Tulare hospital saw success, hurdles in 2019

Tulare Regional Medical Center (TRMC) put a lot of effort into healing itself during 2019, and the results are encouraging, says Tulare Adventist President Randy Dodd.

 

Rebuilding a Reputation

After reopening in October of 2018, 2019 marked the first full calendar year of operation for the resuscitated medical facility, a year that saw much of the new leadership’s efforts directed to undoing the damage to the Tulare Local Health Care District and the hospital’s reputation.

“A lot’s happened over that time,” Dodd said during a report to the Tulare Board of Supervisors at their last meeting of the decade. “You may recall when we got ready to open, we had quite a bit of fear, skepticism, some cynicism perhaps in the community, and I think we’ve changed a lot of that over the course of the last year as we’ve been able to lift up new services in our facilities.”

But the journey so far hasn’t been without its complications, many of which stem from the state of the TRMC campus.

“We opened the hospital in just over 110 days, which didn’t give us a lot of time to do due diligence to make sure exactly where everything was, because we just didn’t have the time,” Dodd said. “But, we’ve gone to work on that. It’s an old building. It needs a lot of love. We’ve invested this year about $5 million in services and equipment to lift up different programs.”

 

Expanding Services

TRMC has added nuclear medicine–the use of radioisotopes in medical imaging–to its arsenal of disease-fighting tools, will begin offering mammogram services this month and construction is underway on a community medical clinic.

“We broke ground recently on a new medical clinic in Tulare just north of the outlets there on Hillman (Street),” Dodd said. “It’s about an 18,000-square-foot medical clinic, and should house somewhere around 10 doctors and three dentists full-time in our community there.”

Staff at the new clinic represents just a tiny fraction of the medical personnel now employed at TRMC as Tulare Adventist becomes one of the city’s largest employers.

“Over the course of the last year, we added about 400 jobs to Tulare County, and our payroll–wages and benefits–year to date through November is just over $16.5 million,” Dodd said. “That will continue to grow over the course of the year as new services continue to come online and additional programs are available to the community.”

 

Thousands Received Care

Tulare Adventist’s main goal, of course, is caring for patients. In 2019, Tulare Adventist held clinics for low-income patients in Tulare and Visalia, providing medical and dental treatment for some 500 individuals. Additionally, hundreds of surgeries were performed at TRMC, and more than 31,000 cases were treated in the hospital’s emergency department.

“That’s 31,000 people who didn’t have to leave their community and go somewhere else for care,” Dodd said.

Being able to receive surgical treatment again in Tulare, says Dodd, is a boon not just for those who receive the care, but for those who care for them.

“It makes it a lot easier for families and loved ones to care for their family if they’ve got someone in the hospital that’s recovering from surgery that they don’t have to travel to do so,” he said.

 

Haggling with Insurance Companies

One of the greatest challenges, Dodd says, has been getting insurers to realize TRMC will no longer accept payment schemes that shortchange the hospital.

“One of the key challenges that we’ve faced over the course of this past year has to do with payer contracts, insurer contracts,” he said. “We still have three of them outstanding in Tulare that are going to be resolved here in January.”

The problem, Dodd says, is that the previous managers of the Tulare Local Health Care District was willing to accept payments that were much lower than industry standards. When faced with demands for better compensation, the insurance companies balked.

“They (contract rates) were about half of what everyone else was getting paid for various services,” he said. “We just couldn’t accept those particular contracts at a base rate of what Tulare Regional had before, so we rejected them, and, unfortunately, the insurance companies have played really hard with us to try and keep those rates low and not let them rise to market levels, but we think we’re finally on a track to make that come together at the beginning of this year.”

 

‘Welcomed Addition’

Pete Vander Poel–county supervisor for District 2, which includes Tulare–expressed his admiration for what Tulare Adventist has managed to achieve so far at TRMC. The progress is even more impressive, he says, in light of the aura of uncertainty at play when the hospital first reopened.

“It was a welcomed addition, but we really didn’t know what to expect,” Vander Poel said. “You’ve really become a member of the community, and I think this county is very well served by what you’ve been able to achieve and the services that you’re offering.”

