Fresno County EMS Director Daniel Lynch has notified Community Regional Medical Center that it has until 5 p.m. Friday to provide the staffing necessary to retain its level 1 trauma center status.

At issue is a CRMC’s relationship with Central California Faculty Medical Group covering 28 physicians in 12 specialties that ended Aug. 31.

Six of these physicians are UCSF faculty who provide the 24-hour neurosurgical trauma coverage required for the level 1 trauma designation.

This means anyone requiring neurosurgical trauma coverage after hours must be sent to another level 1 trauma center as far away as the Bay Area or Sacramento. Neurosurgeons are still staffing normal business hours. The 24-hour coverage lapsed when the contract lapsed.

“CRMC received notice from EMS on Tuesday that they had until 5 p.m. on Friday to restore neurosurgical trauma coverage, or the hospital’s trauma designation would be at risk,” said Dr. James Davis, chief of trauma at CRMC and chief of surgery at UCSF Fresno. “I have been in this role since 1991, and I have never been more concerned about the future of this trauma center than I am today.”

Letter to CRMC

Part of the EMS letter reads: “If neurosurgical service coverage is not established by 5:00 p.m. on Friday, September 11, 2020, the State will be notified about the suspension of your status as a Level 1 Trauma Center. We will also provide notification to local hospitals that trauma destination policy may be modified and could potentially impact emergency departments. It is unfortunate that this issue has progressed to this decision. We are hopeful that some resolution can occur before the deadline on September 11, 2020.”

CRMC Response

CRMC senior vice president Michelle Von Tersch said in a statement provided to GV Wire℠, “Either through a resolved agreement with CCFMG or by securing alternate neurosurgery call coverage, we are confident that we will restore neurosurgical call coverage in advance of the deadline.”

Alternative Staffing?

Friday afternoon, EMS Director Lynch said CRMC was working to bring surgeons up from Los Angeles to help staff the hospital.

During a Zoom call with reporters Wednesday, GV Wire℠ asked Lynch if the hospital could retain their level 1 designation by utilizing doctors from outside the area to provide the 24-hour coverage necessary.

“As long as they can do that,” said Lynch. “The problem is, they can’t seem to secure enough people to provide that level of service on a consistent basis.

“It’s unfortunate. It’s not just an impact to CRMC. This is an impact to our community and the other hospitals,” said Lynch. “A lot of our other area hospitals depend on CRMC.”

He says at least two patients were sent out of the area last week. He’s not sure how many total patients have been transported so far.