Some paychecks issued by the Tulare Local Health Care District (TLHCD) to its employees on July 20 are not being honored.
Employees at the struggling medical center report TLHCD was unable to meet a deposit deadline on July 18 due to a cash shortage. They also report the District is behind on payments to its vendors, and one source tells the Voice the hospital has ordered employees to selectively order blood transfusions because of an unpaid bill from the blood bank. The District is also struggling to make payments to physicians.
“This is serious,” said a current TLHCD employee who wishes to remain anonymous. “It puts the public at risk.”
District Not Meeting Payroll Obligations?
Another employee who reported the dishonored paychecks said not all of the warrants issued by TLHCD have bounced. Those that did, she said, appeared to be for non-medical staff. The District is also late in making payments to employee 401(k) accounts by at least two pay periods, she said. This is the third time TLHCD has fallen behind on its contribution to employee retirement accounts. Previous arrears have run as long as 10 months behind.
Other oddities and inconsistencies abound. District employees report the amounts they’re paid have frequently been inaccurate since TLHCD switched payroll services. The District’s direct deposit system has failed for the last two pay periods, and employees have been issued paper checks on short notice twice.
“You will receive your paper check on Thursday 07-20-2017 pay-date just like last pay period,” an email from Tammy Kegler, the hospital’s manager of Human Resources read. “With direct deposit service, TRMC must transfer funds by noon on Tuesday to the paying bank. We are not able to meet the time frame required for this week’s direct deposit.”
More shocking, the District appears to be broke. According to recent accounting, TLHCD has less than nine days of operating cash on hand. It is also carrying $20 million in unpaid debt.
Calls to the District’s human resources department regarding unpaid employees were not returned. Dr. Yorai “Benny” Benzeevi, CEO of Health Care Conglomerate Associates (HCCA) which operates Tulare Regional Medical Center (TRMC) also did not respond to a request for an interview on the District’s financial health.
Doctors Not Paid
Dr. Mylene Rucker, contracted by the District to oversee physicians assistants and nurse practitioners at the District-owned Hillman Healthcare Center, said TLHCD has not paid her in three months. The nonpayment, she said, has been a hallmark of her relationship with the District.
“They were supposed to pay me every month,” Rucker said. “It was never fine, always delays, six weeks to eight weeks at a time.”
Rucker, who has now stopped seeing patients at Hillman but continues to oversee mid-level staff there, says she knows of at least two other physicians contracted with TLHCD who have not been paid for their services. Rucker complained each time payment was tardy, and eventually met with the CFO of HCCA. HCCA is owned in part by Benzeevi, who serves as its CEO.
“I had a meeting with (HCCA CFO) Alan Germany,” she said. “He said, ‘Well, we have to bill Medi-Cal for the money. We don’t know if all this is going to go through.’”
Rucker says she’s probably had enough.
“I haven’t quit yet, but I’m thinking about it,” she said.
ER in Peril, Numbers Declining
One of the physicians Rucker says was unpaid was an anesthesiologist who has not received payment for services rendered more than a year ago. Now, another source who wishes to remain anonymous says Tulare Anesthesiologist Consultants Inc., which staffs operating rooms at TRMC, is ending its relationship with the District.
Should that happen, the District will no longer be able to operate its emergency room, provide surgeries or offer maternity care, due to emergency C-sections requiring anesthesia.
Deanne Martin-Soares spoke at the hospital’s finance committee meeting on Tuesday, asking whether the hospital had a backup plan in place.
Hospital officials at the meeting did not directly respond.
“Is this anything that will be discussed at the board meeting tomorrow?” Delbert Bryant, the hospital’s long-time controller, asked Germany.
“Certainly,” Germany responded.
Calls to the anesthesia group’s president were not returned.
At Tuesday’s finance meeting, board members Mike Jamaica and Linda Wilbourn were told that the number of patients seen at the hospital has decreased.
“You can see that the volume is down, and we look at this on a regular basis, and a number of reasons for that,” Germany, the hospital’s CFO said, “as we kind of have all discussed, and are all familiar with.”
While the number of admissions at the hospital were roughly on par with last year’s numbers — 710 in the fourth quarter of 2016, and 702 in the fourth quarter of 2017 — the hospital’s average daily census decreased from 40.3 in the fourth quarter of 2016 to 33.8 in the fourth quarter of 2017.