 

Challenges Ahead

While 2019 was a productive year for Adventist and the TRMC, challenges remain. Chief among them is completing the unfinished tower. Funding for the tower was approved by voters in 2005, and construction stalled in 2015. Seismic regulations due to go into effect in 2030 will force the abandonment or repurposing of the current facility, and completion of the project is estimated to cost between $40 and $60 million.

In the short term, however, Tulare Adventist’s most pressing need remains working to remove blemishes on the hospital’s reputation caused by past mismanagement and demonstrating to the community that true change has come to town.

“Our best strategy is the care we provide, so when people leave our hospital, they tell friends and families the kind of care that they received from us,” Dodd said. “Marketing goes far, but skepticism goes deep, and I think until people experience it themselves, it’s kind of hard to realize that things are really different.”

Providing a high quality experience for patients at TRMC is made easier by the attitude of those who work there, Dodd says. Adventist Health is a faith-based, nonprofit health care organization, and Dodd says his employees tend to treat their jobs as a mission.

“They believe they’ve been called there for a reason, and they behave that way,” he said.

In Depth: Tulare Regional Medical Center

19 thoughts on “Tulare hospital saw success, hurdles in 2019

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      • Thanks for the clarification. I personally have an aversion to the name Tulare Regional Medical Center. Too much bad juju attached to it. Adventist Health Tulare it is although I myself will more than likely call it Tulare Adventist (easier to remember and has a certain flow to it). 🙂

  1. I pay taxes to this hospital. for what? Advenist is a profit making place why do they need more of our money in taxes. Let them buy it or even give it to them. theres so many other clinics nearby you can get medical from and cheaper. I got a mri up the street my insurance said it was half of the cost as Advenist. Tulare Regional Medical or Avenist. different smell but same bad fish.

    • You obviously have opted to go elsewhere for medical services. If that makes you happy then good for you. Your choice. I don’t worry about Adventist being a religious based non-profit hospital who makes a profit……I just care about the quality of services they provide. I went back to utilizing their lab for all my blood work and I find the lab to be clean and efficient with friendly tech workers. I expect to eventually get future MRI’s, Mammograms, and X-Rays done at Adventist as well. Tulare needs a successful hospital and I for one am grateful that Adventist is working toward that goal.

    • James The Taxes go to the district not Adventist and you would pay the tax even if the Hospital stayed closed . Who knows you may need to use the ER some day like 31,000 other people have . As far as your insurance goes, do you really think they care about you more than the profits they make off of you . I doubt they told you the truth

  2. > Providing a high quality experience for patients at TRMC is made easier by the attitude of those who work there, Dodd says. Adventist Health is a faith-based, nonprofit health care organization, and Dodd says his employees tend to treat their jobs as a mission.

    “They believe they’ve been called there for a reason, and they behave that way,” he said.

    This is the precise opposite of what Dodd said was the case when asked at hearings before the Board corruptly granted them the right to a public facility.

    The public was told by Dodd that the workers were free from pressure to act according to religious faith.

    Now that he has secured manangement control of the facility, his words turn out to be no more trustworthy and just as corrupt as the previous management.

    If only someone had pointed this out *before* the corruption began anew.

    Oh wait, somoneone did. But no one listened. They can’t believe they have been scammed twice.

      • Linda you beat me to calling out old Barry Caplin . If he thinks we can’t figure out who he is , then he is a bigger fool than I thought he was

  3. I had surgery there, my Dr. is in Hanford but did my surgery in Tulare. I was quite happy with the staff and would not hesitate to return.

  4. No need to over-read anything into Mr. Dodd’s comment about the employees tending to treat their job as a mission. Those who are inclined to treat their work as a mission don’t necessarily do so because of a religious belief. They do so because they take personal pride in the work that they are doing plus one could also say that working in the medical field can be considered rewarding work from a desire to helping others who are in pain, stress, or whatever.

