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.”
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.”
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.”
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.