The total number of clinic visits has also decreased — with the same period in 2016 compared to 2017, from 5,345 to 3,672; from 551 surgeries in 4Q 2016 to 379 surgeries in 4Q 2017. The most significant decline in surgeries was in outpatient surgeries.
Emergency department visits also decreased from 7,905 in 4Q 2016 to 6,606 in 4Q 2017, which Germany stated was likely due to many different reasons — including patients choosing other options, such as patients choosing to go to Federally Qualified Health Centers and clinics admitting to emergency departments in other cities.
“If we went back and worked at this for several years, deliveries at one point were quite a bit higher,” Germany said. “Some of it is the birth rate but quite a bit of it, as we know, is the choice of expectant mothers to go to other facilities to deliver.”
For 4Q 2017, the hospital had 120 deliveries, roughly equivalent to the same period last year
“Roughly, as you look at the three months, an average of about forty a month. Even with that low level of volume, we still have to keep a fully staffed obstetric unit,” Germany said. “That’s a safe thing to do, and of course a requirement to do.”
“Certainly can’t operate efficiently and economically as you have those low delivery levels,” Germany told the board.
A former employee, Greg Cotta, who worked 26 years as an RN at TRMC, agreed that the number of surgeries performed there was down to a third of the volume performed when HCCA took over. Cotta was laid off in September along with 29 other long-time employees.
“It’s just gone down like you wouldn’t believe,” Cotta said.
The drop in patients is similar in the obstetrics department, he said, where births have dropped from about 100 a month to about 30.
“Most of the experienced nurses have gone to Kaweah Delta,” Cotta said. “I don’t blame them. It’s scary for the mothers.”
Many, almost all the paychecks marked NSF (Non Sufficient Funds) were for medical staff.
It looks like it is time for a state or federal investegation as to the finances. HCCA and Kumar need to be held accountable for destroying our hospital.
So what will happen to employees! I just saw this guy in Black named Alex yelling at the Nurse’s saying they ought to be ashamed? And he called one of them a tramp. I didn’t know this was how respectful people act. All involved should be ashamed in how they conduct themselves in public. Sad sad these our leaders. The meeting was a joke. The new lady was sworn in the night before and she looks like a nice lady.
Hell No Bystander get your facts straight. That nurse Kimberly Hughes got into Alex’s face first and started saying unacceptable stuff to him. Then he said somethings to her that she didn’t like and called over the security guard and whined to him. Kumar supporters are sore losers. Time to give the new blood a chance to fix the mess TRMC is in, thanks to HCCA, Kumar, Wilborne, Torrez and Bell have caused.
The employees will not lose their jobs, them being forced to sign a form saying they can’t work for TRMC for 2 years is illegal and won’t even stand up in a court of law. The same thing would happen just like when HCCA took over. They interview and hire, or the new people says we will just take everyone. Hopefully interview, because their are employees who knew and willing put patients in harms way and that is not exceptable.
I was standing right there and Kimberly verbally attacked Alex. He did not say anything to her until after she started getting into his face and Alex was respectful and never called her names
I have seen those people bust their ass to keep that hospital going, I have seen people threaten them, verbally abuse them and take advantage of a bad situation by complaining if they don’t get their way by saying they are going to tell Benzeevi, the public or the newspapers how badly they were treated or the care was if their pompous demands were not met. Let me tell you working there is not easy with all the politics and bureaucracy BS! So stop attacking the staff, they speak up but their voices are never heard. Try doing your job surrounded by a financial and political mess!! It’s easy to go to a board meeting and talk some s*** and complain. Try being proactive and supportive of the staff trying to be supportive of this community. Not many of the experienced people are left and many travelers are taking on positions. Not very personable for the community. So there!!
So basically that was Senovia’s son? And he stooped down to their level. And you are all ok with that? No wonder we are in trouble. You disrespect each other. Well if you are gonna be in politics you better grow some thick skin. He should have walked away from them if he felt threatened. Next time, Take the high road young man walk away and don’t cave in that’s what people want when they push your buttons and that is for you to stoop down and loose your cool. Oldest trick in the book!
