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Was County-USC hospital built too small?

New but smaller


Even before the doors opened on the $1.02-billion Los Angeles County-USC Medical Center many observers warned that the new hospital was too small. Now, more than a year and a half of experience appears to confirm it.

The overcrowding has become so intense that health officials asked County Supervisor Gloria Molina eight months ago what she would think if the hospital began placing patients in the hallways, the supervisor recalled in an interview.

"I said, 'Absolutely not. We will not have patients in the hallway,'" Molina said.

Instead, County-USC officials have increased patient transfers to other hospitals. Despite more than 2,000 such transfers since the November 2008 move into a building with 224 fewer beds, severe overcrowding is routine at the county's flagship public hospital. Few long-term options to relieve the burden are available.

Read Times reporter Rong-Gong Lin II's full story on overcrowding at USC.

What do you think? Share your views below.

Photo: Facilities workers John Rader, right, and Carlos Herrera move barriers to allow ambulances into the new 600-bed County-USC Medical Center in 2008 to start transferring patients from the old facility, which had 224 more beds. Credit: Brian van der Brug / Los Angeles Times

Comments () | Archives (23)

Before retiring from County+USC Medical Center 14 years ago, I had served on countless planning committees for the new facility. EVERY recognized medical and hospital expert and organization recommended that the new hospital be 750 beds. Instead, the Board of Supervisors voted 4-1 for 600 beds, and to build a new hospital of 80 beds in the San Gabriel Valley. The SGV hospital plan died quickly for lack of funds.

Most patients at LAC+USCMC are hard working individuals, doing jobs most of us would not consider doing, for very low wages, and no health insurance provided. They love and care for their families and some take many buses to travel to LAC+USCMC for their healthcare, since it is the safety net.

Readers should remember that, if you are involved in a trauma situation (car accident, criminal activity, or whatever) in the downtown area, YOU will be taken to LAC+USCMC, and their outstanding medical and nursing staffs will likely save your life.

Gloria Molina should be recalled and removed from office for this fiasco and bungling of this. LAC/USC Med Ctr / General Hospital is LA County's biggest hospital and this is UN-ACCEPTABLE. It's like a few years ago when this hospital had doctors moon-lighting and a patient slowly bled to death over a period of 8-hours because they couldn't find a resident Vascular Surgeon. Patients are now going to bleed to death in the hallways and during their transfers to other nearby hospitals because of over-crowding at LAC/USC and that will cost lives. and that's her fault. The biggest newest hospital was build way TOO SMALL. How can you approve a new hospital to be built that smaller than the old hospital it's replacing when the population is growing?

how did this happen? how did they get the logisitics so wrong? or did they underestimate the numbr of people who would need help?

Why be angry at Molina? She was the one fighting FOR it being bigger -- it was her colleagues (with their understandable concerns about costs) that voted to rebuild it smaller.

Everyone knows Country USC needs to be bigger. Every also knows (or should know) that healthcare costs (including for the disastrous King-Drew) have been bankrupting LA County for ages.

Tough call.

No county USC was not built to small. The problem is we have an Over-Population-Crisis due to the massive influx of Legal & Illegal Immigrants, mostly hispanic. The murders in LA county have gone up as well and they're mostly Blacks & Hispanics, with Hispanics far out-weighting them. Look at the Crime section in the LA Times, astonishing.

We need a bill passed similar to Proposition 187 to help abate this influx that did pass in 1994.

It's just a guess but did the original planners count on MLK hospital relieving their burden of patients. Most city hospitals in big cities have or had 900 to 1000 beds approximately. Why not re-open MLK if it's just sitting there in So. L.A. with very little going on?

LAT writers, I remember watching a board meeting on tv, where Gloria Molina was asking a group of consultants who wrote a report about expected waiting times at the LAC-USC emergency room. The consultants, with a straight face, said to Molina and the Supes, that if the hospital functioned at 90% functional capacity, that the wait time would be less than 5 hours, and that if there was a sudden rush of patients, it would be about 8 - 10 hours. I swear this is true, Molina leaned into the mic and said, "Do you know any hospital that runs at 90% efficiency? This was not an academic exercise, I want to know the truth." Look back at the meetings prior to the transfering of patients from the old LAC-USC to the new one. It's a scandal.

