UPDATE NO. 1, MARCH 9, 8:47 A.M.: San Clemente city officials, Save San Clemente Hospital Foundation members and others from San Clemente, Dana Point and San Juan Capistrano opposed to the closure of Saddleback Memorial Medical Center San Clemente are protesting in front of the facility at noon today. “If MemorialCare wants to abandon emergency services in the community, we need to fight that they stay open while stakeholders consider a possible sale to someone who does care about the community,” explains foundation leader Dr. Gus Gialamas. The hospital is at 654 Camino De Los Mares. How did the Mexican-in-Chief put it? Oh, yes: Go Go Go!

ORIGINAL POST, MARCH 3, 5:35 A.M.: MemorialCare Health System’s announcement Wednesday that its San Clemente hospital will close on May 31 was not exactly welcomed by the local physicians and residents who have been trying to save the 73-bed facility.

“Today, MemorialCare decided to fire their employees and close its hospital doors on our community, prioritizing financial profits over people,” said Dr. Gus Gialamas, founder of the Save San Clemente Hospital group. “With billions in their bank accounts, their board along with their high paid executives made this closure decision with zero input from the cities affected, including the doctors, nurses and more importantly their community.”

MemorialCare Health System, which also owns Saddleback Memorial Medical Center in Laguna Hills, Long Beach Memorial Medical Center and three other hospitals, cited declining patient numbers and legislative constraints as the cause of the closure of Saddleback Memorial Medical Center San Clemente.

Company officials previously unveiled plans to convert its San Clemente campus into a comprehensive outpatient facility with an urgent care center, but that idea ran into opposition from locals—including the San Clemente City Council—who want a full hospital to stay.

MemorialCare has not said what will now happen with the 6.6-acre site at 654 Camino de los Mares. Its shuttering leaves a nearly 40-mile gap in public emergency rooms between Tri-City Hospital in Oceanside and Mission Hospital in Mission Viejo.

“This closure decision will prove to be fatal for local residents who deserve access to emergency healthcare services,” Gialamas said. “This decision will directly affect mortality rates in our region and MemorialCare knows this but doesn’t care.”

He noted 12,000 people have signed petitions to save the hospital and four city councils have voted the same way.

In 2005, MemorialCare purchased what has been the only hospital in San Clemente for the past 40 years with promises to grow services, not diminish them, according to Gialamas.

The Orange County Register reported Saddleback Memorial Medical Center CEO Steve Geidt saying that same year, “The hospital runs very well, we need to take what it does well and make it stronger, make it bigger, improve its financial position.”

He was apparently onto something, according to Save San Clemente Hospital, which cites MemorialCare’s own reports showing they have more than $300 million in annual profits from their five hospital chain network, approximately $3 billion in reserves and a CEO who makes just under $2 million a year.

MemorialCare has something else: a board of directors with no representative from San Clemente.

“This move is another betrayal and abandonment of our community,” Gialamas says. “We plead with Congressman Issa, Senator Pat Bates, Assemblyman Bill Brough and Supervisor Lisa Bartlett to bring the stakeholders together to discuss a possible sale and transition for the hospital and ER.”

His group asks members of the community to don red shirts and come to the hospital and protest the closure at noon Wednesday, March 9.

Full announcement from Saddleback Memorial San Clemente:

Saddleback Memorial Medical Center announced today its plans to close its San Clemente campus on May 31.

Since August 2014, Saddleback Memorial has held hundreds of meetings with employees, physicians, local residents, businesses, community organizations and elected officials to share its vision for converting the San Clemente campus into a state-of-the-art ambulatory health care center. The new vision included advanced urgent care, several outpatient programs and space for primary care physicians and specialists to revitalize the property into what many call the “Health Care Campus of the Future.” The goal was to draw more physicians, patients and community members to the campus and become a health care destination for San Clemente and the surrounding communities.

As part of that vision, Saddleback Memorial worked with California State Senator Patricia Bates and Assemblyman Bill Brough on legislation that would have allowed Saddleback Memorial to include a Satellite Emergency Department on that campus as well.

Despite substantial efforts by a coalition of supporters, neither bill received enough votes in January to continue toward passage. The following week, the San Clemente City Council voted to rezone the San Clemente campus property to require hospital services.

Like many small hospitals across the country, the San Clemente inpatient facility has continued to experience declining volumes. The number of inpatients dropped to the low teens with many days in the single digits, and the number of inpatient surgeries to less than one a day.

Without legislation to allow a Satellite Emergency Department, and given this new restrictive rezoning that requires hospital services and a declining census that makes operation of an acute care facility unsustainable, the vision to convert the campus into a modern ambulatory care center cannot now be achieved.

“This is not a decision we reached quickly,” said Tony Struthers, Saddleback San Clemente administrator. “It is the result of many discussions and deliberations. This was not the outcome we had sought or expected. We had hoped the campus could be used to expand health care services in the community. We envisioned a new modern ambulatory center that would better meet the community’s future health care needs and transform the campus into a health care destination.”

With enormous advances in medicine and health care, patients are increasingly being cared for outside of hospitals in convenient, easily accessible and high quality outpatient facilities. Health insurers are increasingly requiring patients to receive care in the most convenient, cost-effective location that is most often provided in an outpatient center. Remaining inpatients are transitioning from small traditional facilities to regional hospital medical centers which provide the broadest range of tertiary services to care for all types of patient needs with the most advanced programs, services, technologies and techniques.

These trends have been experienced first-hand at the San Clemente campus and with a greater impact due to the facility’s already small volumes. Many small facilities across the country are vulnerable and at risk of closure as the nation’s health care delivery system continues to transform. A recent study by iVantage Health Analytics suggest that there are currently 673 small hospitals in 42 states vulnerable to closure, based on factors such as low patient volumes, quality indicators and financial performance.

“We are grateful to the dedicated employees at the San Clemente campus,” added Struthers. “We are working with our employees to identify opportunities within the health care system.”

Over the next months, Saddleback Memorial will be actively working with local agencies to thoughtfully plan for the best transition of services.

“We will continue to serve San Clemente and the greater community through our health centers, imaging facilities, breast centers, ambulatory surgery centers and dialysis centers in San Clemente and surrounding communities, as well as the Saddleback Memorial Laguna Hills campus,” said Struthers. “We are also exploring adding new urgent care services in San Clemente, and we remain committed to seeking ways to meet the growing demand for convenient, affordable, high quality health care.”