A group of state lawmakers from Greater Cleveland asked the city’s largest hospital system this week whether it would pause plans for a new high-level trauma center until an assessment could be completed to show whether the region needed it.
In a letter last week to the Cleveland Clinic CEO, lawmakers said they want to know what adding a third Level I trauma center to the city would mean for patient volumes at the other centers in town, whether the Cleveland Clinic has poached any trauma staff from other hospitals, and how the new center will be funded.
Rep. Bride Rose Sweeney said the group of 11 lawmakers decided to send the letter after hearing concerns from MetroHealth. The county’s public hospital has operated a Level I trauma center since 1992 and has publicly raised concerns about the Cleveland Clinic’s plans.
“We’re trying to suss out, is this just two hospital systems disagreeing on something?” Sweeney said, adding that the information requested will help lawmakers understand whether the new trauma center will help or hurt Northeast Ohio residents.
The 11 lawmakers asked for an independent, region-wide needs assessment but did not provide details in the letter about who would undertake the study or how. Sweeney and Ohio Sen. Nickie Antonio said in interviews that they hope the American College of Surgeons, the national organization that accredits trauma centers, could undertake the assessment at the request of the governor.
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Trauma centers are a special part of an emergency department in which a team of doctors, surgeons and nurses is available 24/7 to respond to the most critical injuries, such as people who were in car crashes or shot.
Three people who signed the letter – Sweeney, Antonio and Rep. Juanita Brent – said that they do not have enough information yet to oppose or support the Clinic’s trauma center. While some states have the power to accept or reject new trauma centers, Ohio largely cedes that power to the American College of Surgeons. The three lawmakers said that they are not currently preparing legislation to change that or the state’s trauma system.
Lawmakers asked the hospital to respond by April 10. A spokesperson with the Cleveland Clinic said it plans to respond to the letter. In previous meetings and press releases, the Clinic said the new trauma center will help limit patient transfers out of its hospital system, which it says is risky, and will add emergency care options for those in Northeast Ohio.
Antonio said they asked the Clinic to respond rapidly because they’d heard that trauma care at the Clinic could begin in coming months. Leaders at MetroHealth also stated Monday that the Clinic could potentially begin accepting trauma patients this summer.
Angela Kiska, executive director of public and media relations at the Cleveland Clinic, disputed that. If Cleveland Clinic’s main campus is granted provisional trauma center status, the hospital’s trauma center does not plan to “go live” until the first quarter of 2028, she wrote.
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Tense relations between Clinic and MetroHealth
The Clinic’s plans have sparked a tense back-and-forth with MetroHealth, whose CEO wrote in February that the plans were “reckless.” The hospital believes another trauma center is not needed and that adding one could dilute its own patient volumes. That could lead to worse patient outcomes, since trauma teams need to practice difficult procedures on a high number of patients, MetroHealth said.
A hospital has to admit 1,200 trauma patients annually to stay accredited by the American College of Surgeons. By that body’s standards, MetroHealth saw about 2,560 trauma patients last year, said Tina Nickell, the hospital’s director of acute care surgery programs, at a meeting MetroHealth held Monday with Cleveland city councilmembers. MetroHealth is worried there are not enough patients to add another trauma center.
But leaders of the Clinic’s new trauma center previously said they expect there to be enough trauma cases for the Clinic to meet the required metric.
They’ve also said that a new trauma center would improve patient care. Because its main campus is not currently a Level I trauma center, it has to transfer out more than 600 trauma patients a year to other hospital systems. Dr. Scott Steele, president of the Cleveland Clinic’s main campus, said in a meeting earlier this year that these transfers delay care and are “an opportunity for things to potentially go awry.”
At the same meeting, leaders at the Clinic pointed out that the number of people falling – a leading cause of trauma as the population ages – is contributing to the need for more care. Ohio’s Trauma Registry, which collects trauma data from hospitals, showed a 62% growth in traumatic falls in Cuyahoga County between 2018 and 2024.
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Clinic gets $50 million investment for trauma care
As the debate plays out, the Clinic scored a major donation for its future trauma care plans this week.
The Jack, Joseph and Morton Mandel Supporting Foundation – a major philanthropic organization – bolstered the Clinic’s plan this week with a $50 million investment, which will support the trauma center and improve emergency care access.
A press release said that the investment in trauma care would assist in upgrading facilities to include expanded treatment spaces, trauma resuscitation rooms, specialized equipment and clinical support areas.
The money will also help design an AI-powered “digital front door,” a tool to help patients find the right site for care based on medical need and location. That could include an online visit, urgent care, emergency care or trauma care, according to the press release. The hope is that the tool will shorten delays and congestion in emergency departments.
“With this grant, we are proud to support the efforts of the Cleveland Clinic to deepen their engagement with the surrounding neighborhoods,” said Mandel Foundation Board Chair Steve Hoffman in the press release.
Will Cleveland City Council weigh in?
MetroHealth also has the ears of some Cleveland City Council members, whose health committee toured the hospital’s trauma department Monday.
Council members, like state lawmakers, don’t have authority over the Clinic’s ability to open a new trauma center.
They could weigh in to support or oppose the new trauma center, though. Council Member Kris Harsh, a member of the committee who visited MetroHealth, said he doesn’t know whether that will happen. Instead, the tour left him wanting to hear from the city’s other two hospitals, the Cleveland Clinic and University Hospitals, which has a Level I trauma center and is certified for pediatric care.
The Cleveland Clinic was supposed to present its plans to Cleveland City Council about three weeks ago but had to cancel due to surgeries that its trauma leaders had scheduled, Kiska wrote in an email. Because the council is on summer recess from June to August, the Clinic plans to present to the Council about its trauma center in September, a spokesperson wrote in an email.
