After Legal Victory, Tulare Hospital Board Forced to Temporarily Close TRMC

Kevin Northcraft speaks to the public at an October 25, 2017 board meeting. Tony Maldonado/Valley Voice

The Tulare Local Healthcare District scored a legal victory Wednesday by convincing a judge to allow it to separate from its current management company. Later that day, the district’s board voted unanimously to temporarily suspend most of the hospital’s operations to prevent the state from shutting the hospital down.

Richard Gianello, a consultant for the board, claimed that Healthcare Conglomerate Associates (HCCA) — the company contracted to manage Tulare Regional Medical Center — indicated it would begin winding down its operations at the hospital.

“I also understand that there was a notice that was submitted by HCCA today, by their attorney today, suggesting that they’re in the process of transferring patients and terminating the employees and dealing under the WARN act, which is the process that you go through to do that,” Gianello said.

The company’s move came after a court victory earlier that day, that would allow the district to exit its management agreements with HCCA as soon it finds an alternate operator to run the hospital, or by November 27, whichever comes first.

If HCCA chose to exit the hospital without a clear handover plan, the California Department of Public Health would order the hospital be closed to protect the safety of its patients, according to court filings and to the board’s legal counsel.

https://www.documentcloud.org/documents/4113596-CDPH-Response-to-Motion-to-Reject.html#document/p5/a384770

A forced shutdown would likely be coupled with hefty fines and a laundry list of requirements to reopen; by voluntarily and temporarily suspending the hospital’s operations, it wouldn’t be subject to fines, and could reopen in a quicker, more expeditious manner.

Although the district has lined up Community Medical Centers of Fresno to run the hospital, the company hasn’t officially applied to the state to take over operations; any hospital operator or manager must be authorized by the state.

“The state needs a licensed, approved operator of the hospital,” Niki Cunningham, an attorney for the board, stated.

 

Closure Not Immediate; Employees Still Show Up To Work – For Now

The hospital’s employees should still show up to work for now, Xavier Avila, a hospital board member, told the Voice.

“The state requires that the emergency room stays open for thirty days,” Avila said. “You don’t want people that show up with an emergency, and the hospital’s closed.”

The departments that the emergency room relies on would also stay open for the same amount of time.

The board and its consultants had differing hopes on the length of time that the hospital would stay closed.

Gianello initially stated that he hoped the closure would be “maybe thirty to sixty days” — but that was on the far end of what the board wanted.

“Thirty or sixty is unacceptable to me,” Kevin Northcraft, the board’s chairman, said, stating his vision of a best-case scenario could be as little as “five to seven days.”

Gianello later stated his vision of a best-case scenario would be a closure time of only one week.

Given the circumstances, the temporary closure was the best of the worst, the board’s attorneys and consultants stated.

Even a scenario in which Community Medical Centers could come in tomorrow wouldn’t be workable, Cunningham told the public, because of logistical issues.

“We don’t have access to all the financial records — we don’t have simple things like all the passwords to the computer systems,” she said.

Responding to one question from the audience, she stated the hospital couldn’t simply operate by naming a CEO, either, she said.

Because the state knows that Community Medical Centers would be serving “in a management role,” they wouldn’t allow the hospital to continue operating under its own license with a CEO in a management position.

 

What Would Close?

Cunningham stated that it wasn’t clear what might stay open or what might close.

“We haven’t fully evaluated this — this is all very recent and very new news,” she said. “If the board move forward with the voluntary, temporary suspension, we’re going to try to keep whatever facilities and operations open that are hospital.”

Evolutions and the hospital’s clinics would likely remain under HCCA’s control until a new operator came in, Avila said.

“Until the contract’s actually broken — until we have a plan that the health department accepts,” Avila said, “it remains in his control.”

 

The Best of a Bad Situation

Northcraft told the public that the board, its attorneys, and its consultants had tried to work with HCCA to ensure a smooth transition to another management company.

Those negotiations didn’t work out.

“This is because HCCA won’t agree to back out and give us the reins,” Avila said. “That’s really it. It would be really easy for [Dr. Benny Benzeevi, CEO of HCCA] to work with us and the health department and say this is what we’re going to do, and there really wouldn’t be any need to shut this down.”

“We’re stuck. This is a hostage situation, and he’s using the employees as the hostages,” Avila continued.

Northcraft stated that while the decision was a difficult one, it would ensure the hospital’s survival.

