INPATIENT TREATMENT TO CEASE\Medical center clients will go to Los Robles.

Byline: R.A. Hutchinson Daily News Staff Writer

Six months after acquiring Westlake Medical Center, health-care giant Columbia/HCA announced plans Wednesday to discontinue inpatient services at the facility and transfer all such care to Los Robles Regional Medical Center.

Ronald C. Phelps, president and chief executive of the Conejo Valley's two Columbia/HCA facilities, said the low number of patients - 13-14 daily - makes it financially unfeasible to keep acute-care operations at the 26-bed Westlake Medical Center. The decision comes almost a year after Columbia/HCA closed 62 beds following the merger of Los Robles and Westlake Medical.

"Since we merged six months ago, we've been averaging about 13-14 patients a day. We can always absorb that inpatient load at Los Robles," Phelps said. "As volume gets lower, it gets harder to provide quality health care. I think a hospital can be too big, but it can also be too small. We're below that point."

The decision also affects Beverly Hills-based Salick Health Care Inc., which leases space from Westlake Medical Center to operate the Westlake Comprehensive Cancer Center and operates its inpatient beds under Columbia/HCA's state license.

Dr. Leslie Botnick, director of radiation/oncology for Salick, said he expects his employer to purchase the property and use it to expand its cancer treatment programs.

"I know they will buy it. Salick is committed to the community and to serving the Conejo Valley," Botnick said. "This just means we'll have more space."

Patrick McDonough, executive director of the cancer center, declined to be interviewed Wednesday.

Phelps said that an agreement negotiated with Salick after the Los Robles-Westlake merger gives Salick first right of refusal to buy the Westlake Village facility. If that happens, the agreement also stipulates that Columbia/HCA will have the option of leasing space from Salick.

"What Salick does, affects us," Phelps said.

David Langness, a spokesman for the Healthcare Association of Southern California, said he has watched the merger between Los Robles and Westlake Medical Center unfold since it was announced in December 1994 by Columbia/HCA and Universal Healthcare, the former parent company of Westlake Medical.

"This is not unexpected," he said. "We have too many beds in Southern California. The average daily census is about 46 percent. It's getting more and more difficult for smaller facilities to maintain financial viability."

Langness said that if Westlake Medical had not been acquired by Columbia/HCA in a facilities swap with Universal, then inevitably financial strain would have taken a toll and probably forced its closure.

"Without the merger, they would have had to go out of business," he said. "A small hospital has only two options - merge with a larger provider and become predominantly an outpatient facility or go out of business. It's much better for the community to have something rather than nothing."

For the next 180 days, Phelps said, there will be no changes in services at Westlake Medical Center. During that time, he said, many of the 190 full-time employees at Westlake Medical Center will be transferred to comparable positions at Los Robles or offered jobs at other Columbia/HCA facilities in the area, including its hospital in West Hills.

"We want to minimize the impact as much as possible," he said.

After the 180 days are past, Phelps said, Columbia/HCA expects to maintain standby emergency services, outpatient surgery, outpatient rehabilitation and industrial medicine at the Westlake Village site.

"Our strategy for the Conejo Valley is to be a cost-effective, competitive health care provider. We can't do that with duplicative services," Phelps said.

Phelps acknowledges that one of those duplications is Salick's cancer program, which competes with Los Robles' own cancer treatment center.

"They are a direct competitor of ours," he said.

Betty De Santis, a newly elected councilwoman in Westlake Village and a five-year volunteer at Westlake Medical Center, said she fears the disbanding of inpatient services is a step toward ending emergency room care at Westlake Medical and toward driving Salick from the community.

"What really bothers me is that I want to see the emergency room stay open. We have people coming in from Malibu and the canyons," de Santis said. "They're not freeway friendly over there (at Los Robles)."

She also fears for the cancer center.

"I think Dr. Salick's cancer center is just tremendous. But he really needs the (partnership) of an acute-care facility to stay in business," she said.

Robert Rathbun, assistant supervisor for the Health Facilities Division of the Los Angeles Department of Health Services, said his agency will oversee the process as Columbia/HCA either relinquishes the licenses of the 26 remaining beds or puts them "in suspension" with the 62 that were suspended last March for a three-year period that ends in 1998.

He said if Salick decides to purchase the hospital facilities, then as new owner the company can approach his department to obtain licensing for beds. Under a contract with the California Department of Health Services, Los Angeles County oversees hospital and nursing care licensing in the county.

"It sounds like they are in essence trying to force Salick out of the facility," Rathbun said.