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 People wave signs on Monday in favor of keeping the San Clemente hospital’s emergency rooms open. Photo: Eric Heinz
People wave signs in favor of keeping the San Clemente hospital’s emergency rooms open in September in front of Saddleback Memorial Medical Center. File Photo: Eric Heinz

By Eric Heinz

Since the beginning of the prospect that San Clemente’s Saddleback Memorial Medical Center might discontinue its emergency services, one particular organization has continuously gathered support to keep it open.

In the wake of the upcoming decision by the hospital, the nonprofit Save San Clemente Hospital Foundation, or SOS, has petitioned the hospital to maintain its emergency services.

Four members representing SOS, Dr. Gus Gialamas, a private-practice orthopedic surgeon who works under Saddleback in San Clemente and Mission Hospital; Mike Clark, an ad hoc committee member appointed by the city of San Clemente to examine the hospital’s potential closure; and private-practice physicians Dr. Steve Cullen and Dr. Nick Karahalios, said they would like MemorialCare to either continue to provide the services or sell the land to another medical provider that would.

Followed by the city’s rezoning of the hospital to require the land on which it sits to provide emergency services, hospital officials have said there is nothing that could legally bind them to keeping the campus’ ER open.

MemorialCare officials said they would pursue all legal options to protect their property rights because the zoning ordinance is too restrictive to allow for alternative options to provide health care.

“What’s transpired since this thing began is everyone has said we need emergency medical services here; nobody disagrees with that,” Clark said.

SOS members are also frustrated by what they claim is MemorialCare’s inability to discuss the issues with them. They said there have been few, if any, meetings between the foundation and the San Clemente hospital’s administration.

According to documents administered by the California Attorney General, the Saddleback campus in San Clemente is designated as a “public benefit,” which SOS members said binds them to providing emergency care.

The hospital is a private nonprofit, and according to documents from the MemorialCare website, SOS members also said they think the hospital has not been utilizing its revenue in the most efficient way, citing not enough has been spent on capital and equipment, education, research and community benefit programs.

The members also said many of the amenities once provided at the San Clemente campus have been moved to MemorialCare’s Saddleback Laguna Hills campus.

Not only would the hospital’s closure affect immediate services in San Clemente, but Gialamas said it would hamper other hospitals.

“Those hospitals that are now going to take those 2,000 additional patients from San Clemente by ambulance … those patients are going to impact that hospital and all those patients who go to the Mission Viejo hospital,” Gialamas said. “It’s a domino effect in Orange County.”

Gialamas said San Clemente’s hospital was once a trauma center and has provided emergency services since it was built in 1978.

“I think there’s overwhelming support for emergency services, and we were hoping MemorialCare would see that and still be the hero,” he said. “We still think, even to this last minute, they still have an opportunity to be the hero and build a scaled-down hospital.”

MemorialCare’s argument to that has been the inpatient service, which has supported the lion’s share of medical costs, has dwindled to an infeasible census—due to the increase in separate outpatient locations that treat people and send them home rather than at the hospital—and cannot financially and adequately support the emergency services. SOS members said they think enough outpatient surgeries still come through the hospitals.

Cullen said because the hospital has reduced service ability, many of the patients have been transferred to the Laguna Hills campus, and census numbers are counted by discharged patients, not the ones initially admitted.

“We believe they have purposely driven down the census to justify the narrative that they want to sell,” Cullen said, adding it would benefit the hospital to do that in order to advocate creating a substantial outpatient facility.

What makes it difficult to quantify these claims is even though the Saddleback revenue is public record through IRS forms, the foundation is coupled with the Laguna Hills campus and they do not separate the two campuses’ finances, at least not on 990 forms.

Despite the controversy surrounding the hospital, the SOS members commended the hospital’s achievements and accolades. They cited the hospital being named as a top 5 percent facility with excellent physicians as judged by top medical examiners.

“We want MemorialCare to keep doing what they’re doing, but if they can’t keep the emergency services, then we think they should sell to someone who will,” Cullen said.

The SOS website can be found at

Editor’s note: See Page 8 of the San Clemente Times Feb. 4-10 issue to read a story on MemorialCare’s position on facilitating emergency services in San Clemente. 

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