“We’re looking at options that are pretty bad on a short-term basis,” he said, “but on a long-term basis, we see a vibrant, quality, and successful hospital in our future. We’re trying to keep our eyes on that.”

In Depth: Tulare Regional Medical Center

48 thoughts on “After Legal Victory, Tulare Hospital Board Forced to Temporarily Close TRMC

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  1. Shame on Benny

    He is trying to make hospital a forced shut down – which will require a bigger, different and more stringent conditions to be met before it can reopen. This includes earthquake safe building – which we do not have at this time — ergo — if hospital is deemed forced shut down, it may never reopen.

    And he claims he is working in the best interest of citizens.

    What a shameless crook !

    He should be tried under anti-terrorism act.

    • If you refer to the Visalia Times Delta front page of last week, you will see that Benny has accused the community of Tulare of anti semitism. Therefore, according to his logic, WE are the terrorists. Sound familiar?

  2. Board should move a court today asking to order that HCCA will not do anything without approval from board’s attorney – to prevent them from poisoning the well.

  3. No surprise here. Only a fool would have believed that Benzeevi would put the needs of the citizens of Tulare and their hospital first. Glad I cancelled membership at Evolutions. Will rejoin once Benzeevi is out!

  4. Kumar is as culpable if not more ,he put his self interests above this community and handpicked HCCA
    He should not be Allowed to simply walk away along with the members of the past board. Shameless!

  5. Kumar should not be able to set foot inside the hospital. He is responsible along with Bennie for all.this to happen.

  6. OK, Board, you finally achieved what you intended with HCCA. YOUR plan? Lots of hand-ringing, and ‘WE’LL stay strong and get through it comments from you. But what will YOU do? The EMPLOYEES are the ones that are shouldering the burden of YOUR decision, not you personally. Your plan? Well, you better get it in gear NOW!

    • To the Board Members….

      This ‘consulting’ company? ‘Who’ from them is working with the ‘on the ground’, ‘day to day’ Managers and Staff who really know what’s going on minute by minute? Isn’t it hard to formulate a ‘Plan’ based on just ‘what you think is going on’?

  7. Shame on the board!!!! They knew exactly what they were doing from the beginning, and that was getting rid of HCCA and not caring about staff although they proclaimed to do so. That is an all out LIE their target was Benzeevi and Kumar and they could careless about what happened to staff!!!!!!

    • I think they have ‘visions’ of riding a Flying Unicorn and proclaiming victory once Benzeevi/HCCA is ‘out’. Kumar will probably make another push at ‘control’ (hoping that all his Skeletons behind Closet Doors may have vanished…

  8. BTW… ‘why’ do you think the Board knows what they are doing? What is their practical ‘Board Experience’? Their practical ‘Healthcare Background’? Listening and watching the Board Meetings should clue you in to the fact that they are working in ‘generalities’ and NOT from experience.

    • At least they are honest and have the backing of the citizens that is why we voted them in and support the one appointed. What expeience did the last board havev except a crooked doctor ( Kumar) who stuck us with Bennie. HCCA.

      • Didn’t the Board decision cost the citizens of Tulare $9 million for voiding contract!? Was that smart? Taxpayers will pay that, right? I don’t usually talk about these things but we need the hospital !

          • That’s good, but why did the Board have to close the hospital and all those people lost their jobs? What if it never reopens?

    • @ Tularean – Does it cost us to keep criminals in jail?

      We dont want criminals running our hospital – no matter what the cost is. Period.

      You must have read in newspapers of avoidable and untimely deaths of patients in TRMC during HCCA – DUE TO lack of safety standards compliance by HCCA.

      If it were. God forbid, your family member who suffers such tragic fate, would you agree that we should pay 9 or whatever millions to keep these spawn of Sat an people away from out hospital?

      These people – Kumar, Benny, Bell, Linda, Torrez were here to steal public money and if they ended up killing patients in their jest, they did not care.

    • You also have no plan, do you?
      You’re just ranting, aren’t you?

      You have no idea what is going on with the attorneys, the state, the courts, the consultants, or the members of the board. You’ve spoken to no one who is doing the work, just read our coverage. Now, you’re ready to condemn the next set of people in charge.

      You appear to have nothing of substance to say in criticism of the current board, which has essentially prevented the theft of the entire District’s assets. Or, if you do have some substance, email me.

