>>Long Beach Community Hospital to close ER, increase mental health services, skirting seismic requirements

With mounting financial strain and patient numbers well-below expectations, Community Hospital Long Beach will phase out its emergency department and acute medical services in favor of increased wellness and mental health offerings, operator MWN Community Hospital announced Thursday.

The move lets MWN—and the city—avoid paying tens of millions of dollars for seismic repairs at the property, a burden that prompted the previous operator, MemorialCare, to abandon the facility. But it also means losing the emergency department that residents and local politicians fiercely campaigned to reinstate.

In partnership with the city, the Community Hospital Long Beach Foundation and local stakeholders, the facility will be rebranded as Long Beach Community Wellness Campus. The site will offer numerous inpatient and outpatient services, including behavioral and mental health, urgent care and other medical and social programs.

A timeline has not been released for the transition, but the company said more information would be shared in the coming weeks.

“Today’s announcement confirms the significant challenges of maintaining an acute care hospital at this site,” the city said in a statement. The city owns the property and leases it to MWN.

“Despite all the effort to reestablish and operate the hospital, the operator has informed the City that it is not feasible and there is not sufficient demand for services, even during a pandemic,” the city added, “to keep the acute care portion of the hospital operating.”

The fact that MWN does not own Community Hospital complicates how quickly the operator can make the transition. Long Beach’s current lease with MWN only allows for the operation of a general acute care hospital, so it must be amended for the transition—and any changes to the lease will require City Council approval. Additionally, the hospital will have to undergo another inspection, a process that dragged on for months amid the pandemic.

The city, in its statement, said staff are discussing the lease agreement with MWN, and the mayor and City Council will meet in closed session to decide how to proceed.

Fourth District Councilman Daryl Supernaw, for his part, declined to comment on Thursday’s announcement, citing ongoing negotiations between the city and MWN. Supernaw was one of the most vocal advocates for the reopening of Community Hospital, with his office going as far as pitching in $250,000 for critical elevator repair.

“The city of Long Beach did everything in its power to get this hospital reopened and the ER functioning,” Supernaw said during a phone call Thursday. “I’m proud to say that we accomplished that.”

The planned change in services comes as the facility has faced unforeseen financial hurdles, hospital spokesperson Brandon Dowling said, including increased costs for equipment and supplies due to the pandemic, as well as soaring wages for supplemental nurses as a result of a national shortage.

But the most significant monetary challenge is the ballooning cost of construction for required seismic retrofits. Nine structures on the Community Hospital campus are at risk of collapsing during a strong earthquake, according to a report by the Urban Land Institute.

To comply with state seismic standards for acute care hospitals, those structures must be retrofitted. The cost of the retrofit project has nearly doubled since the company signed a lease with the city in December 2019—up from $40 million to $75 million—which the operator attributes to the pandemic-induced surge in construction and labor costs.

But by transitioning its services, the state law requiring seismic retrofits for acute care hospitals would no longer apply to the facility, Dowling said.

The law, California Senate Bill 1953, was signed in 1994 to require acute care hospital operators to adhere to higher seismic standards. Community Hospital’s deadline under the legislation was Jan. 1, 2020, but the passage of Assembly Bill 2190 allowed for an extension of the deadline for Community to July 1, 2022.

Under the existing lease agreement, which the City Council approved, MWN has the option to walk away from the facility if the cost for seismic retrofit exceeds $52.5 million, Dowling said, but instead opted for the transition.

“Our primary goal has always been to ensure that the residents of East Long Beach have access to quality healthcare services and the [campus] will answer critical community needs,” John Molina, a partner at MWN, said in a statement.

In the lease, the city agreed to reimburse MWN up to $25 million over 15 years for retrofit expenses—funding that will no longer be necessary.

The hospital reopened less than a year ago after closing in summer 2018. But since receiving its first patient in two years on Jan. 5, the hospital has not seen sustainable patient volumes despite the ongoing global pandemic.

Community’s inpatient occupancy rate has averaged just 32.4%, with only about 25 of 79 licensed beds used each day, the company stated. The hospital also averages less than one surgery per day.

The emergency department, which reopened in May, has been similarly underutilized by the community, the company said. Prior to its closure, Community’s emergency room averaged about 90 patient visits each day, but under MWN, the facility is seeing less than 24 patients per day on average—only one or two of which require emergency services, according to the operator.

Ambulance services returned to Community Hospital on May 21 but certain conditions, such as brain bleed and stroke, require a higher acuity facility than the East Long Beach center provides, Dowling said.

The company intends the rebranded facility to be a one-stop hub for health and wellness care by bringing in various providers to operate on the campus, Dowling said. No partners have been announced at this time.

Some employees will be terminated as a result of the transition but MWN did not say how many staff would be impacted. All staff were informed Thursday and Worker Adjustment and Retraining Notification (WARN) Act notifications are being sent out Monday, Dowling said.

The operator did say it is partnering with Professional Resources EAP and the city’s Pacific Gateway Workforce Innovation Network to provide impacted employees with counseling support, job training and career coaching to help them find new jobs.

A need for mental health and wellness services

MWN cited the Long Beach Department of Health and Human Services’ 2019 Community Health Assessment, in which greater access to mental health care was listed as a top health priority, as evidence of the need for a campus focused specifically on behavioral and mental health.

“There is clearly a great need for these services in Long Beach,” the city said in its Thursday statement.

Thursday’s announcement by MWN comes days before the Long Beach City Council is expected to hear an item agendized by 9th District Councilman Rex Richardson that recommends city staff work with the health department to determine how to establish a “more robust infrastructure for mental health services.” The item has six goals:

• Increase access to mental health services across the city, including for schools.
• Increase direct funding for mental health services.
• Localize and improve crisis mental health response and connection to services.
• Streamline the city’s processes for coordination and access to services.
• Expand the availability of residential care facilities and access in Long Beach.
• Provide more opportunities for engagement with local colleges and universities and expand opportunities for social work and nursing students.

Long Beach saw over 1,000 more mental health-related 911 calls in 2020 compared to 2019, according to Richardson’s memo. The local spike mirrors a national trend: The share of adults experiencing symptoms of anxiety or depression skyrocketed from 11% to a high of 43% during the pandemic, according to the CDC’s National Center for Health Statistics.

With the pandemic seemingly under control, the number of adults experiencing symptoms of anxiety or depression has eased slightly but remains nearly three times higher than pre-pandemic levels, Richardson’s item states.

Though the pandemic amplified these issues, they were plaguing the city for years prior, data from the Los Angeles County Department of Public Health shows. From 2012 to 2016, Long Beach exceeded the county in suicides and unintentional drug overdoses per 100,000 residents. The city averaged 10.4 suicides and 8.3 unintentional overdoses, compared to the county’s 7.6 and 6.6, respectively.

“We are committed to keeping this as a healthcare campus promoting mental and physical well-being while addressing pockets of deep need throughout Long Beach,” hospital CEO Gwen Ocampo said in a statement. “We truly have a unique opportunity … to plan for and secure a future that will allow this campus to answer our community’s evolving needs for decades to come.”

Editor’s note: John Molina of Molina, Wu, Network is the primary investor in the parent company that owns the Long Beach Post and Business Journal. Read more about the Post’s ownership here.