County-USC remains L.A. County's largest hospital.

Hospitals seem to be getting upper hand on finance woes

On the surface, the List of L.A. County's largest hospitals reflects trends which continue to shape Southern California's health care industry.

Occupancy, for instance, is down at virtually all the private facilities, which tend to serve insured patients. It's up at all the government facilities, which tend to serve the indigent.

Overall, occupancy for the hospitals on this year's List has an unweighted average (not allowing for differences in hospital size and numbers of beds) of 62.3 percent, compared to 64.8 percent a year ago.

Industry observers attributed the drop in average occupancy at private facilities to the expanding presence of managed care plans, such as health maintenance organizations, which advocate less-expensive outpatient treatments to hospitalization. Southern California has the deepest penetration of managed care in the country, most health care experts agree.

Still, many hospitals have found ways to pick up the cash flow slack that results from a lower occupancy rate. David Langness, vice president with the Hospital Council of Southern California, a trade group, noted that hospital outpatient volume has increased fourfold in the past five years.

Red isn't as deep

"The situation is not so ugly any more," said Langness, who noted that many facilities have gotten a better handle on finances. "(Overall, hospitals) are still in the red, but things are getting better."

Long Beach Memorial Medical Center, No. 4 on The List, has been boosting the number of procedures performed at its outpatient surgical center. Outpatient procedures now account for 25 percent of total revenues, according to hospital spokesman Ron Yukelson.

"I think any hospital that isn't looking at working more efficiently, while developing increased business, is going to go out of business," Yukelson said.

Long Beach Memorial posted a $6 million operating surplus last year, and is the only non-government hospital on The List that did not experience a decline in occupancy during the past year.

The most crowded facility on The List is Rancho Los Amigos Medical Center in Downey, with a 1993 occupancy rate of 103 percent, compared to 98.1 percent in 1992. The 722-bed hospital -- ranked No. 5 according to number of licensed beds -- is operated by the Los Angeles County Department of Health Services.

USC still tops

No. 2 in terms of occupancy is the county's largest hospital, No. 1-ranked L.A. County+USC Medical Center, with an occupancy rate of 75.5 percent, down from 82.4 percent in 1992. It has 2,045 licensed beds.

Several facilities reduced their number of licensed beds in the past year. Cedars-Sinai Medical Center, No. 3 on The List, reduced licensed beds from 1,200 to 1,004. Kaiser Permanente Medical Center-Los Angeles cut beds from 751 to 586, dropping it to 10th on The List from sixth a year ago. Officials at those facilities did not return calls seeking comment.

Another facility that cut beds, Little Company of Mary in Torrance, dropped off The List altogether. It was ranked 24th last year.

St. Vincent Medical Center in Los Angeles moved up a notch from 25th to 24th. Encino Tarzana Regional Medical Center in Tarzana nabbed the last spot on The List, with 384 beds.

Employment among hospitals on The List has remained fairly stable during the past year, although it appears to be down slightly overall. Twenty-two of the 25 hospitals on The List (three facilities did not disclose employment numbers) employ a total of 64,727, compared to 70,260 last year (when all the hospitals on The List disclosed employment figures). The average hospital on this year's List employed 2,942; last year the average was just over 2,800.