Two of the Tulare Local Healthcare District’s potential partners have indicated that the Tulare Regional Medical Center’s reopening in October is unlikely.
RFP responses obtained by the Valley Voice indicate that both the Kaweah Delta Healthcare District and Community Medical Centers would not be prepared to reopen the hospital by October. According to the hospital’s interim CEO, two other entities have not ruled out the possibility of an October reopening.
“I think they’re looking at their schedules and have other priorities,” Kevin Northcraft, the chairman of the Tulare Local Healthcare District board, said.
Both entities have been offering help throughout their process, he said.
The Hospital’s View
“We’re committed to the hospital being in better shape when we reopen than it was when we temporarily suspended. Several things need to be done. But that’s all being scheduled and waiting for funding,” Northcraft said.
Larry Blitz, the hospital’s interim CEO, agreed that the potential partners may have other priorities.
“I think it’s an independent analysis that each of them are making, and either these entities are going forward because they feel it’s an opportunity and they can meet the guidelines, or they can’t. That’s up to each individual entity to determine whether they can go forward within the guidelines that the board has presented,” he said, adding that all four would be able to run the hospital successfully.
He said that Adventist Health and Dignity Health have both indicated that, so far, they may be able to reopen Tulare Regional Medical Center by October 29.
“We won’t know until the [entities’] presentations to the ad-hoc committee and subsequently the potential presentation to the board on June 27, what the exact stance each of the potential suitors will be,” he said.
Two to three of the entities contacted could be making presentations, Blitz said.
He added that because the board’s current goal is to open the hospital as soon as possible, and certainly before October 29, he did not believe the board would request an extension of the hospital’s suspension.
A long-term lease as theorized in the district’s request for proposals would need voter approval, he said, requiring the filing of a measure at least 88 days before the November 6 general election.
“The board is pleased and the administration is pleased that all four of the targeted individual organizations were interested in the possibility of affiliation or a lease. That, to me, means that the future of this hospital is very very good. Where we have differences in how, when, and where we would open the hospital; and, each organization is different,” Blitz said.
Community’s View
A one-page response from Tim Joslin, President/CEO of Community Medical Centers, states that “…CMC has determined that significant capital is required to replace aging equipment, finish construction projects, address seismic compliance, and complete critical safety and infection-control repairs.”
Representatives from Community Medical Centers have previously been on the grounds of Tulare Regional Medical Center, but it is not clear whether they have performed an in-depth inspection of the hospital’s facilities.
He specifically mentioned Community’s involvement with Tulare over the last 12 months, including making legal services available, providing consulting services at no cost, and providing access to loans as part of their commitment to “all residents of Central California.”
An October 2018 reopening would risk the hospital’s financial future and would not allow time to address critical needs, Joslin wrote.
Representatives for Community declined to comment beyond the RFP letter.
“We’ve been in discussion with the Tulare Healthcare District for more than a year, and it’s very possible that discussion will continue in some way. That’s for the District to determine, of course, and we won’t comment further on our RFP response letter,” John Zelezny, Community’s Senior VP/Chief Communications Officer, told the Voice.
Kaweah Delta’s View
A three-page letter from the Kaweah Delta Healthcare District, written by CEO Gary Herbst, outlines the Visalia-based hospital’s conditions for entering into a partnership.
Herbst stated in the letter that Kaweah Delta was not able to perform necessary due diligence to submit a formal RFP proposal.
He states that it is “not in a position to invest in or loan TRMC the requested $22 million of funds referenced in your RFP,” and that “given the lengthy closure of TRMC’s hospital and facilities and the manner in which it was maintained and managed by HCCA, we must be allowed sufficient time to perform a comprehensive assessment of the condition of TRMC’s facilities..”
The letter goes on to state that “we believe it is unrealistic to try and re-open TRMC by October 1st (as stated in the RFP) or by October 29th (which we understand to be the one-year anniversary of the license suspension),” and that “we believe you must immediately secure an extension of the license suspension to December 31, 2018.”
He elaborated on the statement further with the Voice.
