Hospitals across California are reeling from the effects of the economic downturn and the troubled financial markets. When these hospitals need working capital the most, the credit markets are all but frozen. And in California, low Medi-Cal reimbursements for poor patients and the state budget crisis are making matters worse. The latest complications follow a dozen years during which more than 70 hospitals closed in California, and there is concern that some may not pull through this downturn.