Yep, they forgot to build a wing for the taxpayers, not a hospital full of illegal aliens.

of course neither gloria nor the rest of the supervisors could forsee the hords of illegal aliens pouring into la county. it's not their fault. they though that the federal government, johnson, nixon, ford, carter, reagan, bush, clinton, bush, and obama, would protect our borders. employers would not hire illegals and they would be deported. how WRONG they were.

if los angeles would do something about there illegals the hospital might not be overcrowded dah!!!!!!!!!!!!!

Yes, the hospital was built too small, guess they had to vote the way they did in order to have the plan to built move forward. Why didn't the COMMITTEES listen to the expert, if they know we have a huge population and its considered one of the best hospitals then they should have gone with the 750 beds or even a hundred more!

County always has issues and yes you can bleed out and they still wont help you. Most employees tend to be rude and some times "LAZY". It's kind of a shock when you get that courteous employee that is willing to help you because that they want to and not because its their job.

Those individuals in these committees really do not go to that hospital to get treated so they really dont know how the services are there! or what was really need.

Yes, they should stand in line or wait to be treated 3 or 5 hrs and see how they like it. With rude staff complaining all the time. Not nice, people that go there are human too and just there seeking help.

Three words: They cheaped out.

How could they have even thought they could get away with building that so small??? So stupid. They probably thought they could save money that way.

Maybe what they should do is build a second hospital. Take over an office building in Downtown LA. Gut it. Rebuild it into County-USC Downtown Campus.

LA needs MORE, not less, hospital beds. We need MORE ER capacity. And most importantly, we will need more comprehensive outpatient centers. Meanwhile people are dying because County-USC (and Olive View UCLA, and Harbor-UCLA, and on and on) are overcrowded, understaffed and underfunded.

Pray for SB 810 to finally get passed when Schwarzenegger gets termed out. Pray for a 2/3 Dem majority in both chambers of the CA legislature so that anyone who gets elected to the State House is irrelevant. Pray for California. Because this is only one of the reasons we are in such deep trouble.

Let's acknowledge the obvious: There are simply too many people living in L.A. Almost everywhere you go, you're fighting the crowds. Even in a supposedly modern hospital facility, you feel like you're in a third-world country.

Stanley, the problem wasn't Gloria Molina. Although I don't like Molina that much and I would love to vote her out of office but she was the only Supervisor that was against the 600 bed hospital and wanted a bigger hospital. She was the only one to fight for a bigger hospital but at the end she lost. That is why it was 4 to 1.

I do believe that the hospital need to be expanded again and since the old hospital can't be tear down due to its historic standing the only way to expand the hospital again is to include it with the expansion/new building for the coroner's office and maybe tear down the old women and children hospital and the parking structure next to it because I don't see that building as a historical building.

yeah to small to take care of 12 million illegal aliens.

This was deliberate. The Board of Supervisors wanted the hospital to be smaller to save money both on constructions costs, and so that they wouldn't have to pay the extra staff that would be needed for the additional beds. It's a great evil workaround to the idea of a "safety net" in which the LA County would be required to pay for every patient that walks through those doors. What better way to avoid paying for the treatment of all the excess patients by having them slowly die out in the waiting rooms in the nearby future, in their homes because they cannot tolerate to wait another 20 hours to be seen, and during transit in ambulances who can't bring them to LAC+USC or any nearby hospital for lack of beds? To Gloria Molina and every County Supervisor who wanted it this way... bravo! To the state government who keeps taking money away from County... bravo! To all the people who refuse to pay more taxes that could have paid for these extra beds... congratulations on effectively kill hundreds of future patients.

I'm so sick of politicians, including Gloria Molina, who publicly point fingers at other in blame, when it boils down to herself and her decisions that caused this problem.

Actually, Gloria Molina was the only Supervisor to vote against the smaller hospital. Blame the other four members, not her.

