A law requires them to do so by 2013, but if an earthquake were to happen today, 825 structures that patients use statewide would not withstand a major earthquake.
"There are significant collapse probabilities of hospital buildings in the state of California," said David Carlisle, MD, Ph.D., Office of Statewide Health Planning and Development.
Approximately 250 hospitals, mostly in earthquake-prone urban areas, will not even make the deadline at all, a deadline that has now been extended four times for certain facilities since 2008.
"There are going to be a lot, both in L.A. and my area, the Bay Area, where buildings have not been retrofitted and they're not going to be a safe place to be, and people will die," said state Senator Elaine Kontominas Alquist (D-San Jose), Senate Health Committee chairwoman.
Many hospitals are opting to build brand new facilities instead because retrofitting isn't that much cheaper.
But those struggling say the financial burden of either way is too much. Los Angeles County's Downey Regional Medical Center, for instance, can't even get a loan in this credit market to retrofit.
"Downey Regional unfortunately finds itself in bankruptcy court right now because of the downturn in the hospital business has eroded margins," said Rob Fuller, executive vice president and chief operating officer, Downey Regional Medical Center.
Hospitals in such dire straits can only hope in another extension from lawmakers. Without the extension, hospitals that don't meet the deadline could be forced to shut down.
That could mean some California residents will have to drive farther to go to a hospital.