Unbelievable, just when you think you heard it all, more S_ _t hits the fan.
I would bet the CEO and CFO Checks didn’t bounce.
How do some people work for months without pay, or checks bouncing or benefits not being paid. So sad they cannot find work elsewhere.
I would like to see the A/P total aging, not just 30,60,90 days as some vendors have that written in their contract. What is outstanding
From 90 days on? This would not include what’s owed to physicians.
With such low volume you would think the billing company could stay on top of billing/collections in a timely manner.
We did not get paid when we were supposed to But after we did get paid that’s all that matters , they fixed it !!! Iam not on anyone’s side !!! The only side Iam am on is making TRMC better and instead of doing that you all are fighting like cats and dogs !!! When can we just work together as a community! All this negative has to be turned into POSITVE !!! All these new people on the board how are they going to act , how are they going to make things better please I hope they all work together as a team !!!! What happened in the past let it go MOVE FORWARD NOT BACKWARDS !!! TRMC could be the best , if everyone would work together !!! and for ALEX you need to be taught RESPECT- you don’t point at people you don’t know and call them trash especially TRMC employees that work hard and are there for there patients!
The only way to make it better is to remove HCCA, anything else is just going to require a blank check while he plays at being a CEO.
Unbelievable, just when you think you heard it all, more S_ _t hits the fan.
I would bet the CEO and CFO Checks didn’t bounce.
How do some people work for months without pay, or checks bouncing or benefits not being paid. So sad they cannot find work elsewhere.
I would like to see the A/P total aging, not just 30,60,90 days as some vendors have that written in their contract. What is outstanding
From 90 days on? This would not include what’s owed to physicians.
With such low volume you would think the billing company could stay on top of billing/collections in a timely manner.
Article is about 1.5 year old. None of these is new.
Article does not mention the MOST important doctor there – Dr Saqib Rashid. He is the one who admits patients to the floor and he is the ONLY one qualified to take care of patients in the ICU.
He was not paid for months so he resigned effective July 31. Without him, ICU care will be provided by people who are not trained to provide ICU management.
If you or your family member need ICU care, do not come to this hospital.
How much you wanna bet Bystander is Benny and he’s getting his kicks trying to stir up trouble like always?! I mean come on, the whole town hates your guts and you’re not going to conceal who you really are to find out what they’re saying? HA!
It’s Benzeevi or one of the other cronies. IF A NURSE IN UNIFORM with HCCA all over it, disrespts others she needs reprimanded. She approached Alex in an aggressive fashion, she searched him out. HE should have to taken high road, how about HCCA control their employees put there on TRMC time(taxpayer dollars) to fill seats be allowed to act that way.
I truly feel sorry for the employees whose pay checks bounced, They are the ones providing the care and services to the patients. I am disturbed if the nurse went after a citizen of the community this is a true lack of professionalism and should be addressed. Employees are there to provide care not get into politics, if your not happy with the recent election results stay out of the fray, do what you are there for, or seek employment at another medical provider. Until this turmoil is resolved my family will continue to go north to KDDH for care. That totals over 20 family members not counting friends all life long Tulareans
Employees were there hoping to get answers regarding many questions that are at the moment unanswered! We have a right to be at the board meeting too! However their were some snide remarks as some employees walked passed by my guess were some citizens. I think you need to get something straight just because many of the employees that continued to work at the hospital does not mean we stuck by anybody! If at all we stuck it out by serving this community to ensure there was medical care available. We did not turn our backs on the community because many of the employees not only need their jobs but believe this community deserved to have access to medical care and to have a local hospital. Don’t group all of the employees just because certain people have been more vocal than the rest of the employees. No one in particular represents or speaks for all the employees so don’t jump to conclusions. Just because the employees all wear blue does not mean they chose it, it’s required and mandatory dress code!!! So Stop saying we all chose a side! We chose to serve the community!