“I haven’t been in the hospital in well over a year and same with our staff, so I’m essentially basing that on the conclusion that I would walk into a hospital that is for the most part empty, and I don’t have any idea what the condition is of their infrastructure, electrical, plumbing, just the operating capacity of their ORs, things of that nature,” Herbst said. “I believe that it would take Kaweah Delta at least a full month just to conduct a comprehensive assessment of all of the different systems, and the things that go into the operation of the safe and high-functioning hospital, because certainly the day we open or reopen we would want that very first patient to experience nothing but a highly safe, efficient high quality service.”
He said that press reports showing that the hospital had sold its supplies and equipment played into that conclusion.
Kaweah Delta’s assistance began in September of 2017, when the newly-elected board reached out to Herbst and he provided them with a “Healthcare 101” presentation, he said. Throughout his time assisting Tulare, he stated that his motivation has only been to assist a sister district hospital.
“I’ve just tried to maintain a very collegial, supportive relationship with them, most recently I wrote a letter on their behalf to the state to help support their request for funding out of the governor’s budget, for this coming fiscal year,” he said.
One unique form of governance that Herbst’s letter touched on was the potential of a Joint Powers Authority between Kaweah Delta and Tulare, or potentially Kaweah Delta, Tulare, and the Sierra View Local Healthcare District. The Sierra View district runs Sierra View Medical Center in Porterville.
“Joint Powers Authorities are legally created entities that allow two or more public agencies to jointly exercise common powers. Forming such entities may not only provide a creative approach to the provision of public services, but also permits public agencies with the means to provide services more efficiently and in a cost-effective manner,” according to Best Best & Krieger, LLP.
Herbst stated he was in active discussions with Donna Hefner, the CEO of Sierra View Medical Center, about potentially combining certain functions in a Joint Powers Authority. In his letter, he states that a potential Joint Powers Authority arrangement could potentially be used to manage Tulare Regional Medical Center.
“We never approached Tulare with a formal proposal, but I referenced it in my letter to kind of differentiate where Kaweah Delta is a bit more unique from Adventist or Dignity or Community, essentially we’re kind of a sister district hospital. The 3 hospitals in Tulare County are all district hospitals, whereas Adventist Community Dignity are all private, non-profit hospitals,” he said.
Herbst said that he had not received any indication that Kaweah Delta’s conditions were rejected or unacceptable, and that Kaweah Delta had been asked to provide a presentation to the Tulare district’s ad-hoc RFP committee; he stated that because the RFP was so fresh, there was not such a presentation prepared, but that he would be able to sit with the committee and discuss potential affiliation options.
Northcraft stated that the decision of whether the two companies would be able to continue in the RFP process would be one for the district’s ad-hoc RFP committee to decide.
It is probably time for Mr. Northcraft to recognize the experience that both of these entities have and think twice about his desire for a fast open. The place was run into the ground. Do it right, not fast – the community deserves it. Opening on a shoestring is a very poor idea.
@Reality Check
I couldn’t agree more.
Opening quickly, just to open needs to be weighed heavily. That’s just like saying to choose either quantity or quality. The hospital has needed a lot of work done(maintenance, equipment etc) for many many years. Let’s do it right
Let’s remember that it must not be… what’s good for the hospital today but ….. what’s good for the hospital’s future.
What does CMC and KDDH know that don’t know. I hope the board listens to all interested health care providers.
The letter goes on to state that “we believe it is unrealistic to try and re-open TRMC by October 1st (as stated in the RFP) or by October 29th (which we understand to be the one-year anniversary of the license suspension),”
It will be nearly impossible to reopen once TRMC loses its license in October. TRMC would have been closed for an entire year! How safe are those medical equipments that have not been used or tested for a year? I wouldn’t want to be admitted there as test patient.
Hey, Kevin, you failed us! You promised months ago that you would reopen the hospital in a matter of months. You shouldn’t have misguided everyone with your lack of knowledge on how to run a hospital. You prevented the loan to go through to keep the hospital to stay open, and now you cannot get any loan to reopen it.
What make a community thrives are good schools, good jobs, good medical care, and safe neighborhood. The lost of good medical care with bring down Realestate and will devalue our community. It is vital that we have a good hospital in our area. Medical care is not a luxury, it’s a vital need.
We need our hospital to reopen!
It does no good to reopen a hospital that is not healthy or capable of thriving. Time to consider alternative options. Sometimes we can’t get what we want.
