Hospital prepares to close emergency room - Urgent care to move in

Administrators of Fallbrook Hospital (Community Health Systems) held a public hearing Oct. 14 at Fallbrook Public Utility District to talk to community members about plans for emergency services, based on the fact that the Tennessee-based corporation gave notice to terminate their lease effective Nov. 17. The meeting was an opportunity for the Emergency Medical Services (EMS) for the County of San Diego, Health and Human Services Agency to collect public comment for an impact study.

Though the decision to end services is supposedly not final, the Fallbrook Healthcare District has looked for options that would continue to provide healthcare services to the community.

According to Steve Abbott, president of the Fallbrook Healthcare District, the decision has been “nothing short of agonizing.”

Fallbrook Healthcare District received only two proposals, one of which included turning the hospital campus into an expanded clinic.

“The other proposal was never really an option because it put all the risk and cost completely on the district,” said Abbott. “It would have made us bankrupt in less than a year.”

Abbott stated that Tri-City Medical Center and Palomar Health offered a proposal that would turn the current emergency center into a 24-hour urgent care center for a term of six months. The two medical centers would enter a Joint Powers Agreement in order to provide the services.

“During that period, they would assess what care is provided during what period of the day,” said Abbott.

As a division chief for North County Fire Protection District, Abbott also stated that emergency responders have discussed how and where to transport individuals in need of emergency service.

“A benefit is that every fire engine and ambulance have a paramedic on board, and we have advanced capabilities available on board,” said Abbott. “We will get the right person to the right place fast. If someone has a stroke, we will take them to a stroke center, and if someone has a heart attack or trauma, we will get them to a trauma center, located at Palomar or Tri-City.”

Marcy Metz, EMS director for San Diego County stated that trauma care is not currently provided at Fallbrook Hospital.

“If patients have a cardiac arrest or stroke, they can be taken by EMS to Fallbrook for stabilization but then are transported [elsewhere],” said Metz.

Abbott also said that North County Fire can transfer patients to hospitals within a 30-mile radius – including Temecula area hospitals – depending on circumstances, including personal patient preference.

“Not to take anything away from the work done at the Fallbrook emergency room, but people have adjusted to the change in insurance and patient preference,” said Abbott. “It’s imperative that patients understand their healthcare plan so they know who bears the cost for a call for service.”

Fallbrook Hospital CEO Kapua Conley stated that Fallbrook’s current emergency room could not be freestanding without a hospital setting because of current Title II legislation, and that the current Fallbrook hospital building would be out of seismic compliance in 2030. Bringing the current hospital up to compliance would cost more than building a new hospital, which is estimated around $100 million.

A new hospital facility would not be feasible for the amount of patients seen at the current building, he said.

“In the last three to four years, emergency room visits have been on the upswing, but most visits have been for mostly lumps and bumps,” said Conley. “We lose 40 cents on the dollar on Medicare patients. If the district can create the right infrastructure, they can give more accessibility to the community.”

“It hurts to see a hospital go after 50 years,” said Conley. “The hospital used to be the hub, but with different physicians groups and facilities, we need to approach <a plan for the hospital> with a more comprehensive strategy,” said Conley.

Conley stated he would be meeting with administrators from both Palomar Health and Tri-City Medical Center to help formalize a strategy for urgent care implementation at the current Fallbrook Hospital location.

“We will try to find a way to move in the direction that will work best for Fallbrook in the long term,” he said.