Most Southland hospitals recover quickly from temblor's disruption.

After some initial short-term shutdowns, most of the 148 hospitals in Los Angeles County were up and running within days of the Jan. 17 earthquake. Power outages, burst water pipes, failed air conditioning and heating systems forced several facilities to cease operations. But only a few facilities suffered serious structural damage that will keep them closed for the long term. For the few that sustained serious damage, the road back is going to be much tougher than simply restoring power. And not surprisingly, Santa Monica and San Fernando Valley hospitals were the most affected.

Both Saint John's Hospital and Health Center and Santa Monica Hospital Medical Center suffered damage serious enough to require closure of certain buildings. As a result, neither of those hospitals is expected to be fully operational until this summer.

Santa Monica Hospital, a 365-bed facility located on 16th Street in Santa Monica, was forced to consolidate the majority of its operations into one of its two buildings. One of its buildings had fairly extensive damage and will have to be repaired before it can be returned to full operation. Completion of those repairs is expected to take six to eight months, according to Santa Monica Hospital spokesman Ted Braun. Santa Monica Hospital did not have to divert any of its patients to other facilities. Like most hospitals in Southern California, Santa Monica Hospital was operating at below capacity, so it had room to consolidate. It was even able to accept some of the displaced patients from Saint John's.

Saint John's was even more severely damaged than Santa Monica Hospital. All the patients from this 501-bed hospital were evacuated and relocated to nearby facilities. According to Patricia Bartel, a spokeswoman for Saint John's, the hospital's south wing is being rehabilitated and will reopen for inpatient service in August. The hospital's north wing is to be completely demolished and a smaller wing built in its place.

Over the hill, in the San Fernando Valley, only one hospital remains in critical condition. Of the 22 buildings that make up the Veterans Affairs Medical Center -- Sepulveda, several will have to go through a lengthy process of reconstruction. The center's outpatient facilities are operational, but none of the inpatient buildings are in use. The damage was extensive enough that the VA expects to keep its inpatient facilities at the Sepulveda medical center closed for most of the year. More than 400 patients were evacuated from those inpatient buildings immediately following the quake and have all been placed in other VA facilities around Los Angeles County. The medical center's outpatient services were unaffected by the quake.

Meanwhile, back on the Westside, Saint John's and Santa Monica Hospital's misfortune has brought an unexpected cash bonanza to hospitals in neighboring areas. Several local hospitals were called on in the immediate aftermath of the Jan. 17 shaker to accommodate Saint John's patients.

Hospitals reported to be substituting as health care destinations for Saint John's patients are Daniel Freeman Marina Hospital, UCLA Medical Center and Cedars-Sinai Medical Center. Santa Monica Hospital, despite the fact that its hospital suffered damage, has taken on some of Saint John's patients as well. Both Daniel Freeman and UCLA Medical Center officials stated that, as a result of the shutdown of Saint John's, they are operating at near capacity. Probably no other hospitals in Los Angeles County can claim similar occupancy rates. In fact, most health care institutions in L.A. are operating in the red, and on most days, half of their beds are vacant.

Since the quake, Daniel Freeman Marina Hospital has been operating at full capacity. In fact, Daniel Freeman is making up for the increase in patient load by hiring physicians and nurses from Saint John's.

The situation at UCLA Medical Center is a similar one. Adding patients from Saint John's to its facility in Westwood has brought new demand for physicians and nurses to look after the patients. Approximately 150 doctors, 25 nurses and 40 other medical professionals from St. John's have been added to the UCLA staff roster since the quake, according to UCLA spokeswoman Jackie Michaels. "There is an added patient number, so we have picked up some of the physicians," said Dr. Alan Fogelman, chairman of UCLA's Department of Medicine. He explained that temporary credentials to practice medicine at UCLA have been given to Saint John's doctors. Those credentials will be extended for as long as is necessary, he said.

Fogelman added that UCLA has extended the hours of operation of its facilities, including operating rooms, to accommodate the increased patient load. With the exception of some parts of the hospital that were in the midst of being renovated when the earthquake hit, the UCLA Medical Center is operating at "very near to capacity," according to Fogelman.

Both Santa Monica Hospital and Saint John's are looking toward the future and their rebuilding efforts. The two facilities have come up with very different plans, however. Saint John's will not be rebuilt to its pre-quake 501-bed licensed capacity. Bartel explained that the hospital no longer serves anywhere near that many inpatient clients.

Once the rebuilding is complete, St. John's is expected to have only 140 to 150 beds, she said.

Bartel explained that the hospital's board of directors is in the process of deciding on some sweeping changes in the way medicine is practices at Saint John's. "We need to build for managed care," she said. "There is a whole new way to deliver health care in the future, and we are studying ways to do that." At Santa Monica Hospital, looking forward means looking back. Medical staff there will continue to work in the one standing building until the other building can be repaired. Braun estimated that in eight months, at the latest, the second wing will be back in full swing. Santa Monica Hospital has no plans to downsize, said Braun. "Our bed capacity has gone from 280 to 130 beds since the evacuation, and we need more beds than 130 to operate the hospital on a long-term basis," he said.

The Sepulveda VA Medical Center plans to reconfigure its hospital's operations when it gets into the rebuilding phase. Like Saint John's, one element of the VA's rebuilding plan is to reduce its inpatient capacity. According to Max McIntosh, spokesman for the Sepulveda VA Medical Center, the hospital generally runs at about 70 percent of capacity. That figure is expected to decline further as national health care reform kicks in.