All 386 beds at UCSD’s Hillcrest Hospital — which treats a major share of the county’s poor — would move and the facility would be shut down under a new expansion plan for UCSD Healthcare announced by university officials.

The long-range strategy, moving the Hillcrest beds to the university’s Thornton Hospital, has been met with criticism.

Detailed in the report, “A New Vision for Healthcare,” and approved by the UC Board of Regents, the plans were first publicly disseminated in response to a San Diego Union-Tribune public records request.

“The vision over the next 15 to 20 years is to consolidate both our hospitals into one hospital,” said UCSD Health Sciences Director of Communications Leslie Franz. “We want to expand our care to outpatient and emergency services. It will be better for our patients if we focus our hospital’s resources into one facility.”

Thornton Hospital will expand from its current 119 beds to 500 beds under the plan, according to the report. The university also plans to renovate Hillcrest Medical Center’s remaining outpatient and emergency services through the use of new medical technology.

“In the future, we want to provide sophisticated health care,” Franz said. “We will be able to treat patients without hospitalizing them, with the use of state-of-the-art technology.”

Although the plan will be implemented over 20 years, it has drawn criticism from other members of the health care community, especially UCSD competitor Scripps Health.

“It causes deep concerns, because UCSD bought the hospital from the county under the guise that it would provide medical care for the poor and underserved,” Scripps Health Director of Public Relations Don Stanziano said. “They are moving the hospital from central San Diego, where they can serve the poor, to La Jolla.”

The university’s hospitals now treat one-third of the county’s uninsured, but Scripps officials have said that the new plan to expand the Thornton Hospital is designed to court the wealthier patient base of La Jolla, a charge UCSD denies.

“UCSD will not diminish its commitment to providing medical care for the poor,” Franz said.

However, the university’s own report to the regents acknowledged the need for more affluent patients.

“Thornton Hospital contributes a more favorable patient payer mix to the system, with 88 percent of the hospital’s discharges either privately insured or Medicare patients,” the Union-Tribune quoted the document as stating. “Though it accounts for less than one-fourth of the [overall UCSD medical] system’s discharges, Thornton Hospital contributes nearly one-half of the system’s profit margin.”

Scripps has also said that the plan to develop the Hillcrest Medical Center into a free-standing emergency care center, with no adjacent hospital, is not legal under California law.

“That is not the standard of care. It is not even legal in California,” Stanziano said. “There will be no surgical correspondence. If someone goes there and needs to have emergency surgery or has a heart attack, they will have to be taken to La Jolla.”

However, the majority of the patients treated at the Hillcrest Medical Center are treated on an outpatient basis, according to UCSD Healthcare CEO Richard Liekweg.

“Eighty-five percent of the patients we see are outpatients,” Liekweg said.

In addition, the closing of UCSD Hillcrest Hospital will impact Scripps Mercy Hospital in Hillcrest, according to Stanziano.

“Scripps Mercy is time-challenged as it is,” Stanziano said. “There is already a wait in our emergency room. Now those patients will back up our hospital. Mercy Hospital is already at capacity.”

However, Liekweg said the hospital’s move would cause few problems, because the UCSD Medical Center treats patients from all over the county.

“Forty-five percent of the patients we see are from the North County region and another 9 percent are from East County,” Liekweg said.

The cost of rebuilding the 45-year-old UCSD Hillcrest Hospital was the impetus for restructuring the UCSD Medical Center, according to Liekweg. He also said that consolidating both hospitals will prove to be cost-effective because the Hillcrest hospital has serious seismic concerns.

“The benefit to consolidating our health care is first to improve the quality of our health care,” Liekweg said. “We think we can enhance the quality through consolidation. The second reason is the high cost: We have to duplicate and invest in two of everything for both hospitals.”

UCSD Healthcare is also one of the most profitable health care providers in the county and in the UC system.

“They are making money,” Stanziano said. “Scripps is a nonprofit organization. We rely on the philanthropy of the community.”

Although Stanziano said Scripps has a 2-percent profit margin, while the university’s profits total 7.8 percent, Liekweg said the university does not come out ahead.

“We target at a 6-percent profit margin, but after we invest in academics, it averages about 2 to 2.5 percent,” Liekweg said.