All but two of 21 hospitals that were notified earlier this year that time was running out to become part of a new state-wide trauma system have since had site visits or scheduled them, state health officials said Thursday.

In late June, the Arkansas Department of Health said it was preparing letters to send to 20 hospitals July 1 as a reminder to schedule state reviews within six months for admittance into the trauma network.

Another letter had already been sent to Northwest Medical Center-Springdale telling the hospital that it had failed a previous site review. At the time, it was the only hospital to fail, officials said. The Health Department has declined to say why the hospital failed.

Hospitals that join the trauma system are rated in terms of their capabilities for handling trauma cases. The Springdale hospital was seeking a Level III designation on a scale ranging from Level I to Level IV.

Hospitals that don’t end up joining the trauma network will no longer receive referrals from a state-wide call center in Little Rock and will be ineligible for trauma system funding, the department’s branch chief for injury prevention, BillTemple, has said.

The call center’s dispatchers use an electronic dashboard to direct ambulances carrying trauma patients to the nearest, most capable and least-busy hospital emergency room that is available.

Previously, the state had no system for rating hospitals on the basis of their ability to provide trauma care.

By Thursday, the vast majority of hospitals receiving the July 1 letter had received a site visit or had notified the Health Department of the wish to schedule one, said a department spokesman Kerry Krell.

“All of the hospitals are scheduled between now and the end of March - except for Northwest Medical Center in Springdale,” Krell said Thursday. “However, there are plans for it to be scheduled.”

The other exception is National Park Medical Center in Hot Springs, which decided to discontinue its pursuit, Krell said.

Northwest Medical Center spokesman Pat Driscoll said in a message that the hospital expects a site visit in the first quarter of 2013. She did not return later phone messages seeking more details.

Back in June, state health officials said that 18 of the 20 hospitals receiving the July 1 warning letters were seeking Level IV trauma designations, the lowest level. They included Physicians’ Specialty Hospital in Fayetteville as well as hospitals in Harrison and Siloam Springs.

The remaining two - Sparks Regional Medical Center in Fort Smith andSt. Bernards Medical Center in Jonesboro - have since become Level III trauma centers.

In all, 59 hospitals had been designated as trauma centers for the Arkansas network by Dec. 17. The state’s list can be found by logging on to: www.healthy.arkansas.gov/programsServices/ injuryPreventionControl/ TraumaticSystems/Pages/ DesignatedTraumaCenters. aspx.

Level I and Level II hospitals offer the most comprehensive trauma care and have the most rapid response capabilities, with the primary difference being that Level I centers have more research and educational capabilities.

Arkansas’ two teaching hospitals - the University of Arkansas for Medical Sciences and Arkansas Children’s Hospital, both in Little Rock - are among five designated as Level I centers in Arkansas’ network. The others are Mercy Hospital Springfield in Springfield, Mo., and the Regional Medical Center and Le Bonheur Children’s Hospital, both in Memphis.

The five hospitals thus far designated as Level II centers are Baptist Health Medical Center and St. Vincent Infirmary Medical Center, both in Little Rock; Washington Regional Medical Center in Fayetteville; Jefferson Regional Medical Center in Pine Bluff; and Mercy Hospital Hot Springs, according to the state’s list.

Nineteen hospitals have been designated Level III, and there are 30 Level IVs.

By midyear, 76 of the 82 hospitals in or near Arkansas that were eligible to apply for the Arkansas network had done so, the state said then, with 55 having received their requested designations.

Northwest Arkansas, Pages 9 on 12/21/2012