The hospital providing emergency room services to West Contra Costa's neediest patients is on life support, and without outside financial help, it won't survive past the spring.
It's time for Doctors Medical Center officials to begin preparing for what seems an inevitable shutdown. It's time for Kaiser to brace for an onslaught of emergency patients at its Richmond facility.
It's time for leaders at John Muir Health, officially a nonprofit organization, to look in the mirror and ask how they can live with themselves.
John Muir's Walnut Creek facility holds the lucrative contract as the county's designated trauma center. With that should come a social responsibility to help more-needy portions of the county.
Absent a bailout, Doctors will run out of cash sometime between March and May, current projections show. No one should be surprised by this.
In 2011, the West Contra Costa Healthcare District, which operates the hospital, sought and received voter approval for a $47-per-house tax increase.
We backed Measure J, but warned that district and hospital officials needed to move quickly to restructure the operation and find a way to keep it going. Back then, it was clear that, even with the tax money, the district would go broke in 2014.
The projection then was this summer. Declining hospital inpatient volume has shortened its life expectancy a few months. But emergency room visits have not declined. And that should be great cause for concern.
The inpatient visits will probably be absorbed by nearby hospitals in a somewhat orderly manner. But the lack of an emergency room at Doctors will create a chaotic situation. Most residents in distress will go to the next-nearest facility.
Kaiser, which is not designed to take in patients who are not enrolled in one of its plans, will have no choice but to provide care to all emergency patients showing up at its door. That's the law.
To a lesser extent, Sutter's Alta Bates Summit Medical Center in Berkeley is in the same boat. So, while John Muir has a moral obligation to assist, it's in Kaiser's and Sutter's financial interests to help out, too.
Whatever aid they do provide would probably be only stopgap. In which case Doctors Medical Center cannot continue on its own. That's clear. It must find a new permanent source of funding or a larger hospital to absorb it. Given Doctors' high level of uninsured and poorly insured patients, that will not be easy.
But without emergency resuscitation, death is certain. It's only a matter of time.