Temporary closure of ER angers officials
“(Patients are having to travel) at minimum a 45-minute drive away . ... Forty-five minutes can determine whether patients suffering from acute medical conditions survive.”
Rep. Anna Eshoo, D-Palo Alto
The future of a recently closed emergency department in a coastal Bay Area community is up in the air, as local officials are demanding that it reopen immediately, against the wishes of hospital executives who shut it down temporarily for repairs.
Seton Coastside in Moss Beach — about halfway between Pacifica and Half Moon Bay — includes an emergency department and a 116-bed skilled nursing facility. It closed April 1 to begin construction that’s expected to take up to nine months. Hospital administrators say that the construction is to repair damage the facility sustained during last year’s storms, and that they plan to reopen both the emergency and skilled nursing services once the work is completed.
But the issue has spurred an unusually public fight between the hospital and county officials. Attorneys for San Mateo County are demanding that Seton reopen the emergency department by April 29, arguing that the closure violates the terms of a state-approved agreement that requires the hospital to keep emergency services open until December 2025.
The agreement was enacted in 2020 when Seton Coastside and its sister hospital, Seton Medical Center in Daly City, were sold by their previous owner, the bankrupt Verity Health System, to their current owner, AHMC Healthcare. The sale was approved by the California attorney general, which can block or impose conditions on the sale of nonprofit health care facilities.
The closure of the ER also violates a separate agreement that AHMC and the county reached in 2021, in which the county provided $10 million for seismic upgrades at Seton Medical Center, according to a March 28 letter that San Mateo County Attorney John Nibbelin sent to AHMC executives demanding that Seton Coastside remain open.
The 2021 agreement says that in exchange for receiving the $10 million — from Measure K, which is funded by local sales tax — Seton must continue operating as a full-service general acute care hospital until 2027. If it does not, the hospital must repay the county a portion of those funds.
Patients coming to Seton Coastside are being redirected to Seton Medical Center in Daly City, about 13 miles north. The next closest emergency room after that is Mills-Peninsula Medical Center in Burlingame, about 18 miles away.
Seton Coastside will not be able to reopen by April 29 because construction will take at least six months, said Tim Schulze, associate chief operating officer at Seton Coastside and Seton Medical Center.
“The intention has always been to temporarily close that facility,” Schulze said. “The plan has always been to do the repairs as fast as we can.”
The California Department of Public Health approved the temporary closure of the emergency department in February, according to a March 29 letter an AHMC attorney wrote in response to the county’s demands. The hospital had considered keeping emergency services open during construction, but determined it would not have been feasible because of the presence of mold and asbestos.
The roughly 100 skilled nursing home residents were moved to Seton Medical Center in Daly City or discharged before the April 1 closure. The ER was seeing three to four patients a day prior to closing, Schulze said.
Supervisor Ray Mueller and Rep. Anna Eshoo, D-Palo Alto, are pressing for more transparency on the closure, including information about the impacts of the closure on access to emergency medical care, estimated repair timelines, and an assessment of whether the closure complies with federal and state requirements. Mueller said his office has been frustrated with the lack of information from AHMC about the closure.
“We simply don’t have adequate information right now that substantiates the necessity for the closure,” Mueller said at a March 27 meeting of the Midcoast Community Council.
“Seton Coastside is the only facility providing emergency services for 55 miles along the Pacific Coastline from Santa Cruz to Daly City and is a lifeline for patients in need of emergency care,” Eshoo wrote in an April 4 letter to Dr. Tomas Aragón, director of the California Department of Public Health.
“Patients in need of acute or emergency medical services are being directed to Seton Medical Center … at minimum a 45-minute drive away from Seton Coastside. Forty-five minutes can determine whether patients suffering from acute medical conditions survive.”