I respect the employees who have hung in there thru this. You all need to support families.But the ones in scrubs disprecting citizen makes everyone look bad unfortunately. If you aren’t one of the regulars there every meeting that’s good you were there. We know that most are there on the clock
All I have to say is the good people of this town deserve better from their healthcare leaders. The remaining original staff here, (and they know who they are) have stuck around not only for the people of this community but for each other. They know that the leaders they work under don’t support them so they hold on to support each other. I have taken my mother here to recive care in the past and they have always been attentive, respectful, and above all caring for her, especially in the ICU. I have seen the staff worked together to find solutions to better the health of patients. If someone acted out in a matter that was disrespectful to “Alex” they may not have meant to, but like the saying goes “corner a cat and get scratched”. We all have our bad days. I know Kimberly Hughes, as she has attended my mother and other friends that have been admitted here, and every time I have seen her she has a smile on her face and a tune coming out! if she lashed out it was for a reason something had to lead up to these actions. Were they the rights ones probably not, but if she was in the wrong I know she would personally apologize.
Actually, I was the first person he called “Trash and a Tramp” right after he told Linda Wilbourn off, and I don’t even know him..
After that he then went after a young girl from the Hillman clinic who’s mother sits on the city Council and threatened to kick her ass and her mothers , again witnessed by many many people. That girl walked off started crying and called the police. After the meeting was adjourned I had numerous people come up to me and ask me why he called me trash and a tramp.
I said I have no clue I never met this guy. Then after That he started to attack Kim telling her she was a tramp and trash along with other staff and this was heard by many people a young lady even came to her defense as Alex was telling her
” I know who you are I follow you I know everything you do”
This is completely false, I was there. The council woman’s daughter wasn’t crying, far from it. She was glaring at Alex, myself and other’s around us. She said some horrible things to Alex. He was letting it role off of him and was very calm.
When he told me what was said to him and then what he said, I then went over to speak to your group about it. Never once did anyone mention him “telling Linda Wilbourn off.”
We and I especially have received numerous attacks, horrible things. It solves nothing. Currently the checks bouncing are terrible and create angst in people. But unfortunately it was envitiable and you could see it coming. HCCA had no management skills and they have raped the assets with bloated salaries. It wasn’t sustainable and those of us that could see that have worked hard to avoid this.
I will say I am not going to stoop to this level. I did today and I am sorry for that. I am a grown woman and to have some young person glare at me for no reason was very strange. In trying to discuss with Kimberly I did mention it takes intelligence to understand the financials. So Kim sorry for that it was uncalled for and I think it is best if we just agree to disagree.
Deanne – I was actually there when Alex started calling people names – you were not , you were still inside the conference room at Evolutions. You did not come out until later. Alex was neither respectful or calm and was simply trying to cause trouble. Hospital employees asked him to stop calling them names and he told them he could call them whatever he wanted and raised his voice and aggressively approached them. I have never seen Alex before but I was shocked at his behavior. I have no idea why you would want to lie to stand up for him – but I suspect that is par for the course where you are concerned.
I’ve read all posted accounts of this so-called verbal altercation and it just doesn’t ring true. If this Alex person called you a trash and a tramp and you went as far as calling the police then why don’t you use your name in posting this info….makes one think that you are just slinging mud. Just doesn’t have a ring of truth in my opinion.
And while people are glaring at each other and arguing with each other and families are trying to pay bills even though their checks bounced Benzeevi is collecting his $25,000 a day….maybe that’s who people should be holding to account…
July 28, 2017 at 5:02 pm
We did not get paid when we were supposed to But after we did get paid that’s all that matters , they fixed it !!! Iam not on anyone’s side !!! The only side Iam am on is making TRMC better and instead of doing that you all are fighting like cats and dogs !!! When can we just work together as a community! All this negative has to be turned into POSITVE !!! All these new people on the board how are they going to act , how are they going to make things better please I hope they all work together as a team !!!! What happened in the past let it go MOVE FORWARD NOT BACKWARDS !!! TRMC could be the best , if everyone would work together !!! and for ALEX you need to be taught RESPECT- you don’t point at people you don’t know and call them trash especially TRMC employees that work hard and are there for there patients!
Ladies and Gentlemen Who Are Reading This,
First and foremost, I am a current hospital employee at TRMC. I, along with my co workers, come to work each day ready to take care of all patients who enter TRMC. We do care about the community we serve. We are not about the politics or other distractions, we are about taking care of patients and supporting families.