      I find it laughable you’re telling the people who are doing it that it can’t be done. If you were really concerned, you’d do more than complain on the internet.

  9. vv1reader, Closeitdown or maybe you are really Benzeevi and Kumar…….do you actually think that anyone is buying your posts? The employees that stayed are not mindless victims, they knew the risks they were taking in staying. They are profiles of courage. Anyone that dedicated won’t be left unemployed for long. They have proven their value and worth. Of course I am talking about the hospital workers, not HCCA administration. Sooner or later this hospital will reopen giving “full” service to the citizens of Tulare. Thank God Benzeevi/HCCA won’t be a part of the hospital when it does.

    • Sorry, but I’m NOT ‘B’ or even ‘K’. (Thank God!)

      The Employees that are staying, don’t have much of a choice at the moment and NO ONE said they were ‘mindless’.

      Yes they are courageous in my eyes as well.

      Since the Board/Consulting firm HASN’T made any offers to the existing Staff to my knowledge.

      HCCA ‘Administration’ is Ben and Germany. The rest are ‘rehired’ from TRMC when HCCA came into control (and now, from what they are saying, didn’t want HCCA in the first place. Thanks again for another great decision from the previous Board.)

      I want our old TRMC back as well. Don’t be so fast to ‘assume’…

      • They do have a choice. It is there choice to stay to help the patients still at the hospital. Would you stay on your job if you were not getting paid? I think not.

      • At this point they can’t offer anything until all the i’s have been dotted and all the t’s have been crossed and this limbo period is over. The Board doesn’t hire staff, hospital management does. Once new management is in place then the accessing, processing, and hiring can begin. Patience is needed to let this play out. The destruction of this hospital didn’t happen in one day and rebuilding it back will take time. Quit looking for instant fixes and gratifications……that just isn’t going to happen.

  10. We as employees will survive this as with any other issues that come our way.

    Employees were told today that the Hospital will shut down at 12am Saturday. There is still the question of ER and OB to stay open for 30 day period. Regardless, if RMC comes in, we as employees have to go through the process to be rehired.

    But here is the part you should all know. All of employee files are not being turned over from HCCA to whoever comes in. That means ALL certifications, backrounds etc will have to be redone. That may take us to the 30 day and may have to close completely.
    This presents a huge problem.
    Hopefully RMC will expedite the process and get us in quickly. If not, we will have to go on UI insurance. Plus, our benefits will be on COBRA for 30 days. Then counter that we may have to wait 90 days for benefits to kick in.
    In the end, we will get what we need done.
    This Board is doing right and going through the motions with legal help. That is the first step. The Board hired people that know how to do this.
    That’s all we ask.

  11. Does it really surprise anyone that Benzeevi did what he did? The new board had to expect he would do something like this, especially after the court voided the contract. When does the new board start to shoulder the blame, say 60 days from now and the hospital still isn’t opened. Is it still Benzeevi fault. The new board had a plan, and that plan was to remove the HCCA. Now they need a plan to open the hospital back up, and I am not 100% confident they are capable of doing that.

    • Do you realize that the financials are completely unknown. The scant amount known is that since January cash of $8.6 million is gone, supposed amount Benzeevi loaned is around $7 million in that time and the payables meaning the money owed jumped to $28 million from $15 million. Does that include the money supposedly loaned by Benzeevi.

      In essence this means that in 10 months Benzeevi has used minimum of $15 million to operate the hospital, do you not see how ludicrous that is. Why would you poor more money into his management and his pocketbook.

  12. So first it was HCCA you were attacking. And rightfully so. Now that HCCA has been kicked out. A lot of you now go on to attack the Board! What is it with you guys? Do you have to attack something all the time? HCCA screwed us The board did the right thing by suspension so we won’t have fines to pay or go thru a bunch more hoops to reopen. The board is Working with state and CRMC as fast as they can. I am an employee. This will all work out. Why don’t you people wait a day or so before you go on another Attack

  13. ABSOLUTELY!!! Board did the right thing. HCCA still playing games they don’t have to close on Saturday, just more of his ” stick it to you” this is the mentality we have been dealing with! This parasite needed to be eradicated from the host to save the patient.

