Level I Trauma Centers 


The explosive growth in recent years has transformed the Rio Grande Valley from a sleepy, rural segment of the Lone Star State into a bustling and urbanized economic force.

While good on many levels, this subsequent urbanization revealed a critical healthcare void that could only be filled by adding a Level I Trauma Center to address critical emergencies such as gunshot and stab wounds, industrial or traffic accidents, and catastrophic injuries or illnesses.

The Valley has been fortunate to have two Level I Trauma Centers– Doctor’s Hospital-Renaissance (DHR) in Edinburg and South Texas Health Systems (STHS) in McAllen– since 2022.

But it didn’t happen overnight.

State lawmakers from the Valley have long recognized this need. In Nov. 2018, they took advantage of Governor Greg Abbott’s visit to Pharr when State Representative Terry Canales (D-Edinburg) hand-delivered a letter from the RGV delegation seeking support for funding to expand the state’s network of trauma hospitals.

For many years, patients who needed critical care for serious or catastrophic injuries at a Level I Trauma Center were often transported to University Hospital in San Antonio or Brooke Army Medical Center (BAMC) at nearby Fort Sam Houston and there were times those patients died en route.

However, that all changed in September 2021 when Doctor’s Hospital – Renaissance (DHR) in Edinburg became the first Level I Trauma Center in the Valley.

“Most hospitals follow a similar pattern,” said Dr. Jeffrey Skubic, DO, who serves as the Trauma Medical Director at DHR. “This hospital originally [1997] started out as a surgery center. They started by adding patient beds and an emergency room and over time they became the largest hospital in the Valley.”

In December 2022, STHS became the Rio Grande Valley’s second Level I Trauma Center.

Dr. John Hovorka, M.D., the Trauma medical director at STHS McAllen, said the pursuit of becoming a Level I Trauma Center aligns with the hospital’s trauma service mission of delivering optimal standards of trauma and critical care to the injured in the community.

“STHS McAllen was the first hospital in Hidalgo County designated as a Level II Trauma Center by the Texas Department of State Health Services, following its verification by the American College of Surgeons in October 2018,” Hovorka said. “But we didn’t stop there. It was our goal to level up; we’re proud to be one of only 22 facilities in Texas to meet the stringent.

Level I Trauma Center verification process of American College of Surgeons and the Texas Department of State Health Services.”

Hovorka adds that the essential goal of STHS McAllen’s Trauma Program is to improve the value of care provided to injured patients in the Valley.

“By having a Level I Trauma Center, we’ve been able to decrease the out-of-Valley transfers, and we’re fully capable of providing care to serve our ever-growing community,” he said. “As a Level I Trauma Center, we’re also able to provide important educational opportunities for medical residents in our mission to increase the number of physicians in the region.”

Most major cities in Texas have one or more Level One Trauma Centers. There are two in Austin, and two in San Antonio, while Houston has at least four. Dallas has eight Level I Trauma Centers, including nearby Fort Worth and smaller nearby communities.

The process that hospitals undertake to achieve Level I status can take years and cost millions in taxpayer dollars before hospitals seeking that designation are certified by the American College of Surgeons and the state’s department of health.

Trauma centers in Texas with a level three or four designation are only certified by their state and cannot treat serious injuries. Examples of Level III and IV Trauma Centers in the Valley include Rio Grande Regional Hospital in McAllen, Knapp Medical Center in Weslaco, and Harlingen Medical Center.

According to the Texas Department of State Health Services, 302 hospitals in the state are designated as trauma facilities.

The level one designation is based on certain criteria, some of which include the level of medical and surgical expertise available 24/7 to treat critical or life-threatening injuries, the availability of practitioners such as orthopedic surgeons and neurosurgeons, and among others, acts as a teaching facility to improve trauma care.

“When you’re a level one hospital, you are beyond the clinical capabilities. You are a teaching hospital, and you have residents and fellows,” Skubic said. “You’re doing injury outreach prevention in your community, you are training EMS providers in your region, and you contribute to academic research. You’re not only practicing a high level of trauma surgery, you are on the cutting edge of defining how to take care of those patients.”

Bryan Kirk