  5. Barbara you probably have medicare pay for everything you get but some of us who work for a living and have a $5000 deductable and have to pay a copay theres noway the hospital can compare with the local private offices for care whether its lab xray or anything. whats the ER bill, $1500 for somebody without medicare or medi-cal ? Xavier, you dont understand hospital economics at all. whats their cost for MRI, $1000 ? GET REAL ! And who is the doctor reading your mammograph, do they even have one ? Hardly any local doctors work there. Adventist buses them in from Hanford or Selma. Yep those are true “centers of excellence”. Barbara, its commendable for you to support local businesses and the hospital is certainly a business. But in reality the little hospitals are closing everywhere because they cant compete. On price or quality.

    • Yes I have Medicare; Part A coverage was paid for through payroll Medicare taxes that I paid into while working over 20 plus years and Part B coverage I pay for myself (I do not draw Social Security – I am a PERS recipient). Additionally I also pay high monthly premiums for supplemental medical insurance that provides me the type of medical coverage that I personally wanted (no deductibles or co-pays). Nothing is given free to me. As for where the doctors are from I don’t care where they live (my own doctor lives, works, and sees me in Visalia). As long as they are good doctors, nurses, lab workers, x-ray technicians, etc. etc. etc. that is what matters most to me. I also don’t care what their religion is or what their politics are….I care about safe reliable quality services. To denigrate any business that hires people who live outside Tulare’s borders is beyond belief or reason as many Tulareans workplace is in other towns. Hospital ER’s are mandated by law to see anyone who comes in seeking services regardless of their ability or inability to pay. It is the law. Your beef should with the law and with the billing practices of insurance companies not with hospitals. We have a shot at keeping our local hospital opened and running. As someone who lives in Tulare, who was born, raised, educated and worked in the City of Tulare I personally choose to support Tulare Adventist Hospital and I will do so by utilizing their services.

  6. Xavier, 31,000 people went to the TRMC Adventist ER in 1 year. How many of them went for sniffles, cough, ear ache, tummy ache, sprained ankle or drug refills. How many could have gone to a local clinic or doctors office. Except they would have to pay $100 or so for the doctors visit unless they have zero coverage. These are the real numbers. What does the hospital charge for the same thing these patients could have got at a clinic. Yes the insurance companies are greedy, nobody would disagree. Adventist is not here to give away anything because they have a big heart, no sirree. They get thousands from medi-cal for those ER visits. Cant blame them either. Plenty of greed to go around.

    • Jeff P
      You are being negative just to be negative. What’s exactly is your point ? Do you believe Hospitals should be free ? Do you believe hospital force people to go to their ER ? Last I checked the people make that decision . So I don’t see why you’re complaining ! Be thankful the Hospital is open and that AH is running it . Be thankful that people don’t have to wait for hours to get the help they need . I have had to take my family members there so I’m very thankful and your comments don’t make any sense

  7. Let’s hope the ER is being adequately covered with physicians and on-call support doctors. Rumors are spreading of a death that should have been avoided. Sent out of the ER to follow up with regular doctor and died within two hours. Sounds as though surgical intervention was needed. The community goes to an ER with trust in mind. Please Adventist don’t repeat the mistakes from the past. Physician coverage matters or don’t be an ER.

    • Was just at the ER yesterday. Was seen quickly and RN Rick was efficient and on top of things from the get-go. Duty Doctor Brown too was efficient and answered any and all questions that we had. In at about 8:30 and out by noon. So far husband is feeling 100% better and in fact he is at his medical clinic for his ER follow up visit. I am greatful for having the hospital up and running and meeting the needs of Tulareans. Sad to hear of the person’s death. Rumors aren’t facts. For the sake of the family hopefully it was just the person’s time (something we are faced with).

      • An emergency room is for emergencies and people expect that emergencies can be handled. If there isn’t a surgeon available for an emergency then it is just an urgent care. Slippery slope and why Adventist will suffer in Tulare.

        Maybe if the person wasn’t discharged and admitted for treatment it wouldn’t be their time. Death within 2 hours of leaving an ER is extremely questionable.

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