  14. I wouldn’t be surprised if the Office of the Inspector General begins investigations (if it hasn’t done so already) in light of the fact CMS cancelled the hospital as a Medicare and Medicaid provider. As far as the ER and OB remaining open for 30 days is highly unlikely as that would require a complete hospital to do so (all ancillary services) FORENSIC AUDIT is essential.

  15. Jobs are not lost permanently. Soon, hospital will reopen and there will be a bigger number of hiring.

    Anyone who thinks jobs were safe under HCCA is a fool. It was not a question of IF but was of WHEN employees would have faced loss of job – perhaps permanently – under HCCA. The contract was just not sustainable. TRMC has never made 5 million $ a year in profit in its history – there is no way TRMC could have afforded 5 million $ manager fee.
    And all during this time, employees would face the unfair treatment they were facing under HCCA – anyone who did not campaign for measure I or supported Dr Kumar in recall was summarily fired. It was an environment of extreme kiss the feet of TPTB or lose job. Samantha Bland at Hillman clinic announced it very clearly several times that anyone who does not agree with her will not work there. It was dictatorship.

  16. After a long time, TRMC is now turning to move in a positive direction.
    Dr Kumar’s big plan right from 2007 was to let it collapse so he can buy it for pennies on the dollar. When Bob Montion refused to dance to his tunes, he got him gone. Then he got Shawn Bolouki to spend so much that it was impossible to not lose money. Then he used those loss reports to base their decision to give TRMC to HCCA. He got his puppets to sign a contract that is unbelievable and will probably be subject of study about corporate abuse and mishandling of public money for decades to come. Plan was to get another 55 million and then let it go to auction block so they can buy it for pennies on the dollar.
    BUT, citizens woke up and grouped under CFHA umbrella and fought back and took back hospital.

    Now, we can expect CMRC to run it well – because – it is a gold mine for them if it is run well. TRMC will work as their satellite location. All big ticket profitable procedures can be sent to Fresno now, instead of Kaweah or UCSF as they were going until now.

    It is a win win for everyone. Patients get better care, hospital gets stability and freedom from thieves, doctors get safer better place to work and a system to fall back on for more complex cases, city get relief from taxes and CRMC gets a big source of additional revenue.

    It is such a slam dunk golden idea,it makes me wonder why did they reject it in 2013/14? There can be only one correct answer to it – the board was not working in good faith. If I were in position, I would sue the old board for working in bad faith with intention to steal public money.

    We need forensic audit STAT.

  17. KDH received ONLY 2 patients from TRMC.
    It appears that all other were FAKE admissions.
    A friend of mine works in ER at TRMC. He has taken pictures of Dr Kumar herding in homeless people into the ER. They would be admitted there for a day or 2 just to show attendance, would get “hots & cots” and 100$ from Dr Kumar.
    Medicare & Medi-Cal will be billed for an unnecessary service. Fraud.

  18. Does anyone know more capable or bigger or financially more stable healthcare system in entire central valley – except UC Davis – than the CRMC/Sante ??

    If they can not reopen this teeny-tiny hospital, no one else could.

    I do not have any doubts about their ability or willingness. In fact, I feel this deal is so good for them, we could have asked them to pay money to us for running this hospital. In better times, I could have dared that but not now. This is another loss we have due to Dr Kumar/Benny gang.

  19. Someone said we want our old TRMC back.

    No, I do not want our “old TRMC” back.

    I want higher standards of quality for doctors. A requirement for passing board certification exam is reasonable & customary. Is there anything wrong in asking for at least some threshold for quality?

    I also do not want that a female employee had to suck it up and keep it quiet when a certain doctor checks out her body in an unwelcoming way.

    I also do not want that a doctor who can write pornographic prescriptions and MEC is too weak to stop him from working there for 5 years AFTER the discovery and report to MEC.

    I also do not want a hospital where one doctor can control who works there and who does not.

    No, I want a better hospital.

    • Yes well said KD , if there is any silver lining to this disgraceful situation it is that,
      As a community we learned the need to be more responsible in who we elect to represent us on ANY board ,we learned we need to do our homework not just rely on a candidates
      position in this community ,sadly we learned how flawed that logic can be.
      Maybe it is time to look at our own city council And make them responsible to US: I would like to see term limits to their time on the board that would hopefully protect us from a council member with an alternative motive for serving or one with to many connections that are self serving and keeping Tulare from advancing it not to late to get Tulare back
      we just need to look at our hospital with the tarp covering its signs to remember what a few bad apples can do!

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