Cleveland’s trauma center debate, explained

Cleveland Clinic’s push to open a level 1 trauma center on its main campus — a plan critics say would strain the region’s trauma system — took a new turn June 10 as MetroHealth announced it will not seek reverification for its pediatric trauma designation, citing declining case volumes. Here’s what to know.

1. Cleveland Clinic announced plans in January to pursue level 1 verification with the American College of Surgeons and state regulators, with a target opening of 2028. If approved, it would become Cleveland’s third level 1 trauma center, alongside MetroHealth and University Hospitals. 
2. MetroHealth CEO Christine Alexander-Rager, MD, pushed back in February, arguing the region’s current trauma network is appropriately sized and that adding a third center would not support sufficient case volume needed to preserve clinical expertise and patient outcomes.
3. Cuyahoga County lawmakers sent a letter to Cleveland Clinic in March requesting more information on the proposal, including whether an additional level 1 center is needed, how it could affect volumes at existing providers and how the system plans to staff the facility amid workforce shortages. Lawmakers also urged the system to pause its effort pending an independent regional needs assessment.
4. Cleveland Clinic’s initial American College of Surgeons consultation for a provisional designation was scheduled for June 10. If granted, the system could begin seeing trauma patients under provisional operations as early as July, according to lawmakers. Cleveland Clinic has said it does not plan to open or operate as a trauma center in the summer and continues to target 2028.
5. On June 10, MetroHealth announced it will not seek reverification for its level 2 pediatric trauma center designation, citing a decline in pediatric trauma cases and a regional shortage of pediatric neurosurgeons. The system said it will stabilize and transfer pediatric trauma patients to UH Rainbow & Babies Children’s, the city’s only level 1 pediatric trauma center, as needed. “When pediatric trauma cases are declining and pediatric neurosurgeons are in critically short supply, concentrating that care at the region’s high-volume children’s center strengthens it. Spreading it thin would dilute it,” Dr. Alexander-Rager said.
6. MetroHealth will retain its level 1 adult trauma center designation, continue treating pediatric emergencies in its ED and remain a comprehensive burn care center for both children and adults. A system spokesperson said “in practice, almost nothing will change when it comes to how we provide emergency care for our youngest patients.”

Becker’s has reached out to Cleveland Clinic for an update on the June 10 American College of Surgeons consultation and will update this story if additional information is received.

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