Hospital Operator Backs Off Closure of East San José Trauma Center After Public Outcry

Updated 5:15 p.m. Friday

Following months of outcry from residents and county officials, leaders of the Regional Medical Center in East San José are backing off plans to shutter the hospital’s trauma center and cut other services.

Although the hospital announced Friday morning that it would preserve its trauma center, severe heart attack treatment program and stroke services, they will be downgraded to less comprehensive levels.

The changes were announced with little notice to local officials and advocates, who expressed frustration on Friday and said the course change doesn’t address their concerns and instead raises more questions.

The hospital’s trauma center is one of three in Santa Clara County and the only such facility on the east side of the county. The Level II trauma center had been scheduled to close on Aug. 12. Hospital officials said it would be reinstated that day as a Level III facility that “provides prompt assessment, resuscitation, surgery, intensive care and stabilization of injured patients and emergency operations.”

“We worked closely with our emergency services partners to ensure we will meet the evolving medical needs of our patients and the East San Jose Community,” Matt Cova, CEO of Regional Medical Center, said in a press release. “We’re pleased to have found a path that supports the revisions we’re announcing today.”

Regional Medical Center, which is owned by the Hospital Corporation of America, or HCA Healthcare, also previously planned to eliminate its ST-elevation myocardial infarction (STEMI) program, which handles severe heart attacks, and downgrade its stroke services from the “comprehensive” level — which can care for all types of stroke patients and has 24/7 availability for complex neurosurgery — to “primary.”

County Executive James Williams said Friday that with the new announcement, “HCA has finally acknowledged the severe impacts of its previously announced closure of trauma services and downgrading of STEMI and stroke care at Regional Medical Center.”

But even with the closures avoided in the new proposal, the downgrading of services “would have a very negative and permanent impact on healthcare access in our most vulnerable communities,” Williams said in a statement.

Residents, doctors and nurses, patient advocates and elected officials had earlier decried the planned cuts as discriminatory and likely to cause more deaths and poorer health outcomes for potentially thousands of vulnerable residents in the largely working-class area. The closures could also have “cascading negative effects” on the broader county health system, a county report said.

Advocates called on state officials, including Attorney General Rob Bonta, to intervene, though Bonta’s office has declined to comment on the situation other than to say it is reviewing the matter.

The hospital company said Friday that instead of eliminating its serious heart attack services, it is “revamping” its acute heart attack program “to feature around-the-clock cardiologist availability and a daytime catheterization laboratory.” The hospital currently has a full-time catheterization laboratory, where cardiologists insert catheters to help diagnose heart issues.

The hospital will also operate a stroke center with “enhanced interventional capabilities to address the needs of 97% of stroke patients,” with the remaining patients expected to be transferred to other health care facilities.

The hospital statement didn’t clarify what specific level of service would ultimately be offered in the stroke center. A source familiar with the planned changes confirmed the stroke center would be downgraded to less than the current “comprehensive” level but noted details are still being worked out.

It also will stick to a previous plan to increase its emergency department capacity from 43 to 63 beds by 2025.

Dr. Raj Gupta, the head of neurology and stroke services at the hospital, who has spoken out previously against the cuts, criticized the changes Friday, including the reduction in catheterization lab hours.

“Between nine to five, there may be some cath lab, but at 5 p.m., if a patient shows up, they have no cath lab. They have to transfer all the patients (who arrive) at off times, as well as on weekends,” Gupta said. “Without real, modern cardiology services, this is just lip service.”

He also raised concerns about the lessening of trauma services.

“I don’t think this community’s needs are met by a Level III,” Gupta said during a press conference outside the hospital. “This is a big downgrade.”

While Regional’s statement said the decision to make these changes came “after extensive coordination with local agencies, internal discussions, community outreach and analysis of the county’s impact report of the initial changes,” county officials and advocates countered that narrative.

Williams, the county executive, noted in his statement Friday that Santa Clara County “has not received any formal proposal from Regional related to these changes, and there is a process it must first follow to propose, obtain approval, and then implement these service changes.”

Santa Clara County Supervisor Cindy Chavez, who has been one of the leading critics of Regional Medical Center, said the company did not submit a formal request about the changes to the Santa Clara County emergency medical services agency.

“Not even a letter saying, ‘Here’s the things we’d like to work on, here’s how we’d like to work on them with you.’ So the idea that they are collaborating with the county is just untrue; they are having conversations, but that is absolutely not the same thing,” Chavez said.

The changes announced by Regional “feel like a good press move” but don’t help with “moving our communities forward in terms of their health,” Chavez added.

“I take big issue with the fact that in their release today, they claim to be working with community,” Darcie Green, head of health nonprofit Latinas Contra Cancer, said. “I can find nobody that HCA and Regional Medical Center have been working within the community.”

Green said the community’s fight with the hospital chain is not over.

“We will continue organizing community and patients to hold HCA Healthcare accountable to being responsive to the community, to being present in the community and to not divesting from East San José.”