The major project that has brought much consternation to Tulare’s hospital may very well be its pathway to a stable, if not surging, future.
In 2015, construction stalled on the hospital’s so-called “Tower of Shame.” Despite that, much upheaval has come since to the hospital and the public agency tasked with operating it.
In 2005, voters approved an $85 million bond to construct the new tower at the former Tulare Regional Medical Center. But funds ran out in 2015, leaving the tower with an uncertain future and under the microscope of Tulare’s Grand Jury.
Recent years saw the hospital declare bankruptcy and close down for a year.
But the former TRMC reopened in October 2018 and voters approved the partnership and lease agreement between the Tulare Local Healthcare District and Adventist Health.
Since reopening, Adventist Health Tulare has been on the rebound pushing an upward trajectory toward the hospital’s best shape in years.
Though it may take many years to find a solution to complete it, the tower is unquestionably the hospital’s future, especially because the existing hospital structure will not comply with California earthquake safety requirements that take effect in 2030.
The 2030 seismic requirements are the driving force for finishing the tower. California Senate Bill 1953, passed in 1994, set regulations that renders much of the existing hospital unusable in 11 years.
District Board of Directors President Kevin Northcraft was elected in 2016. He said since the hospital recently reopened and is averaging 10 occupied beds a night, finishing the tower is not immediately critical but is essential for the future.
The idea is to have the new tower available by 2030, otherwise, the hospital will have very little space to work with and would not be able to provide the necessary healthcare Tulare needs.
Completing it will be expensive though. Northcraft said completing the tower will take about $40 to $60 million.
The district may decide to complete the tower in stages – floor by floor, Northcraft said. Starting with the first floor, the lobby could be completed within the next couple years.
They’ve already started clearing out the first floor and have plans to improve the front of the building, Northcraft said.
The first floor also has an emergency room, which Northcraft called “state-of-the-art” and said it would be a big improvement over the current one.
While it could cost more money to phase the tower, Northcraft said it just might be the most practical option. There is no estimate yet as to how much more it would cost to complete the project in phases.
Funding is the elephant in the room, which is nothing new for the district. Voters turned down a $55 million bond in 2016 decisively, with two-thirds voting against it.
But that was years ago under the old management. With the successful reopening and new improvements coming to the hospital over the next year, like the obstetrics department and sleep lab, the district might have better luck now.
The district could look at going to the public for another bond but other options are on the table too.
“Everybody talks about a bond that we could go to the public, and I think the public might well support one,” Northcraft said. “But I also think they might well think, ‘Hey we already spent $85 million to build it. How many times are we going to have to pay for it?’”
If the district decides to try for a bond, private equity funding and future lease payments could help decrease the overall cost of the bond.
When the tower eventually opens, the lease agreement would be adjusted accordingly, bringing in more money to the district.
But another option could be to sell the hospital to Adventist Health.
The lease gives Adventist Health the opportunity to buy the hospital at fair market value, subject to voter approval in a potential future election.
“We fit very well in [Adventist Health’s] plans for expansion in the Central Valley, and so it’s something they may want to look at down the road,” Northcraft said. “But at this point I think they’re just trying to get the hospital fully functional. And I think it would probably be several years before they consider that option.”
Although it will likely be several years before the district proposes a solution for the tower, the 2030 date looms over and is the deciding factor on the future of Tulare’s hospital.