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More patients have been heading to the emergency room in San Benito County, driven by the lack of options and a growing population.
ER visits have gone up every year since 2018, and 2025 was another record year with more than 28,000 visits, according to BenitoLink’s analysis of Hazel Hawkins Memorial Hospital’s utilization reports from the California Department of Health Care Access and Information.
For every 1,000 San Benito County residents, Hazel Hawkins logged around 401 ER visits in 2025.
CHART: See yearly ER visits at Hazel Hawkins Memorial Hospital
“We are the only game in town and our town has been growing,” Hazel Hawkin CEO Mary Casillas said.
From 2019 through 2025, ER visits at Hazel Hawkins went up 31%, versus 4% in California overall, according to BenitoLink’s analysis. Over the same period, San Benito County’s population increased nearly 12%, versus the state’s population decline of less than 1%.
“We have trauma pretty close to daily, whether that is car accidents, or farming accidents, or ranching accidents,” Casillas said. “We certainly see a lot of trauma that you may not see at other smaller hospitals.”
More recently, the ER has had to keep more patients overnight and mental health cases have increased, she said. The ER can be a financial strain on the hospital, she said, in part because some patients no longer qualify for Medi-Cal. Still, she said ER costs have come in under budget and she expects visits to be flat in 2026.
“The ER is one of the most resource-intensive units in the hospital,” Casillas said.
Lack of care
One of the biggest reasons the ER has had more traffic is the shortage of primary care providers. A community health survey found residents viewed primary care as the top priority this year.
Casillas said the ER is often taking a lot of the county’s “lower acuity patients,” people who could have been treated at a primary care or urgent care clinic.
There were only 21 primary care doctors in San Benito County in 2023, the most recent year of data available, according to the Health Resources and Services Administration.
The shortage is seen in how many San Benito County residents there are compared with primary care doctors. In 2023, there was one primary care doctor for every 3,246 county residents, a ratio that greatly exceeded the neighboring counties of Fresno, Merced, Monterey, Santa Clara and Santa Cruz.
Urgent care is in short supply, too. There are only two urgent care clinics in the county: Hollister Urgent Care, which opened in 2025, and Agile Occupational Medicine’s Hollister center, formerly known as Pinnacle HealthCare.
“If you’re in a larger community, you’re going to have urgent cares, sometimes on every other corner,” Casillas said. “We don’t have that here.”
Kimberly Hill, co-owner of Hollister Urgent Care, declined to be interviewed for this article. Peter Murray, chief executive of Agile Occupational Medicine, which merged with Pinnacle HealthCare in 2023, didn’t respond to requests for comment.
‘Crisis’ in the ER
Workers have also been under pressure. ER visits have gone up during a “chronic staffing crisis,” said Ariahnna Sanchez, a nurse who has worked at Hazel Hawkins’s ER for over 13 years.
Staffing hasn’t increased to meet the higher workload, she said. At times, patients have to wait hours before receiving treatment.
“Some people have to wait longer because of the amount of sick people we have to treat,” she said.
Sanchez said the ER is overly reliant on traveling nurses who work on short-term contracts, typically two to three months. Of the 17 traveling nurses at Hazel Hawkins, nine work in the ER, she said.
Traveling nurses aren’t as familiar with the ER, its protocols or the county’s residents, Sanchez said. As a result, charge nurses like Sanchez, who help run day-to-day operations, aren’t able to take breaks and often have to care for patients instead of tending to their other responsibilities.
“It’s a huge burden,” she said.
Dr. Michael Bogey, who is in charge of the Hazel Hawkins ER, wasn’t available for an interview. Mohammad Al-Hasan, a local doctor who works in the ER, didn’t respond to requests for comment.
Sanchez said the staffing situation worsened when full-time nurses quit over the loss of benefits following the hospital’s bankruptcy petition in 2023. A judge dismissed the bankruptcy petition in 2024, saying there wasn’t evidence of insolvency, and the hospital lost its appeal of the court’s ruling.
This year, Casillas said Hazel Hawkins has enjoyed a turnaround in its finances. The hospital brought on a recruiter in February and is now looking to hire full-time ER nurses. It’s also working with the nurses union to create a hiring pipeline through graduate nursing programs.
A new union contract could draw more nurses, too.
In May, the National Union of Healthcare Workers secured a 4-year contract, which restored paid time off and gave its members a year of retroactive pay, among other agreements. Sanchez said she is hopeful that the new contract will shore up the hospital’s staffing.
“We hopefully have a way out of the crisis,” she said.
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