S.D. General Seeks ‘Standby’ Emergency Room Status

San Diego General Hospital has asked the state to downgrade its emergency room to “standby” status, in hopes of stemming a flood of red ink and keeping the facility alive until it can be converted to a nonprofit facility.

The move would relieve San Diego General, formerly called Physicians & Surgeons, of the day-to-day burden of caring for the approximately 350 patients who arrive by ambulance each month.

Like most of the other 1,150 patients seen in the emergency room every month, these patients are poor. They often have no insurance at all, or are covered by public programs such as Medi-Cal, which do not reimburse fully for care.

The proposed change comes several months after the expiration of an agreement the city of San Diego imposed before approving the sale of the hospital in May, 1989. This required the new owners to keep the emergency room open under full status for a year after the purchase.

If San Diego General goes on standby status, ambulances would take patients to other nearby hospitals instead, including Paradise Valley, Mercy and UC San Diego Medical Center. In some cases, the hospital would also seek to transfer severely ill patients who did not arrive in ambulances, said James Zanca, associate administrator of the hospital.

Such transfers require the permission of the receiving hospital, however.

Also, the change cannot occur without state approval, which would come within the next 60 days.

Zanca said it is possible that within that time the hospital will find a way to avoid the downgrading. If it does occur, he added, hospital officials are hoping it could revert to full-service status within 90 days after the downgrading.

But the state also will consult with officials of other San Diego hospitals, the county Department of Health Services and medical societies before approving the change.

The change in the emergency room’s status is the first time in the Southeast San Diego hospital’s rocky history that the emergency room has been downgraded.

It also is the same tactic taken by Harbor View Medical Center in 1983, when it faced similar financial troubles. That emergency room remains a “standby” facility, and the hospital appears to have succeeded in rescuing itself from closure.

A group of investors from the Riverside County community of Perris bought Physicians & Surgeons in 1989 from National Medical Enterprises, one of the largest health-care firms in the nation. Principals in the for-profit firm are Benjamin F. Davis Jr. of Coronado and John Motte of Riverside County.

Because of continuing financial difficulties at the hospital, a consultant hired in the summer is working to turn the hospital into a nonprofit concern.

It is hoped that can be done by January, Zanca said.