Editors’ note: This article has been edited to add a quote from Gurvinder Kaur and to correct her gender. Additionally, statements from Adventist Health representatives regarding the hospital’s COVID patient numbers in Tulare were added under ‘Second COVID-19 Isolation Incident Alleged.’ A statement that Kaur said the moves were to maximize the use of its facilities, as well as patient care, was removed as it was not accurate.
Kaweah Health’s CEO told the Valley Voice that Adventist Health Central Valley Network (AHCVN) didn’t pull its weight during the height of the massive local winter 2020 COVID-19 outbreak and used the state’s temporary COVID-19 rule exemptions to direct surgical business to its facilities.
The comments came during a face-to-face interview with Kaweah Health CEO Gary Herbst in September. AHCVN has denied any wrongdoing.
Angry Health Officials
During the interview, Herbst alleged officials at AHCVN kept three of the network’s facilities — those in Tulare, Selma and Reedley — relatively COVID-19-free by sequestering COVID-19-positive patients at its Hanford hospital.
Herbst was responding to a question about rumors local officials had been angered by Adventist’s COVID-19 response during the winter months of 2020-21, when COVID-19-related hospitalizations were at a local peak. He agreed that ire was raised.
“During the height of the pandemic in December and January, the Adventist Health Central Valley Network made a decision to cohort all of their COVID positive patients in their Hanford facility and to not admit any COVID patients into Tulare, Selma or Reedley,” Herbst said. “At the same time, we’ve had to completely shut down in-patient surgery, shutting down almost every procedure so that we could fully support the entire COVID population of the county.”
‘No Substantiated Complaints’
According to Dr. Gurvinder Kaur, Chief Medical Officer for Adventist Health in the Central Valley, the California Department of Public Health was informed about Adventist’s transfer of patients within its network of four local hospitals. Its staffing waivers were never removed.
“Since the pandemic began, there have been no substantiated complaints to CDPH related to facility staffing at Adventist Health Tulare or Adventist Health Reedley,” Kaur said in a written statement issued to the Valley Voice.
“Because we have a network of four hospitals in the Valley and are part of a system of 23 hospitals, we have more options for care than stand-alone hospitals,” Kaur’s statement said. “When appropriate and at the direction of our skilled physicians, we have transferred patients to other hospitals within our network or system. We informed CDPH of this process and provided updates about the movement of patients between Adventist Health facilities.
“Like other hospitals across the nation, all of our hospitals have paused elective surgeries during the pandemic. The decision to resume those surgeries has always been in accordance with state orders and with patient safety at top of mind. From mid-December to mid-February, we cancelled elective surgeries at all four CVN hospitals: Hanford, Reedley, Selma and Tulare,” Kaur added.
The main motivation for the transfers was providing the best medical care, said Kaur.
“Every day, we carefully weigh the best available care options for each of our COVID-19 patients,” Kaur wrote.
Federal Numbers Back Claim
The number of COVID-19-related admissions reported each week for every hospital in the nation is available at HealthData.gov, a website provided by the Department of Health and Human Services. That agency’s data sets seem to corroborate the idea certain of Adventist’s hospitals were admitting few or no patients for treatment of acute COVID-19-related illness.
Beginning in mid-November 2020, admissions for COVID-related illness increased quickly at Kaweah Delta in Visalia and at Sierra View District Hospital in Porterville. At Kaweah Delta, weekly admissions ranged from 17 to 76 during the autumn, rising to a maximum of 144 admissions for COVID-19 during the week of January 8.
Admission numbers running in the range of 52 to 87 a week during the fall months in Porterville at Sierra View — where the majority of the county’s COVID-19 cases were clustered — jumped to nearly triple that by mid-December. Officials at Sierra View declined to comment or issue a statement for this story.
Meanwhile, Adventist Reedley had a total of just 48 COVID-19-related admissions from October 2020 through February 2021. Adventist Tulare admitted no patients at all for COVID-19-related treatment from the time HHS began collecting data until the week of December 18, 2020.
Herbst: State Intervened
The situation was finally rectified when, according to Herbst, the CDPH threatened to end an exemption allowing Adventist to exceed patient-to-nurse ratios in order to treat greater numbers of COVID-19 patients.
“The state finally stepped in and threatened to pull their exemption from the nurse staffing ratios in Hanford, because they were working under an exemption, and said if you don’t start taking care of COVID patients and shut down your elective surgeries, we’re going to take this away from you,” Herbst said.
Adventist Tulare abruptly began regularly admitting COVID-19 patients the week of December 18, 2020. While there were a handful of COVID-19 patient admissions at Adventists Health Reedley also starting that week, those admissions have since slowed to a trickle, with just 14 total COVID-19 patients admitted since February.
In her statement, Kaur was careful to point out there had been no “substantiated” claims against Adventist Health Tulare or Adventist Health Reedley. She did not mention CDPH in relation to Adventist Health Hanford or Adventist Health Selma.
CDPH has not yet responded to a request for comment on the situation and any action it may have taken regarding it.
COVID-19 Profiteering Alleged
The point of concentrating COVID-19 patients in the Adventist Health Hanford facility, Herbst said, was to allow Adventist to continue performing elective surgeries.
Hosting elective surgery is a major source of revenue for hospitals, and Adventist, Herbst said, used the transfer of COVID-19-positive patients away from Tulare, Reedley and Selma so it could reroute surgical cases to those facilities. The move, Herbst said, intentionally drew away surgeons and hospitalizations from taxpayer-supported medical centers, undercutting important revenue sources.
“(Adventist) Tulare Hospital advertised itself as the safe non-COVID hospital, and all of our surgeons took their cases there and did their surgery there, while we were losing millions here and taking care of the COVID population,” Herbst said.
Second COVID-19 Isolation Incident Alleged
While Adventist resumed admitting patients with COVID-19 symptoms for treatment in Tulare in December 2020, HHS numbers show COVID-19 admissions in Tulare stopped again in March and no COVID-19 admissions were reported there again until August. Adventist Health Reedley reports admitting just 14 COVID-19 patients since March. There is no data available for the Selma facility.
Adventist Health representatives stated that they admitted many COVID-19 patients since March and continue to, though the number of patients dropped to zero during periods of low COVID-19 transmission in the community. Its hospitals began reporting their statistics on Facebook in September.
At times, Tulare’s COVID-19 patient load accounted for more than 25% of hospitalized COVID patients in their network, the representative stated.
The date Adventist’s public numbers dropped coincides with Herbst’s allegation that Adventist resumed the practice of drawing off other hospital district’s potential surgical patients once the peak of the winter COVID-19 outbreak had passed, prompting him to make a complaint to the CDPH.
“But then just recently, within the last few weeks, they went back to that MO,” Herbst said during the September interview. “Our physicians told us that they were taking their surgeries there, and so we called the state.”
COVID-19 patient admissions resumed at Adventist Health Tulare during the week of August 20 and have continued since. According to HealthData.gov, 164 confirmed cases of COVID-19 were reported at the Adventist Health Tulare emergency department during the week ending October 8. The hospital admitted 10 of those COVID-19 patients for treatment.