So the reality has finally hit us… I really wonder what drove Northcraft and Jamaica to start this revolution to close down the hospital in the first place? Senovia is just a puppet for Northcraft. She doesn’t know up from down. The other two board members joined when the mess already happened. They are not at fault. They mean well.
Northcraft and Jamaica have blood on their hands… the lack of medical care on our area will cause that. Why did they start the revolution especially when they don’t know how to run a hospital? Why they did not approve of the loan HCCA was seeking to have the hospital to stay open and then renegotiate the contract with HCCA to oust them instead of filing bankruptcy? Why closed the hospital without any certain plan to reopen it? Who is driving these two people? What is their motive? They should be investigated. How can they think any one will loan or invest in a closed and bankrupt hospital? There is a serious lack of logic here. Perhaps these two are up to something…maybe getting a kick back from the management company that they hired that is as costly as HCCA.
Why did HCCA leave the hospital in a mountain of debt? Why did they not pay their suppliers for months on end? Did the traveling nurses service HCCA stiffed also play games with their employees pay checks like HCCA for theyre employees? Why was HCCA so unclear with its funding sources for the loan, and why did HCCA refuse to bring the loan back for approval? Why did HCCA not pay its outsourced billing provider? Do you think I want to collect money for you when you refuse to pay me? Why does Community feel that significant safety and infection control repairs are necessary? Why did HCCA not cooperate in the smooth transition to another provider and instead force the board’s hand into a suspension?
Truth time,
It is apparent that HCCA did not have the funds to to pay all their suppliers, that was why they asked for the board approval of the loan, which the board refused by seating Senovia to stop the third vote. The board was adamant about not wanting the loan to go through under any circumstances. The board loathed HCCA with a vengeance with name calling and all kind of accusations, you expect HCCA to “cooperate” when the board attacked HCCA and did not pay them for their services either. If you want to work with the enemy (HCCA), being cordial and professional is the better approach than to constantly attacking the enemy and demanded them to cooperate.
Wow “ angry” the blames lands squarely on the shoulders of Bell,Wilbourn, Gadke, Torrrez ,Benny and Kumar….. that hospital was going to close one way or the other at least the board stopped another loan to be placed on the backs of the district…..I will say I hope that hospital does not open until it is prepared and ready to give quality care and have quality doctors not the Rejects from the other hospitals in the area, a hospital is only as good as it’s staff more so than it’s leadership. Kevin you have one chance to get it right … please think outside the box !
@frustrated. The hospital can apply for extension of the license and can get it. This isn’t over. It just needs to reopen with EVERYTHING in working order. CMC will provide that, they just want a long term lease which has to go to a ballot. They have the $$
I hope they will be able to ask for an extension. However, the longer TRMC stay closed, the debt will continue to mount up.
@angry. Northcraft and Jamaica did not do this. HCCA created this mess and raped the hospital. Kevin and Mike were just left to clean up. You need to read all of the board minutes and news covered by the VV. HCCA would have put all loan funds in their pockets. You are quoting many false statements.
I think that reopening the hospital in October would be a mistake. Don’t rush it, do it right. As for me personally, I would prefer that Kaweah Delta be the new partner of the Tulare Regional Medical Center.
There are two entities who need to be appeased before October. The CA Department of Public Health is one – they may or may not extend the license suspension. The second is OSHPD and they are the major reason this hospital has to open by October or it won’t open at all. The current facility is grandfathered into seismic code that allows it to not meet current standards until sometime in the 2020’s hence the need to build the tower. That grandfathering goes away if the hospital doesn’t open in October. They will not waive seismic regulations and the current facility will not meet them. Period. Stop hoping for some perfect solution that will never come – get the damn hospital open in whatever capacity is possible with the minimum services required by the State (8 active services and ancillaries) and fix what you can when you can. CMC has been stringing the hospital along for months promising to take steps they never complete while member of citizens for hospitality accountability continue their ego driven scorched earth campaign and attempt to undermine the efforts of Wipfli to negotiate. Kevin Northcraft – who promised in board meetings that the hospital would be open in weeks knew CMC was not ready to step up – hence the reason he was so keen on getting an RFP out several board meetings ago when the rest of the board still had faith in CMC. His continued back channel efforts do nothing but serve his ridiculous ego and childish antics continue to casue nothing but ruin. Northcraft, Jamaica, and Senovia (dumb, dumber, and dumbest) and their evil puppet masters (Patricia “Orin Scrivello” Drilling and Deanne “god-complex” Martin-Soares) own this current fiasco and continue to do what they can to satisfy their own petty power-mongering. Their torch and pitchfork wielding minions who have literally no effing idea about how to operate or run a hospital need to all sit down shut up and recognize that they bit off way more than even their gaping maws can ever chew.