The public should be thankful that the employees, including the one’s whose checks bounced, still are coming to work. We are dedicated.
I am asking that the public please don’t attack employees verbally or otherwise. We are doing our best to serve the public.
As employees, we don’t support what HCCA is doing. Quite frankly, we all are very upset. But of course, employees are concerned about retaliation if they speak.
I do not condone any actions that make our situation worse. That includes employees not keeping calm. We as employees must stay the course and battle through to make it right. Employees, be professional and treat everyone with dignity.
To the Board, do the right thing and fix this. You have the authority to suspend the HCCA contract, get a $40 million dollar loan for operating costs, and contact the TC DA Tim Ward and CA ATTY General office. Have HCCA financials, creditors etc reviewed. TLHCD is protected under state law, and, HCCA falls under PC section 424. Mis appropriation of public funds because we are a district. HCCA is entrusted to maintain public funds.
Again to the public, please stop the attacks on employees. We are here to serve and ready to help you.
Thank you.
The DA won’t do anything. Dr. B is his pal and gave him a lot of “donations.”
I really applaud what you’ve said and I have the utmost respect for the healthcare employees that have suffered through the inept management of TRMC by HCCA and relief should come soon. I hope you realize that what is being referenced here is a very small group of employees that have allowed themselves to be used by Dr Benzeevi in his political campaigns. They go door to door in their scrubs saying pretty vile things about political opponents, they post libelous Facebook pages like “Nurses Against Northcraft”, and they attend meetings and publicly attack family members of the new board members…this I know first hand. But, I have never assumed they represent anything but people that will sell out their integrity to their current boss. But soon things will move ahead in a positive direction for TRMC to benefit all the employees at the hospital and I do mean all regardless of past activities.
This whole mess has everyone so inflamed and defensive you can’t see straight. First of all, Benzeevi isn’t that intelligent to give good advice let alone take any! You really think he knows anything about thick skin or taking the high road? You are giving him to much credit!! Chris Northcraft you are right!
TRMC EMPLOYEE 91, very well stated. I have never said anything bad about any single employee who is there doing their job, through all the CRAP HCCA has/is putting you through. But being bullied and verbal attached from certain employees personally does leave a bitter taste. I am friends with a lot of employees there still and took on this cause because I could see thru the smoke and mirror when they first brought in Boluki and then HCCA. this community deserves the best in healthcare,and I will continue to fight for this.
Bright girl
“one source tells the Voice the hospital has ordered employees to selectively order blood transfusions because of an unpaid bill from the blood bank”. This explains why I never got all the blood transfusions that were ordered and somehow lost when I was in the hospital for life threatening blood lose
I wonder if governor will be able to ignore it if board sends him a letter to request a forensic audit conducted by the state, with CC of that request to all concerned politicians – the house members & senate. I guess opponents will set fire under his touche if he sits on it.
Great idea! It would also be a great idea for a letter to go to the governor (and house & senate) to investigate campaign contributions from HCCA to the TC DA’s office!!!
It’s a sad situation for Tulare and nothing new. It started when Mr Balouki ran the show. The awe and scar tactics he used not only destroyed this wonderful hospital but also paved the way for more like him. The same board members that sang his praises were now calling him the worst thing that ever happened to us. In all this process we failed to learn from Corcoran hospital who’s history of corruption is probably at a lower level but in a similar pattern as Tulare. Unless we have visionaries who have the imagination to fulfill a dream and ability to sacrifice this situation will never change, not in a century may be never. Another HCCA will replace someone like another Bolouki. I have learned whenever things go bad or doesn’t happen it’s at 50% fault of the community also in which predators thrive on. Unless we are willing to change and sacrifice nothing new or progressive will happen to this community.
I always wonder why this area does not have quality hospitals despite having some of the richest farmers in the nation. My analysis is simple. Our elite believes when it’s turn to get sick, they’ll fly over to the university and fancy hospitals at the cost in their private jets. Let me tell you my rich friends. When a catastrophe will hit you or your family, where minutes count. No private jet or chopper will be fast enough to take you there. Get involved in your community. Make smart decesions. Creat a health care that can serve all- rich and poor. Ran honestly. I’ll assure you things will change. We’ll have to sacrifice to make it better for those to follow