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March 3, 2022 - Community Engagement Virtual Meeting

QUESTIONS FOR 3/3/2022 COMMUNITY ENGAGEMENT MEETING

  1. CURRENT COVID-19 NUMBERS IN KAWEAH HEALTH
    1. Positive COVID-19 cases currently in Kaweah Health: As of this morning, we had 49 COVID-positive patients in inpatient beds.
    2. How many are in ICU and do we have empty beds in our ICU? six of the admitted COVID inpatients were in the ICU (4 on vents). As of this morning, eight of our 41 ICU beds were available for admission or transfer.
    3. Hospital Census: As of this morning, 318 of our 344 adult inpatient beds were occupied, representing an occupancy rate of 92%; in addition, we had another 29 patients waiting in the Emergency Department for an inpatient bed to open up (what we call an “admit hold” patient); including these admit hold patients, our real adjusted occupancy rate was 101%.
    4. Vaccinated employee percentage: Our employee vaccination rate for those employees that are subject to the Governor’s vaccination mandate is approximately 82%; for our Medical Staff providers, it is approximately 96%.
  1. I saw on the news earlier this week the central valley is still considered high-risk in California, how does the State measure this? Probably because of our County’s continually-low vaccination rate which stubbornly stands at 51.5% fully vaccinated with another 6.6% that are partially vaccinated; at the State level, 70.5% of residents are fully vaccinated with another 11.5% partially vaccinated. Tulare County’s positivity rate sits at 7.2% whereas that State has dropped down to 2.6%.
  1. California lifted the mask mandate in schools starting on March 12, has there been any talk on lifting masking for employees and/or visitors at Kaweah? We would love to lift the mask mandate for our employees and visitors but the Governor’s recent order to lift mandatory masking specifically excluded hospitals and healthcare entities; as such, our masking requirements remain unchanged for now.
  1. We know there have been epidemics within the pandemic, how will Kaweah address or be prepared for our mental health crises? Kaweah Health is committed to a significant expansion of our mental health service line. In addition to operating our 63-bed acute mental health facility and our psychiatry residency program, we just recently matched our very first residents into our new Child & Adolescent Psychiatry Fellowship program. We also were just awarded a $4.9 million grant last week by the California Health Facilities Financing Authority to jointly develop, with our Tulare County Health & Human Services Agency, an Adolescent Crisis Stabilization Unit, to care for children experiencing an acute mental health crisis. We also plan to develop an Adolescent Mental Health Residential Care Facility that would provide inpatient, voluntary mental health services to our youth. Lastly, we are working with our mental health physicians to develop additional outpatient mental health services in our community.
  1. The COVID 19 pandemic influenced every niche and significantly increased competition amongst business across all industries. Have the open positions at Kaweah decreased at all? Our workforce has certain been under great strain as has the rest of the Country in almost every industry. We currently have 564 open positions across the entire organization of which 191 are bedside nurses. We also still have close to 250 contracted staff (often times called “travelers”) and continue to pay hundreds of thousands of dollars every pay period for overtime and extra shift bonuses.
  1. How many beds are staffed in the ED now? How has zone 5 helped with the pandemic? All 73 beds across the five zones of our ED are open and staffed; this has only been made possible by the presence of contracted staff and our employees working overtime and extra shifts. As of this morning, we had 29 patients sitting in the lobby or exam rooms waiting for a bed to open up upstairs. We have nurses and doctors who are dedicated to caring for these inpatients who wait in lobby chairs or ED rooms. Zone 5 and its 24 new beds has had a very positive impact on our ability to care for more patients and keep fewer in the lobby.
  1. How has the pandemic effected our primary care providers? Has this effected retention and recruitment? I think it has definitely accelerated the retirement of a number of primary care physicians throughout the country, the State and our local community. I know that many of them are burned-out and fatigued and concerned about their patients not seeking timely care from them and letting their health deteriorate. The pandemic has also had a significant financial impact on physicians as patient visits and procedures have steeply fallen during periods throughout the pandemic.
  1. When are elective surgeries going to reopen? Elective outpatient surgeries have been fully open for many months but elective inpatient surgeries have been capped at eight per day due to the lack of inpatient beds. But, as the Omicron variant and associated hospitalizations continue to fall, we believe we will be able to fully remove the cap within the next week or two.
  1. What is the status on SB1953? It still remains the same but the California Hospital Association continues to work with the Governor and State legislature to change SB1953 from a requirement that all hospital buildings in which acute patient care is provided meet very stringent seismic standards to one where hospitals can demonstrate an ability to provide post-event emergency care for up to 72 hours in seismically-compliant space, including the emergency room, operating rooms, patients rooms, pharmacy, dietary, water, etc.



    Under this definition, buildings would have to have a Structural Performance Category rating of at least SPC-2, WITHOUT considering a hospital’s geological seismic risk rating assigned under FEMA’s Hazus program. Unfortunately, it appears that Kaweah Health’s Mineral King Wing was given an SPC-2 rating by OSHPD only because of its low Hazus rating; without the Hazus rating, the MKW would only meet SPC-1 and cannot practically be retrofitted or braced to meet SPC-2 without the Hazus consideration. While all of Kaweah Health’s Emergency Department and many of its operating rooms and beds located in the Acequia Wing, East Expansion and West Expansion are SPC-3 or higher, the 206 inpatient beds located in the Mineral King Wing are only considered SPC-1 under CHA’s proposed bill.
    As such, our efforts continue to be exploration of a new hospital tower that would replace all of the Mineral King Wing beds as well as a new pharmacy and dietary. To make this happen, we would need the State legislature to grant us more time beyond the current SB1953 deadline of 2030 and we will need significant financial support from our community.