Stanislaus Medical Center in Modesto, Calif., may soon become a casualty of declining patient load and the advent of managed care.
Stanislaus County health officials earlier this month unveiled a plan that would effectively stop the center from operating as a traditional hospital.
"It's a difficult path we're putting ourselves on," said Reagan Wilson, the county's chief executive officer. "We believe it's a prudent path, and one that is necessary, (but) we don't do it lightly."
Under the plan, all inpatient services-surgeries, acute care and emergency room treatment-would be gradually phased out, eliminating as many as 400 jobs, or half the hospital's 800-member work force.
The county would then operate a system of community-based health clinics, Wilson said. Treatment for low-income people would be shifted to private hospitals.
The plan was released at a meeting with hospital employees.
Although no final decisions have been reached, Wilson said it would be difficult to continue operating the 105-year-old hospital in face of a dramatic decline in patients and the advent of managed care, which will cap Medicaid payments to the county at $70 per patient per day.
The hospital has averaged just 30 to 40 patients a day in recent months, said Beverly Finley, who oversees the hospital as director of the Health Services Agency.
Although licensed to accommodate up to 199 patients daily, staffing at the hospital now reflects an 84-bed maximum.
In four years, the maximum number of patients on any given day is expected to fall to 32 at the hospital, Wilson said.
"The math doesn't add up," he said. "The bottom line is you can't make enough to operate a 32-bed facility."
The county Board of Supervisors must still approve the plan.