I was a resident of this facility for 37 days starting last December. I believe that this facility is lacking space. Overcrowding seems to come from the constant stream of homeless people and abusers of the system. The emergency room is constantly operating with precision and does their job well. People have to realize that it takes time to see everybody and that everybody ( with a wait depending on the severity of your illness or injury ) will get seen by a medical professional. When I arrived at County-USC I waited 15 minutes before I was seen by 6 different specialists as to determine what was wrong with me. The Trauma Unit of this hospital is second to none. The ICU operates like a well oiled machine. The Burn Unit has exemplary care. This is the process to see this many people. It has to suffice. These people are doing all they can do with the space they have. LAC-USCMC Trauma saved my life and I and my family are forever grateful.

When LAC-USC was being planned for rebuilding, Sup Molina wanted a 750 Bed Hospital, the other sups wanted a 500 bed hospital. It was all political with planning studies of need going out the door. Sup Molina was a strong advocate for a larger hospital and she fought for it, unfortunately she was voted down several times by the other supervisors. One can say that priority of care should be given to residents before non-residents, but the federal law mandates that everyone have access to medical care at county centers. While Obama is intervening in Arizona's law saying the issue of immigration is a federal concern, then he should be responsible for providing adequate funding to treat all of the undocumented that access local centers for care. The federal government should stop imposing federal mandates without properly funding them.

How about this idea ... for every dollar sent out of the state of California to a foreign country the state takes half and applies these funds to the areas of welfare that are being used by our undocumented work force ... Lets see for every $100.00 sent out that would be $50.00 to the state and how many undocumented workers are their in California ... Since the state can't or won't fix the illegal issue how about looking at the possibility of making money to cover the costs they incur .

I was just there Visiting this hospital.
After being laid off and not being able to afford private COBRA health coverage.

Had to goto hospital to follow up from cancer surgery because private insurance ended, after lay off. I tried making appointment, and seems there is little or Limited info on care assistance. I was told i must be admited only thru Emergency room to be seen by any doctor. So since I was having chest pain, heart palpitations and a host of anxiety from cancer issues, I walked into ER. where i waited 15 hrs then went home. came back next day and waited 11 hrs before seeing a doctor.

Care could be better, but outpatient services where 100% covered by gov program. as far as my inpatient bill i am left owing $4200. dollars for hospital visit.

This place gave me a feeling its setup for profit and not care, but as it should be as this is a capitalistic government, and thats the engine of our economy.
Thus any career would be for profit ironical even doctors and health care providers. I mean how much proper health care could you receive if they were in business to profit from the sick. anyways thats another silly thought.

Although after visit I was shamefully left with many questions:
Who owns, this hospital?
Who pays for the remainder of what I pay of $4200, as total bill was alot more than that. does California pay for rest of bill? or does hospital simply drop rest of bill? Or does the hospital profit or get reimbursed by California tax payers for rest of bill?
Very curious as to how this works?
Do doctors here, get paid? or are they all just Interns Including the ones doing surgery? Herd rumor from patient that his surgeon was intern, who would graduate upon successfully, operating on this man? Would it be legal for interns an un-paid surgeons to do surgery?
Does this hospital operate for profit?

One more thing after sitting and waiting in the emergency room for 15 hrs one day, then 11 hrs the next, and on a return visit for 21 hrs then 10 hr wait. for a total of 57 hrs sitting in waiting room,

My observations on waiting times are as follows:
-If you have open cuts and came in with an ambulance, you probably get care ASAP.
-If you have broken bones or cuts care within 3-4 hrs wait.
- if you are elderly and have some type of complication 4 hrs wait.
- if your complaining of abdominal pain, i.e food poisoning, kidney stones, gallstones etc, 8-12 hrs wait.
-if you are in minimal pain but have concerns about some complication, expect to wait from 9-hrs to 24 hrs, no lie.
These observations where on june 2010.

As far as service and courtesy, expect to get exactly what our city is made of, good and bad characters, as I encountered both, I think the bad service and bad attitudes that i did encounter maybe do to overwhelmed employees or lack of Supervision. After all if you are unafraid to get fired your attitude is poor, in my opinion. And I dont think there are many supervisors at this hospital, Because if you fear losing your job due to complaints to supervision, my guess is you would be alot more courteous, than if you had GOV job security, and no fear of being fired due to government policy not to fire or over supervise, because they fear lawsuits.


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