Judge Tentatively Blocks Closure of Rancho Hospital

A federal judge issued a tentative decision Friday to block Los Angeles County’s planned closure of Rancho Los Amigos National Rehabilitation Center, an order that could upend the county’s plans to restructure its ailing health system.

U.S. District Judge Florence-Marie Cooper concluded that closing Rancho, a renowned Downey hospital that treats severe brain and spinal injuries, would violate federal law by depriving disabled patients of necessary medical care. In a strongly worded ruling, the judge signaled her intent to stop the shutdown until the county can prove that Medi-Cal patients will receive comparable and timely care elsewhere.

“It is abundantly clear to the court that the harm to the plaintiffs if Rancho closes far outweighs the harm to the county if it remains open,” Cooper wrote.

Cooper issued her tentative ruling in a lawsuit filed against the county by patient advocates. Both sides will be in court Monday for a hearing, during which the burden will be on the county to change the judge’s mind. If the county fails, Cooper is expected to issue a preliminary injunction halting the planned June 30 closure.

The ruling touched off a celebration for Rancho’s patients and staff, some of whom had camped out on the lawn to protest the hospital’s closure. As the news spread through the sprawling complex, health-care workers embraced one another in the halls.

“Word is spreading like wildfire. People are elated,” said Dr. Irene Gilgoff, head of the pediatrics department. “Then they stop and ask, what does it mean? Is it another stay of execution and we’re going to be closing down later anyway?”

For county leaders who voted to close Rancho as part of a plan to pull the health system from the brink of bankruptcy, the tentative ruling was a surprising disappointment. They said that if the decision stands they will be forced to make new cuts at overcrowded hospitals and clinics throughout the county.

County attorneys and Supervisor Zev Yaroslavsky insisted Friday that the judge had misinterpreted key elements of the case.

One example, they said, was Cooper’s contention that the county secured a $900-million Medicaid waiver earlier this year, when it occurred in 2000. Much of that money has been spent.

“We believe the judge has seriously misunderstood and misconstrued both the facts and the law,” said Donovan Main, the county’s chief deputy counsel. “Her characterization is totally, totally wrong. She misunderstood. We hope on Monday to clarify that to the judge.”

The county Board of Supervisors voted in January to close Rancho over the objections of hundreds of health-care workers and patients, many of whom showed up in wheelchairs to plead their case.

Lawmakers defended the closure, which is expected to save about $59 million annually, as being necessary to help close a projected $709-million budget gap over the next three years.

The county also moved to eliminate 100 beds at the sorely overcrowded County-USC Medical Center in Los Angeles and to convert High Desert Hospital in Lancaster to an outpatient center.

In March, a coalition of disability rights advocates filed a suit seeking to block Rancho’s closure. They argued that closing the hospital would violate the federal Americans With Disabilities Act because hundreds of disabled patients, including people with cerebral palsy, quadriplegia, muscular dystrophy and other disabling conditions, would have nowhere else to turn for medical treatment.

The plaintiffs later asked the court to issue a preliminary injunction, halting closure plans until the case could be tried.

The judge found Friday that the plaintiffs had substantial probability of prevailing at trial. “Public interest clearly favors the granting of the injunction,” she wrote. “The court will issue the preliminary injunction.”

At the law offices of Protection & Advocacy, one of the public interest firms representing the disabled patients, attorneys started jumping up and down the moment the 10-page ruling rolled off their fax machine.

“The county can’t willy-nilly decide that they want to close it. They have obligations to meet,” said attorney Maria Abdo.

The hospital serves more than 9,500 patients per year. Roughly half of them are covered by Medi-Cal, California’s version of Medicaid, the federal program that funds medical care for the poor.

If Rancho closes, the judge concluded, these patients “will not be able to obtain adequate substitute care at surviving hospitals or other settings.”