MURRIETA -- A history of violations at two local hospitals operated by Southwest Healthcare System has caused the state to deny Rancho Springs Medical Center's application to open a new emergency room and women's center in Murrieta.

Lorraine Sosa, the Riverside district administrator for the California Department of Public Health, denied the application in a letter dated Feb. 25, saying "the facilities have a prolonged history of noncompliance with applicable statutes and regulations that escalated in 2008 and continues."

The department is responsible for inspecting hospitals throughout the state.

The Murrieta hospital completed work in late January on a $53 million, 72,000-square-foot building designed to replace the current emergency room and expand the services it offers to women. In January, administrators said they were excited about the expansion and eager to open the facilities to patients -- they were just waiting on state approval.

Two of the area's three hospitals -- Rancho Springs and Inland Valley Medical Center in Murrieta -- are operated by Southwest Healthcare System.

In a written statement, Southwest Health Care said they hoped to resolve the issue quickly and open the new facility soon.

"We feel that some of the concerns identified by the State would be resolved by the licensing and opening of the $53 million expansion at Rancho Springs Medical Center," spokeswoman Teresa Fleege was quoted as saying in a prepared statement e-mailed to The Californian. "The survey and plan of correction process can be lengthy, we look forward to completely resolving this matter."

Riverside County is already drastically short on hospital beds to serve the population. While the nation maintains an average of one hospital bed per every 370 people, Riverside County's ratio is far lower, at one bed per every 1,000 residents, the Riverside County Department of Public Health estimates. The shortfall is expected to continue as the county grows, leaving professionals in the health care industry to believe that the county will be short 1,400 hospital beds by 2020.

State officials say the health care provider's continuing history of violations has tied their hands, however, because federal law requires that the department deny a provider's application if the provider is not in compliance with laws and regulations.

Citing four conditions and more than a dozen standards the hospital has still not met after a July 2008 visit by state officials, department spokesman Ralph Montano said Thursday the hospital must bring its current services in line with expectations before another building can be opened.

"The Health and Safety code requires the (health care) provider to demonstrate satisfactory evidence of its ability to comply with the law," Montano said. "This provider has thus far demonstrated a disregard for patient safety and the statutory and regulatory provisions meant to afford patient safety."

Monaton did not provide details of the violations cited in the application's rejection. But he pointed to a history of citations issued to the health care provider dating to 2005, including a $25,000 fine issued to the health care provider in mid-2007 for failing to provide "adequate" on-call physicians at emergency rooms in both of the hospitals earlier that year.

But the crux of the problem, Montano said, is an issue of space and available beds -- a problem hospital administrators hoped the new emergency room would alleviate.

Southwest Healthcare System's plan was to convert the current emergency room to accommodate scanning services, and move all emergency services into the new building next door.

The new emergency room contains 27 treatment bays, each separated by walls. The current emergency room has only eight treatment bays, and those are separated by curtains.

Upstairs sits an expanded Women's Center with the first intensive care unit for infants in Southwest County. Currently, ailing infants are transferred to Riverside or Loma Linda for treatment.

Twenty-four private post-partum rooms, a nursery, a birthing center, a private sleeping room for parents and two Cesarean section surgery suites round out the digs.

The new building is part of a broader expansion that continues farther north in Wildomar.

At Inland Valley Medical Center, work continues on an 85,000-square-foot expansion to include an emergency room with an intensive care unit, and a cardiac unit where diagnostics, bypass and other heart surgeries will be performed. Those expansions are expected to be complete by the end of summer.

Contact staff writer Nelsy Rodriguez at (951) 676-4315, Ext. 2626, or nrodriguez@californian.com.