By R. Christian Smith
Beacon-News
AURORA, Ill. — Over allegations of staffing shortages, the Illinois Department of Public Health has revoked Mercy Medical Center in Aurora’s Level II Trauma Center designation.
Previously, Mercy Medical Center in Aurora was designated by the state as a Level II Trauma Center, which means it was able to provide trauma care to patients with serious injuries, like those from car crashes, falls or violence, through 24-hour on-site or readily available essential services.
But that status was revoked as of April 20 due to violations that “present a substantial probability that death or serious physical harm will result,” according to a letter obtained by The Beacon-News that was sent by the Illinois Department of Public Health to Mercy Medical Center.
“This action does not affect other services at the hospital and patients can still walk into the ER for emergency treatment,” said a department statement sent to The Beacon-News Thursday.
The state revoking Mercy Medical Center’s Level II Trauma Center designation is a “big deal” for Aurora, especially since Mercy is one of only two hospitals in the second biggest city in Illinois, said Richa Sharma, a doctor who up until Feb. 14 worked in Mercy Medical Center’s intensive care unit and was the hospital’s chair of internal medicine.
The other hospital in Aurora is Rush Copley Medical Center, which currently has a Level II Trauma Center designation.
People can still use Mercy Medical Center’s emergency room, but it is possible trauma patients that otherwise would have been taken to the hospital may now be redirected, Sharma said.
An Aurora public safety spokesperson confirmed Thursday that the Aurora Fire Department’s EMS is shifting where it sends “significant trauma patients,” especially those on the city’s East Side, because of the change to Mercy’s trauma designation.
Following transport protocols set by the Southern Fox Valley EMS System and the Illinois Department of Public Health, those trauma patients will now be taken to hospitals such as Rush Copley or Northwestern Medicine Delnor Hospital in Geneva, according to the city public safety spokesperson.
“While this represents a procedural change, we’ve implemented the necessary adjustments to ensure a smooth transition,” the city public safety spokesperson said in a statement sent to The Beacon-News. “Patient care remains our top priority, and individuals continue to be transported to the most appropriate facilities based on their condition.”
Emergency response times are not expected to be impacted by the change, and “the community can expect the same high level of care and professionalism from our teams,” the city public safety spokesperson said.
An Illinois Department of Public Health spokesperson said in a statement Thursday that the department and state officials have been in communication with Kane County leaders as well as nearby hospitals, trauma centers and EMS providers to make sure area residents continue to have access to vital emergency services.
For trauma patients that do end up at Mercy, a lot more of them will now be transferred out, Sharma said, because the hospital can no longer handle as many things as it used to be able to.
According to a Mercy Medical Center spokesperson, the removal of the hospital’s Level II Trauma Center designation does not change the quality of care provided in the hospital’s emergency room.
“Critically ill or injured patients will continue to be stabilized and treated appropriately in our Emergency Department,” the hospital spokesperson said in a statement.
The hospital losing its trauma center designation means little to no change for patients coming to Mercy for emergency care, and all current hospital services — including emergency medicine, critical care and surgical care — will continue without interruption, the hospital’s statement said.
Emergency medical services will also continue to transport patients to the hospital, according to the hospital’s statement, and only a small number of patients will be diverted to other hospitals which have a trauma center designation.
The Illinois Department of Public Health’s letter to Mercy Medical Center, dated April 19, alleged that at several points over the last few months Mercy did not have the staff to cover essential services required of a Level II Trauma Center under state code.
The alleged staff shortages were from both before and after Prime Healthcare bought Mercy Medical Center along with a number of other hospitals from Ascension, which officially took place on March 1 .
While the hospital has a chance to appeal the state’s decision, a Mercy Medical Center spokesperson said Thursday that the hospital had already started the process of voluntarily withdrawing its trauma center designation when the state sent the letter.
“Over the past year, the number of Level II trauma patients has significantly declined and the Level II designation does not represent the emergency care needs of our patients,” said a statement from the hospital. “We are committed to ensuring the highest standards of quality care and low volume trauma services cannot reliably ensure consistent quality.
“Therefore, the withdrawal of Level II trauma designation and continuation of all other emergency care services best addresses the needs of our patients and ensures safety and clinical excellence,” the hospital’s statement said.
The Beacon-News previously reported that Advocate Health Care recently completed a quiet pull-out of its doctors from Mercy Medical Center and that there were concerns about its impact on the hospital’s standard of care.
But, a hospital spokesperson said earlier this month that there was at the time “no impact to the hospital’s emergency care and no impact to patient care or access” due to Advocate pulling its doctors from the hospital.
On Thursday, a statement from the hospital said that the trauma center designation being revoked by the state is “a separate matter that does not involve Advocate physicians.”
However, it appears that Advocate pulling its doctors out of the hospital may have been part of, but not the only, cause of the staff shortages alleged in the Illinois Department of Public Health’s letter to Mercy, according to Sharma.
Prime Healthcare decided to go with a different group for critical care services, which is why Sharma no longer works at Mercy, she told The Beacon-News. The hospital has lost staff across the board, not just those being pulled out by Advocate, she said.
“The trauma designation being lost is just another symptom of the attrition of medical staff from that hospital,” Sharma said.
Many of the staff shortages alleged in the Illinois Department of Public Health letter were likely because a group that previously covered trauma surgery at the hospital mostly left in February, which was not related to Advocate Health’s pullout of its doctors, she said.
The Department of Public Health’s letter to Mercy Medical Center alleges that the hospital’s trauma surgeon was also covering general surgery from February until April 17, when the department’s investigation began. State code requires Level II Trauma Centers to have separate general and trauma surgery services, according to the letter.
A related allegation detailed in the letter said Mercy’s trauma center did not have a call schedule with at least one primary and one back-up surgeon, which is also required of Level II Trauma Centers under state code.
While the call schedules for March show there should have been 62 entries or shifts, trauma surgery invoices show only 41 entries or shifts, the letter said.
Mercy Medical Center also did not have orthopedic surgical services on call to arrive within 60 minutes as required of a Level II Trauma Center by state code from Feb. 1 to Feb. 3 and Feb. 10 to Feb. 28 as well as in the entire month of March, according to the letter’s allegations. On-call urologic surgical services were also missing from the hospital from Feb. 1–13, the letter alleges.
Advocate doctors used to provide orthopedic and urologic surgical services to Mercy Medical Center before they were pulled out, Sharma told The Beacon-News. She said Mercy was in talks with other groups to fill those gaps, and a hospital spokesperson has said the gaps left by Advocate are now filled.
The Illinois Department of Public Health’s investigation into Mercy Medical Center’s Level II Trauma Center designation began after the hospital told the department that it would be on “limited resource status” from 7 a.m. on April 17 to 7 p.m. on April 18 because it did not have a trauma surgeon to cover the primary call and its back-up surgeon was also not able to cover primary call, according to the department’s letter.
That day, the department requested documents about the hospital’s surgeon call schedule from February through April along with policies, procedures and other documents that would help the department determine whether the hospital’s decision to divert trauma patients to other hospitals was reasonable, the letter said.
In addition to the other allegations, the letter alleges that the hospital failed to show this decision was reasonable, since the trauma surgeon schedule showed both a primary and a back-up surgeon for April 17.
Plus, the hospital’s Emergency Department Diversion Policy did not include staff shortage as a basis for diverting trauma patients to other hospitals, the letter alleged.
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