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No. CV 03 2008FMC(PJWx) (C.D.Cal.), filed March 12, 2003 

Updated: August 25, 2006

Issue: Whether the County of Los Angeles, under state law and the Medicare and Medicaid statutes, may close a rehabilitation hospital and eliminate 100 beds from another public hospital.

Relief Sought: A preliminary and permanent injunction prohibiting the County from reducing the hospital services available to the County's uninsured citizens.

After the complaint was filed in state Superior Court, the County removed the case to federal court and plaintiffs dismissed the State defendants.  Plaintiffs' motion for a preliminary injunction to keep the hospitals open was fully briefed as of May 2, 2003, and the motion was scheduled for argument on May 12, 2003.  At the request of counsel for the plaintiffs, attorneys from the Center for Medicare Advocacy joined the litigation team in April.

On June 3, 2003, a federal judge in Los Angeles preliminarily enjoined the County of Los Angeles from making the proposed closing and cut.  After oral argument, the Court of Appeals affirmed the district court's preliminary injunction. 366 F.3d 754 (9th Cir. 2004).  The Court reiterated the deferential standards applicable to appellate review of a preliminary injunction.  It then applied the traditional three-part test to establish plaintiffs' standing, determining that they had met the "actual injury requirement" by establishing the risk or threat of injury.  It also determined that there was a likelihood of success on the merits in both plaintiffs' state law and Medicaid claims regarding discharge requirements.  Finally, the Court reiterated that, when there is a conflict between financial concerns and preventable human suffering, the balance of hardships invariably tips in plaintiffs' favor.

After extensive negotiations, the parties settled and the complaint was dismissed.  The settlement guarantees that the County will maintain substantially the same number of hospital beds for the next few years.

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