Hospitals

Hospitals across California and the country are reeling from the effects of the economic downturn and the troubled financial markets. Patients are putting off medical care because of job losses, job insecurity and high out-of-pocket expenses. As a result, the number of paying patients and profitable elective procedures is down. At the same time, the number of uninsured patients whom hospitals treat is rising. Like just about everybody else, hospitals are losing money on their investments.

More than three years into L.A.'s crackdown on patient dumping downtown, officials have reached settlements with four hospitals and collected millions in payments. But although enforcement has been aggressive, much less has been done to address the problem at the heart of the issue: If patients can't be left on skid row, where should they go?

Winding up in the emergency room is bad enough. But the California Supreme Court ruled Thursday that patients no longer have to worry about getting billed for emergency treatment charges that their HMOs fail to pay. Health maintenance organizations and patient advocates hailed the decision as an important protection against gouging by hospitals and physicians. But doctors said it would encourage greedy HMOs to underpay them and that that could put emergency rooms in jeopardy.

Frustrated emergency room doctors filed a class-action lawsuit against the state Tuesday, saying that California's overstretched emergency healthcare system -- which ranks last in the country for emergency care access -- is on the verge of collapse unless more funding is provided. Across the state, scores of hospitals and emergency rooms have shut their doors in the last decade, leading to long waits, diverted ambulances and, in the most extreme cases, patient deaths.

The Motion Picture & Television Fund -- a charity started by Charlie Chaplin, Mary Pickford and other Hollywood luminaries to care for entertainers who fell on hard times -- said Wednesday that it was closing a hospital and nursing home by year's end. With more than 500 hospital admissions last year and about 100 long-term residents, the Woodland Hills facilities have been a $10-million annual drain on the fund's budget for the last four years.

It was Easter weekend when people in Oaxaca noticed strange happenings at the state-run Dr. Aurelio Valdivieso General Hospital. Sections were suddenly off-limits. Security guards were added. The cop reporter at the local newspaper, El Diario Despertar, got a tip from a source at the hospital. Not above dressing its journalists up as paramedics, the paper sent two people to investigate. They quickly realized that the hospital was seized by alarm.

On Long Island, N.Y., hospitals are scrambling to bring extra workers in to handle a 50% surge in visitors to emergency rooms. In Galveston, Texas, the local hospital ran out of flu testing kits after being overwhelmed with patients worried about having contracted swine flu. At Loma Linda University Medical Center near San Bernardino, emergency room workers have set up a tent in the parking lot to handle a crush of similar patients.

Federal regulators investigating serious failings in UC Irvine Medical Center's anesthesiology department threatened to cut off Medicare funding after identifying dozens of new problems within the hospital. In a 127-page report, regulators described repeated examples of poor oversight and inadequate systems to protect patients. In one case, a psychiatric patient urinated on a pile of bed linens because the audio equipment used to monitor seclusion rooms was not working, according to the report.

Eleven California hospitals were fined $25,000 each in administrative penalties Thursday for violations that, in some cases, led to death or serious injury, according to Department of Public Health officials. Most of the hospitals fined were in Southern California, and about half were cited because doctors or hospital staff had left foreign objects in patients after surgery. Coast Plaza Doctors Hospital in Norwalk and Los Angeles County-USC Medical Center were fined for failing to follow proper surgical procedures.

The California Department of Public Health on Wednesday issued $25,000 penalties against 13 hospitals -- including seven in Los Angeles and Orange counties -- for serious violations that, in some cases, led to patient deaths. Each violation comes with a $25,000 fine, part of an ongoing effort to hold hospitals more accountable for placing patients at risk of death or serious injury.