By Stacie Sasso

The Southern Nevada Health District is reviewing five applications from Las Vegas Valley hospitals, all requesting low-level trauma center designations even though no new trauma capacity need has been identified. This is a replay of 2016, which was recognized as a ploy to boost hospital profits. Once a hospital has a trauma designation, it can charge thousands of dollars in activation fees for the same care seen in the same emergency room (E.R.) now.

The tragic events of October 1, 2017 proved that we have enough care, as the highest level trauma center in Las Vegas was never over capacity. But there are problems that remain from 1 October – the survivors now struggling with mounting medical debt from those activation fees, charged in addition to other emergency room charges for low-level care.

There is a misconception that having a trauma center in your neighborhood will get you faster, better care. In fact, if your injuries are more severe than an E.R. (with or without a level III trauma designation) can treat, you will be transferred to an actual trauma facility, where you should have gone in the first place.

Currently, there are three trauma centers in the valley – a Level I for the most urgent, life-threatening care; a Level II for definitive care for all injured patients; and a Level III, which sends more severe trauma patients to other hospitals. There are also at least another 20 emergency rooms and more are planned. With no trauma care shortage risk identified to date in our community, what is at risk is too many centers wanting the profits created by trauma designation.

The result will be that patients will either be taken to a low level trauma facility and treated as they would during an E.R. visit, but charged much more, or they will be taken to a low level trauma facility and have to be transferred to a high level trauma facility. (There is no significant investment in hospital personnel, equipment or construction that is required to have the trauma center designation.)

The American College of Surgeons, the leading authority on trauma systems, urges trauma center allocation to be based on unmet need, not on the needs of powerful hospital companies from out of state that are interested in economic advantage in Nevada. This is now completely in the hands of the Board of Health.

Our coalition fights for better, more affordable health care every day. On behalf of the more than 280,000 lives our coalition represents, we advocate for smart growth based on solid data and community need. We oppose a rushed process that does not allow the public or the professionals to fully evaluate the proposals, system need, and the impact of approvals on existing trauma centers.

In 2016, the Board of Health was directed to complete a needs assessment of what trauma capacity need exists in the entire community before new capacity is developed that will harm the existing system. Why hasn’t the Health District staff completed the needs assessment? A letter-writing campaign, as is currently being pursued with vigor by these hospitals, should not be a substitute for capacity-building.

Each new designation takes patients from existing trauma centers, affecting them financially and reducing their patient volume. Oversaturation damages our existing system. Studies show that trauma centers need certain levels of patient volume for health care providers to develop their expertise and assure quality health care outcomes.

Past poor political decisions resulting in unneeded trauma care and increased costs for patients should not be repeated. There is no evidence that Las Vegas has a shortage of trauma care. Any new designations must be based on identified need in the trauma system.

The Health District’s Regional Trauma Advisory Board and Board of Health should be required to review and recommend any applications only after a trauma care shortage has been identified through a system-wide assessment. That has not happened.

Stacie Sasso is executive director of the Health Services Coalition, which includes major casinos, unions and local governments.