San Mateo County’s public hospital says it will have to start turning some patients away in an attempt to fill a $5 million budget hole.

The San Mateo Medical Center, mandated with serving the county’s poorest residents, has a capacity of about 70 patients in its acute care and intensive care units.

But the financially-strapped medical center may have to “cap” the number of patients it accepts into the unit, said county Supervisor Jerry Hill, who chairs the hospital’s board of directors.

Once the hospital reaches that cap, patients will be turned away, some sent to other hospitals. Others will be diverted to lower level care facilities, he said.

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The average number of people staying in the hospital in January was 47, but Hill said the cap could be in the 30s.

The medical center treats hundreds of thousands of patients a year in its primary hospital and the dozen clinics around the county under its umbrella. Medical center spokesman Dave Hook said the hospital cares for most of the county’s medically indigent, and about half of its patients are on Medi-Cal, the public health insurance program for low-income people.

In December, the medical center realized it would overshoot its $232 million budget by $5 million. The shortfall is partly due to a new labor contract and an unusually high number of patients, Hook said.

To save money, the hospital has encouraged staff to use as few supplies as safely possible.

Hill insisted that the hospital will be able to maintain quality of care despite becoming “more efficient.” He said patients who have been admitted into the acute care unite but cannot be released will be shifted to a long-term facility, a less expensive option, he said.

But budget problems are likely to get much more serious in the next fiscal year, said Melissa Stafford Jones, CEO of the California Association of Public Hospitals, because the governor has proposed a 10 percent cut in Medi-Cal reimbursements. About half of the center’s funding comes from Medi-Cal, Hook said.

“Public hospitals make up just 6 percent of the state’s hospitals but provide 50 percent of hospital care to the uninsured,” Jones said. “It’s very unfortunate that when the programs are needed the most, that’s when those programs are cut.”

kworth@examiner.com