Tulare Hospital’s First Medical Staff Election Underway

Tulare Regional Medical Center’s first full medical staff election is underway, the Tulare Local Healthcare District Board of Directors were told Wednesday.

Dr. Ronald Ostrom, the chief of staff for TRMC’s current medical executive committee, hailed the election as the first in which all members of the medical staff were able to vote during his presentation to the board.

“We’ve got about fifty to sixty — over half of the ballots have been returned,” Ostrom said. “The election — all of the physicians across the board are allowed to participate.”

The election is the first one being held by the new medical staff, installed by the Tulare Local Healthcare District Board of Directors in a January 2016 meeting; immediately following that meeting, only the seven doctors that formed the hospital’s current medical executive committee had the ability to vote in medical staff elections.

“We felt we needed time to implement all of the changes that were required for the sake of certification,” Dr. Anthony Trujillo, one of the seven, said regarding the revocation of voting privileges. “[To] maintain the MEC and not have it replaced a month later.”

In court testimony earlier this week, Ostrom stated that each member of the medical staff could vote individually for a chief of staff, vice-chief of staff, and secretary/treasurer. Others could be nominated for those offices as well — Ostrom called the election the first of its kind at the hospital.

Under the ousted medical executive committee/medical staff’s election system, a nominating committee created a “slate” of officeholders — a set consisting of a chief, vice-chief and secretary/treasurer — and a petition with ten signatures was required to run an opposing slate.

“Over half the ballots have been returned — we’re seeing good participation,” Ostrom said.

According to Ostrom’s presentation, the nominees currently are:

• Dr. Ronald Ostrom, Chief of Staff
• Dr. Gary Walter, Vice Chief of Staff
• Dr. Jon Miyakawa, Secretary/Treasurer

In addition to serving as the Chief of Staff for TRMC’s Medical Staff, Ostrom is also Tulare’s Emergency Room Director, and the Medical Director at Southern Inyo Hospital, another hospital managed by Healthcare Conglomerate Associates. Ostrom also works as the Medical Director at Hall Ambulance, a Bakersfield ambulance company, among other positions.

Walter recently made headlines for an incident in San Luis Obispo — an article in the Visalia Times-Delta detailed a March 2016 arrest for suspicion of driving under the influence. Walter may also face disciplinary action from the Medical Board of California, according to the report.

Miyakawa was previously part of a competing slate in 2012 — before two of the ten signatories on the petition withdrew their support. Sherrie Bell, then the Chairman of the TLHCD Board, claimed that the signatures were withdrawn after intimidation by members of the MEC.

The winner of that election, Dr. Anil Patel, was later told by Bell that she considered the issue one that needed to be resolved — and that she could not acknowledge him as chief of staff until it was.

“This is the first time in the hospital’s history where every single doctor on the medical staff can vote regardless of status,” Dr. Benny Benzeevi, CEO of HCCA, which runs TRMC, said. “It’s a completely free and open election.”

“We’re hoping — if anybody else would like to nominate anybody else, we’re taking nominations,” Ostrom joked, pointing to his name on the screen.

Tower Construction Updates

Alan Germany, CFO for HCCA/TRMC, provided an update to the board and the public on the hospital’s beleaguered tower project.

Work continues at a slow pace, Germany said, but hospital officials are still waiting for financing to finalize before construction can resume at full speed.

“There’s not a lot going on in the tower,” Germany said.

Germany then highlighted one use of the prior bond funds — a $5.5m expenditure to Siemens Medical Imaging for a 3T MRI Machine, one which Germany highlighted as excessive for even large hospitals, let alone one of Tulare’s size.

The check was given to Siemens to essentially hold a machine while tower construction proceeded — Siemens never delivered the equipment to Tulare.

“I’ve never seen anything like this,” he said. “You would never do such a thing.”

One of HCCA’s first actions, Germany said, was to negotiate the return of the $5.5m. The efforts ended up in $4,632,661.89 returned — Siemens kept $713,612 as “profit” and $153,726 for two ultrasound machines.

“This is the kind of thing we’re cleaning up,” he said.

Dr. Parmod Kumar defended the prior board’s decision — and Kamboj’s — to spend the $5m on the machine.

“To put Kamboj on the spot is not fair,” he said. “[Shawn] Bolouki sold the board: if you put $5m down, we will get the latest — and we will save hundreds of thousands of dollars. It sounded like a great deal.”

Germany then noted the ongoing costs of maintaining the hospital’s current building.

Two steam boilers recently failed simultaneously, Germany said, and the hospital’s chiller failed as summer season kicks into full swing. The hospital spent upwards of $56,000 in an initial rental fee for use of a chiller for four weeks, and will spend $7,800/mo in rental fees monthly.

Kevin Northcraft, a new board member, lamented the state of the ongoing construction and maintenance of the current building.

“Competent administration knows those things are going to happen,” Northcraft said. “They anticipate those expenditures and have money funded for them so they can deal with them at the time. We are not doing that currently, and we need to pick up the pace to recognize that.”

“I realize we don’t have anyone on board who has prior hospital administrator experience, we’re kind of in training on that, but we need to pick up the pace and do what competent administrators do,” Northcraft said.

Shortly after, Benzeevi presented to the board a November presentation which highlighted what HCCA touts as the hospital’s “dramatic turnaround.”

“No experience sure beats being fired from every job,” Benzeevi retorted later in the meeting. “While everybody’s talking trash, we’re putting in the cash.”

The presentation, Benzeevi said, was shown to governmental agencies that the company is courting to provide loans to continue tower construction.

“Six CEOs in seven years — lots of experience there,” Benzeevi said, referring to the hospital’s leadership before HCCA.

“We’ve talked about what’s happened in the hospital and in the last three years,” he continued, “and the reason I bring this up, is because this is what’s convinced them to give us the opportunity to get a loan.”

Benzeevi told the board that the hospital is still in the evaluation process — that it has not secured a loan at the current time.

School Officials Celebrate Physical Partnership

Samantha Phillips-Bland, Vice-President of Ambulatory Care Services at HCCA, presented checks to three Tulare high schools: Mission Oak, Tulare Union, and Tulare Western.

The checks came from a partnership in which HCCA provided sports physicals to students from the three high schools for $10, Phillips-Bland said.

The proceeds were then returned to the high schools so that they could use them for safety and medical equipment for their student-athletes.

Accepting the checks for the schools were Mike Powell, Tulare Western’s athletic director; Diana Hatton, Tulare Union’s athletic director, and Michele Borges, Mission Oak’s principal.

“We appreciate the partnership,” Powell said.

“It’s a win-win on both sides,” Board Member Linda Wilbourn said.