Open the hospital with Adventist or Dignity – they will do it and have done it with worse situations. Stop letting your hope for the perfect destroy the potential good. Let Wipfli and Adventist or Dignity get this deal done or you can watch the Tower and the current facility turn into a monument to the enormity of stupidity and desire to tear everyone down that seems to infect Tulare.
Been there,
I cannot agree with you more. You are the voice of reason. Thank you.
Time will tell that all the people who supported dumb, dumber, and dumbest will see that what they have done will destroy TRMC with no chance of recovery. They are driven by hate not by logic and definitely not by what is good for our community. Their egos are bigger than their IQs. I hope the other two board member put some sense into them.
Totally concur with what been there has stated above. Tulare has been cursed with vocal folks who know nothing about healthcare, made poor decisions on management groups and goes after any group that comes in. So perhaps these entities see this pattern and don’t want to have to deal with an inept Board and loud mouthed dentists and someone who ran their healthcare business to bankruptcy. Get something opened, maybe the clinics without using the hospital license and get there own until they get someone in there like Dignity or Adventist, not sold on CMC if they have been there all along since Wipfli got there
Really people you just want it open no matter the circumstances. Well let your family members be the canary in the coal mine ! Me thinks the above comments are from staff trying to keep their jobs a little longer ……and get something straight EH the old board started this mess, thank God this new board stopped the unsafe nonsense going on at HCCA, both of you have no idea what was going on at HCCA ……of course it’s always easy To be the Monday morning quarterback .
Geez people,
Anyone that said anything against the new board is either a nurse, an ex employee, or Benny himself. Get real. The old board included Northcraft and Jamaica. These two started the entire revolution to bring down the hospital. The hospital was doing better until 2016, when they came along with their negativity to make the hospital to lose members and income. These people do NOT represent all Tulareans. They are just more vocal
All of those who supported them to bring close the hospital are responsible for the down fall of Tulare…Loss of jobs, income, healthcare, and now realestate value. How can you be so one sided and blind? You choose to follow regardless of what is happening on the ground.
No frustrated you are very wrong… the employees wanted HCCA exposed for the unethical people they are and that includes Kumar who has had his dirty little fingers in this for years . Really the hospital was doing better. How’s that? Inform me…. you have no clue what was going on at HCCA they wanted that hospital to fail, that hospital was losing money because of their incompetence and lawsuits and lack of confidence of the community, your anger is also misguided aim it at Bell, Wilbourn, Torres, Gadke and Kumar for signing on to the most insane contract imaginable! I guess you believe like Nancy Pelosi sign it ……..then we will read it latter…..
Down fall of Tulare, 1 certain members of city counsel 2. Bell and cohorts 3. Lack of new industries 4 . People not doing their homework when voting 5. Homelessness on almost every corner, massage palors everywhere …….. solution get involved , ask questions, educate yourself and dont vote for someone unless you know what they stand for … then maybe Tulare will once again be a great little town ….frustrated Even though I disagree with you …I do appreciate that you at least care,
Bottom line all of you….we will not know for years, yes years all the illegal things Kumar and Bensleasy did to the hospital a d therefore to this community! Get a grip. Did not see any of you brsintrust people stepping up and taking on this mess! Seriously.
Many of these comments are from Benny and his pseudonyms. He trolls these pages. He just does not have any allies who would defend him and lashes out at those who see him for the dimwit he is.
The new board and the Citizens committee were left to deal with the ruins and did what they had to do to prevent even greater theft of public resources. That alone is a major accomplishment. The hospital closure was a foregone conclusion when Benny commenced his scheme to steal the hospital.
The hospital will probably remain closed for some time to come. The fact they are still maintaining staff is a charade and that should be stopped. Benny has used a scorched earth policy of “if I cant have it, no one can”. He has evil in his heart, there can be no disputing that.