Santa Clara County wants state to stop trauma center closure

Santa Clara County leaders are calling on state officials to stop a for-profit hospital from closing one of the county’s only trauma centers.

The Board of Supervisors voted unanimously on Tuesday to send a report to the state on the impact of closing Regional Medical Center’s trauma center in East San Jose. County hospitals have just under four months to prepare for the shockwave of changes, which become effective Aug. 12. The public hospital system is already running at capacity and being forced to transfer patients to other hospitals — largely because of service reductions that have already occurred at Regional.

The closure, decided by owner HCA Healthcare, will most affect East San Jose’s vulnerable residents who are uninsured or on Medi-Cal. Though officials this week said the impact will be felt across the county.

The California Department of Public Health has the authority to stop HCA’s decision if it determines action is warranted to avoid public harm, though officials said the state has historically refused to intervene on hospital decisions.

“(The report) gives the state every tool at its disposal to take that action,” County Executive James Williams said at the meeting. “We don’t have the authority at the local level to block the decision, but we urge the state to exercise its authority to step in and take action to keep these services open … it will be a political endeavor.”

The county report largely echoes what scores of county doctors and residents said at the meeting: People will die, delays in care will leave people in wheelchairs, and families’ lives will be changed forever by patient backlogs and life-threatening 911 transport slowdowns across the entire system.

Milpitas resident Sharon Martinez said Regional’s stroke center saved her life.

“I wouldn’t have had time to get to any of the other (hospitals) you’re talking about. I was there in five minutes and that was just what I needed,” Martinez said, speaking at the podium in a wheelchair.

Yet doctors said every county resident will be affected, regardless of where they live.

“The ripple effect I want to stress is it will also affect our ability to take higher level-of-care transfers from other hospitals in the county to provide time sensitive, lifesaving care,” Sanjay Kurani, Valley Medical Center’s director of inpatient medicine, said at the meeting.

Paul Lorenz, CEO of the county hospital system, said HCA’s plans to reduce services at Regional in favor of an expanded emergency department are highly irresponsible.

“Make no mistake about it, this is about margins and profits and not about responsible health care,” Lorenz said at the meeting. “HCA has the ability to prioritize and fund the essential services needed for our community.”

HCA has a reputation for placing profits over patients. In San Jose, the multibillion-dollar corporation has been systematically closing services that rely on Medicare and Medi-Cal patients due to lower profit margins.

In 2004, HCA closed San Jose Medical Center, the city’s only downtown hospital. In 2020, the corporation shut down the maternity ward at Regional, which had an immediate effect on East San Jose residents. In 2023, HCA shuttered its acute care psychiatrist services and neonatal intensive care unit at Good Samaritan Hospital in San Jose.

Supervisor Cindy Chavez said HCA is the reason the county hospital system — the second largest in the state, behind Los Angeles — is already overburdened.

“They have a pattern and practice of taking advantage of the community already, so by the California Department of Public Health not stepping in, essentially they will be speeding up the devastation of our health care community,” Chavez said at the meeting.

Supervisor Joe Simitian said no one should be surprised by HCA’s efforts to maximize its shareholder value and that the county may not win the state over based on questions of right or wrong. He said that as a hospital network, HCA is a regulated private enterprise — one operating under rules that in its pursuit of profit should not conflict with public safety.

“There is a legal obligation for a regulatory body to exercise its authority,” Simitian said. “I understand it’s discretionary, but it is a regulatory body that exists in part to render judgment about when a public harm is about to occur that is inconsistent with the regulatory framework.”

The county bought St. Louise in Gilroy and O’Connor in San Jose in 2019 when the hospitals were on the verge of bankruptcy. Supervisor Susan Ellenberg said the county isn’t looking to grow their hospital system.

“It’s an immense lift to operate,” Ellenberg said, as the county grapples with a $250 million budget deficit in the next fiscal year. “I believe our board will do everything in our power to remedy, mitigate, address the situation and we will keep all of you certainly apprised.”

Contact Brandon Pho at [email protected] or @brandonphooo on X, formerly known as Twitter.