Kern Medical Center has a new name. But that's actually the smallest change the venerable public hospital is set to undertake in the next year. After being run by Kern County for over a century, the hospital - now branded simply as "Kern Medical" - will be spun off later this year to a newly created, independent hospital authority.
Kern Medical CEO Russell Judd says the new name reflects a new era for the nearly 150 year-old institution.
Judd: "This is a symbolic way of us communicating and telling the world we've taken that next step, that we're something new we are something different, we're providing a higher level of service, while we're still the safety net care provider."
The next step that Judd mentions has been two years in the making. As of July 1, 2016 the new state-authorized board, the Kern County Hospital Authority, will take control of the facility, meaning financial and operational independence.
The county will still remain a player in the hospital's operations, as it will contract with Kern Medical to provide health care services to medically indigent adults as required by state law. And county supervisors will be responsible for appointing members to the new board of governors. But Kern County will no longer be responsible for the hospital's operations or finances.
Judd: "As we step into the Authority, the burden of an unsuccessful hospital will no longer sit on the taxpayers back. Other than this obligation to cover the medically indigent adults, no dollars from the general fund will be used to operate the hospital."
That's a big step for Kern Medical. Just two years ago the financially troubled hospital required a major bailout from Kern County taxpayers, as it was losing as much as $3 million a month. While Judd says those days are in the past, he claims being independent will make Kern Medical more nimble and more financially sound.
Judd: "Stepping away from the county does free us up from some of the bureaucracies that exist in county government that are very appropriate for the typical county department."
He says more efficient operations are a big part of the plan.
Judd: "Our budget is just under $300 million a year, and the county this year is contributing under $7 million of that, but to then put all of those bureaucracies - the civil service, the procurement, so many of those governmental processes on the back of the hospital, really handcuffed us a little bit."
The move comes as safety net hospitals throughout the state are facing an era of dramatic change. With the expansion of Medi-Cal and the creation of the private insurance exchange under the Affordable Care Act, many residents who previously relied on hospitals like KMC for care now have new choices on the open market. It's also changed the way the state directs money to these hospitals. Judd says Kern Medical has already seen a shift in the types of services used by patients.
Judd: "We've had extreme growth in our outpatient clinic visits or our doctor office visits. That's the best place for health care to be provided, in the doctors office and not in the emergency department. So thankfully we've seen a decrease in the non-emergent cases in our emergency department, and now with them having the ability to pay, they come more often to our clinics."
But even with the Affordable Care Act, many are still without coverage, specifically undocumented immigrants, who aren't eligible for Medi-Cal or Covered California plans. According to a report from USC's Center for the Study of Immigrant Integration, the county has around 68,000 undocumented residents, or 8 percent of the county's total population. But getting the county and the hospital to agree on a number for that population, and how much the county will contribute to pay for their care, is a sticking point.
Judd: "Literally, as we're in negotiations with the county, that's the million dollar question that we have. We don't have that number. The big moving target in this is the undocumented. It's a transient society when they're here in our community. We're here to provide care for them. Capturing that real number is a very difficult [thing], and we don't have a real handle yet on what that population number is."
Still Judd insists that the new Kern Medical will retain it's role of providing safety net care, as well as trauma and other advanced care that other hospitals in the area don't provide. He adds that while the new environment in health care has the hospital facing a newly competitive environment, Kern Medical isn't attempting to compete with mainline hospitals.
Judd: "We're not out there trying to take the typical community hospital patient away from the other health care providers in the community."