April 27, 2023 - Community Engagement Virtual Meeting

Community Engagement Webinar - April 27, 2023

1. Current Census at KAWEAH HEALTH
   As of 7:00 this morning, we had an adult occupancy rate in the acute medical center of 83.7% with 23 of 41 ICU beds, 23 of 54 ICCU beds and 11 of 237 medical/surgical beds open for admission and only three admitted patients holding in the ED; we also had only four pediatric patients in our 12-bed pediatric unit. Yesterday we had only nine COVID-positive patients in-house and none were in the ICU or on a ventilator; over the last week, 35% of our COVID-positive inpatients had COVID-19 as their primary diagnosis and they stayed for 11 days on average; we now only test for COVID of admitted patients if they are symptomatic.

2. When will the Industrial Park Clinic be opening? What services will be offered there?
   The Industrial Park Clinic (i.e. Kaweah Health Medical Clinic - Plaza) is on schedule to open Monday, September 4, 2023. Its initial focus will be occupational medicine, workers’ compensation and walk-in care as well as radiology and lab draw. As the Clinic establishes itself, we foresee adding primary care to this location as well. Skilled and passionate occupational medicine and workers’ compensation staff currently working at our Ben Maddox Clinic will transition to the industrial park clinic when it opens in September.
   a. How is the staffing at the hospital? Do you still have a lot of open positions?
   Staffing has improved as the acute inpatient census declines to more normal, pre-pandemic levels but we still have 400 open full-time and part-time positions across the organization; 150 of the open positions are for registered nurses and 50 for LVNs.
   b. How many travelers does Kaweah have at this time?
   We currently have 85 traveler nurses supporting the acute medical center with most of them deployed to Labor & Delivery, the CVICU and the Emergency Department. The average hourly rate paid to the staffing agency continues to hover around $120.
   c. Did your staff receive the healthcare retention bonus?
   We did finally receive approximately $4 million under the California State Retention Bonus Program, known as “Worker Retention Payment”, and paid it to all eligible employees on Friday, April 21^st. Along with this payment, Kaweah Health paid approximately $300,000 in unfunded payroll taxes.

3. March Financials Review
   For the month of March 2023, I am thrilled to announce that Kaweah Health reported a positive operating margin of $3.8 million. We did see some positive trends as our contract labor expense for March dropped to $2.5 million for the entire month compared to over $7 million we experienced back in August and September. Through the nine-months ended March 31^st, our cumulative contract labor expense stands at $41.6 million, equal to the amount we spent for the entire 12-month period ended June 30, 2022.
   Our year-to-date cumulative operating margin now stands at $39.1 million but we are still projecting that we finish the last quarter of the fiscal year at close to break-even, due to the efforts of our “Back in Black” financial recovery plan, and it is quite possible that the quarter ends in the “black” if we receive the $12 FEMA recovery we are pursuing. This said, we will still finish the entire fiscal year in the red and quite a bit more than the $11 million operating loss we budgeted for the year.
4. Update on VMC
   The transfer of ownership of the Kaweah Health Medical Group medical foundation to the Adventist Health Physicians Network medical foundation will officially occur at midnight on April 30^th, this coming Sunday. At that time, Visalia Medical Clinic will become a contracted medical group of the Adventist Health foundation. Kaweah Health, at the request of both VMC and AH, will continue to provide ongoing support services to the Clinic for a period of time until AH can fully build and integrate the infrastructure necessary to operate the Clinic (e.g., phones, computers, medications, etc.).
5. State
   4. Is the state doing to help hospitals financially?
      On April 18^th, AB 412 was approved by a 15-0 vote by the State Assembly Committee on Health. The bill would create the “Distressed Hospital Loan Program” and would provide a perpetual annual funding appropriation of $150,000 million. It would be available to non-profit and public hospitals that have less than 90 days of cash on hand and have incurred an operating loss over the last 12 months. These interest-free loans would have to be repaid but they are working on provisions to make them forgivable under certain circumstances, likely continuing financial struggles. The bill now heads to the Assembly Committee on Appropriations and then will go to the full Assembly for a required two-thirds vote and then on to the Senate for a similar two-thirds vote and then on to the Governor.
      
      Separate from this, the California Hospital Association continues to lobby the legislature and the Governor’s office for a one-time, $1.5 billion appropriation in the Governor’s fiscal year 2024 budget. This funding would be distributed to those hospitals most in need which would likely be those serving a disproportionately-high number of Medi-Cal patients. We will know much more when the Governor issues his revised budget in May.
      e.Is the state going to start working on overhauling the Medi-Cal reimbursements?
      Senate Bill 870 has been put forward by State Senator Anna Caballero whose district covers parts of Merced, Madera and Fresno. Her bill would impose a tax on Managed Care Organizations, like Anthem Blue Cross and Health Net, to raise anywhere from $2 to $3 billion per year to enhance Medi-Cal payments to providers. It is currently sitting in the State Senate’s Committee on Health and has a ways to go before it would become law
      f. Is the state going to delay the seismic requirements related to SB 1953?
      State Assembly Member Jim Wood, whose district covers the coastal areas of upper northern California, has introduced Assembly Bill 869: “Hospitals: Seismic Safety Compliance” that would grant a five-year extension to district hospitals who could demonstrate that they were financially distressed. The bill would also allow district hospitals to apply for State grants to meet the seismic requirements and would allow continued and indefinite extension of the compliance deadline until adequate funding becomes available. The district would have to regularly submit financial reports to the State demonstrating their continued financial hardships. The bill was approved unanimously by the Assembly’s Committee on Health back on March 21^st and is now before the Assembly’s Committee on Appropriations. It appears that there is currently no union opposition to this bill.

State Senator Shannon Grove, a big supporter of Kaweah Health, introduced Senate Bill 759 that would grant a 10-year extension to the 2030 seismic deadline for all California hospitals but she pulled it yesterday from the Committee hearing for some unknown reason, perhaps as to not conflict with Assembly Member Wood’s bill