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With Measure H Approval, A New Era Begins For Tulare Regional Medical Center

Nov 13, 2018

About a month ago, in mid-October, Tulare Regional Medical Center was in the middle of a makeover. In less than a week, it was due to reopen, after closing abruptly a year earlier due to mismanagement. New pavement was still drying and workers in forklifts were painting the whole building a uniform beige.

Inside, beds were full of patients—fake patients. Doctors and nurses were running mock drills in the emergency room. “We've tested your blood sugar, and it's going to be in the lab results,” lulled nurse Rick Albert to another nurse, who was pretending to be a car crash victim named Jane. “So just breathe deeply, Jane. Relax the pain away.”

Nurse Charlene Dawson drops in on doctors and nurses posing as patients during mock emergency drills a few days before the hospital's reopening.
Credit Kerry Klein / Valley Public Radio

Albert and “Jane” were having some fun, but they knew these drills were serious. They’re a chance to test emergency responses, as well as equipment and procedures.

They were practicing because they had to be ready for patients just a few days later, on October 15, when Tulare Regional finally reopened. Then, last week, voters overwhelmingly supported Measure H, which will keep the hospital running under a new contract for up to 30 years.

We’re taking you to Tulare Regional because it’s an example of what happens when a rural area is waiting for a local hospital. Just a few months earlier, this place had been a ghost town. Only a skeleton crew was here, keeping the lights on and waiting for the day they could see patients again.

One of those workers was nurse Charlene Dawson. “I was part of the staff that was here when it closed,” she says. “That was a very very sad day for all of us who work here, for this whole community. It was incredibly painful and very surreal.”

Dawson, who's worked for Tulare Regional for over a decade, is director of the hospital's emergency department and intensive care unit.
Credit Kerry Klein / Valley Public Radio

Dawson is the director of the hospital’s emergency department and intensive care unit. She says there’s no question residents here in the City of Tulare need a hospital. “Many of them have a lot of challenges, socioeconomic challenges, that make it very difficult for them to go to Visalia or go to Porterville to receive their care,” she says.

But that’s exactly what patients had to do for a year. Each day the hospital was closed, around 80 emergency patients had to go elsewhere—mostly to Kaweah Delta Medical Center in Visalia, which at one point this past winter set up two tents in its parking lot as a makeshift waiting room.

Ambulances, too, felt the impact of the hospital’s closure. “It's affected our whole county, it's affected all of the ambulance companies,” says Jackie Paull, Vice President of Life Star Ambulance in Tulare. Paramedics had to drive further and wait longer with their patients. “With our ambulances always going out of town, then the other companies have to come in and help cover our area,” she says.

The hospital had been mired in mismanagement and scandal for years. Its former governing board made a lot of bad decisions, and the company managing it eventually drove its finances into the ground. The board decided the only way to revive the hospital was to declare bankruptcy and shut it down.

Dawson says the day Tulare Regional closed in October of 2017 was "incredibly painful and very surreal," but she was optimistic the hospital would open again within a year.
Credit Kerry Klein / Valley Public Radio

Larry Blitz is a crisis manager who took over as interim CEO while the hospital was closed. “Over my 40 years of managing hospitals and healthcare facilities, I had never seen anything so complicated and the hole as so deep financially as this particular facility,” he says.

Here’s a sampling of what went wrong: Financial bungling meant a construction project approved by voters in 2005 still isn’t finished. Former board members have faced lawsuits and even been recalled for benefiting from potentially illegal decisions they made while on the board.

And, perhaps most egregiously, the Tulare County District Attorney recently seized nearly a million dollars from the CEO of Healthcare Conglomerate Associates—or HCCA—the company that previously ran the hospital. He’s under investigation for allegedly stealing even more of the hospital’s money.

“We’re awaiting indictments and the rest, and we’re hopeful that the people who did bad things that harmed our community have justice served on them,” says president Kevin Northcraft of the Tulare Local Healthcare District, the hospital’s governing board. He was elected in 2016 after much of this corruption was brought to light.

Today, the hospital is operated by Adventist Health, which runs a network of health centers and hospitals in Selma, Reedley, Bakersfield, and a dozen other locations across California. Adventist’s Randy Dodd is the president of Tulare Regional, and he says things will be different now. “I don't know what happened prior with HCCA and where their profits may have gone,” he says, "but I think based on what we see, and our ability to run a hospital, that we’ll be able to do it in a very effective way.”

Randy Dodd of Adventist Health is Tulare Regional medical Center's new president.
Credit Kerry Klein / Valley Public Radio

He argues Adventist is efficient and compassionate. And he says being part of a big network means they have access to more expertise. “We have a number of shared services that would help us with things like infection prevention, quality, marketing, finance,” he says.

The revived Tulare Regional still has a lot of trust to build in the community. A small faction opposed Measure H, though it ultimately passed with 88 percent of the vote. And even up to the election, many Tulare residents were still calling for more transparency from the board.

Still, one thing that’s not debated is the hospital is serving the community. According to Adventist, the emergency department treated 1500 patients in its first three weeks—including its first call, which came while the ribbon was being cut on opening morning.