Health Planning and Development.

Reports from the hospitals on their estimated costs won't be available until 2002, he said.

Hospitals around the state have begun trying to decide what to do.

At St. Rose Hospital in Hayward, President and Chief Executive Michael Mahoney said Wednesday that two of its four buildings are listed as in danger of collapse.

"We're looking at a retrofit cost of $44 million," he said. "How do we fund that, given that we've got an operating loss? It's hard to borrow money if you're already operating in the red."

He suggested that it might be more cost-effective in the long run to just build a new hospital.

Lori Aldrette, a vice president of the nonprofit chain Catholic Healthcare West, which operates 43 hospitals in California, estimated that it will cost more than half a billion dollars to retrofit her organization's buildings to comply with the 2008 standards and hundreds of millions more to meet the 2030 requirements.

She said the firm is in the red but is "restructuring."

It has already closed its Long Beach Community Hospital, which had been losing significant sums of money.

"When we anticipated the costs that would be required to comply [with the tougher seismic codes], it didn't make sense for us to keep it open," Aldrette said.

The state study, listing results from 426 hospitals around the state, is posted on the Internet at http://

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