Southwest also plans to build Temeculas first hospital.Citing Southwests problems with its existing facilities, state officials have not allowed the opening of a $53 million Rancho Springs expansion that includes a bigger emergency room and the regions first neonatal intensive-care unit.Even with Loma Linda University Medical Centers Murrieta hospital opening early next year, local officials have said the region will still need Southwest hospitals to provide adequate health care coverage.hope she was availableSince June 2007, state inspectors have written seven reports on Rancho Springs and Inland Valley.In most cases, they were working on behalf of Medicare. On three visits, inspectors found patients needing intensive care in general acute care beds at Inland Valley.In June 2008, an intensive-care nurse told inspectors that in case of an emergency the medications and supplies in a satellite intensive-care unit werent like those in the regular unit “and the nurses were not ICU trained, so she would call for the ICU charge nurse and hope she was available. “The satellite unit often had only one registered nurse, while state regulations called for at least two nursing personnel in intensive-care units, the accusation read.While patients undergoing vascular or spinal fusion surgeries routinely needed to stay in intensive care afterward, nurses told inspectors those surgeries took place even if an intensive-care bed wasnt guaranteed.Responding to inspectors, Southwest said intensive-care-trained nurses were assigned to intensive care patients wherever they were housed.Universal Group Vice President Frank Lopez said that, in the past month, Southwest has hired 30 specialty nurses, including those trained in intensive care.a daily impedimentAnother part of the accusation dealt with the use of a voluntary on-call system for specialists treating emergency-room patients.In April 2007, a senior hospital official told inspectors many doctors “had expressed that being on call had become very intense,” with doctors often canceling next-day patient appointments to catch up on rest.At one point, 80 percent of the medical staff said they wouldnt agree to be on call for the ER “without some sort of reimbursement in the form of a stipend,” the accusation read.In e-mails last week, Southwest spokeswoman Teresa Fleege said a voluntary on-call system remains in place.

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