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Thursday, Mar 28, 2024

Growing Pains

Fifteen months after the new Palmdale Regional Medical Center opened its doors with great anticipation to quickly expand to 239 beds, large parts of the new hospital remain empty and unused. Now with a new CEO on board, the hospital is putting together a three-year strategic plan to identify the kind of services that would bring in enough patients to allow the hospital to fulfill its original plans. Palmdale Regional opened in December 2010 with 121 beds and now has 157, still 82 short of planned. Half of the second floor, half of the third floor and the entire fourth floor remain empty, hospital officials said. Former CEO Robert Trautman, who shepherded the institution through its move and transformation from a 117-bed community hospital in Lancaster to a much larger institution in Palmdale, resigned earlier this year for personal reasons and moved out of state. The hospital had planned to have all 239 beds open this year, but some of those plans have had to be put off, due in large part to the souring economy. “The economic conditions of the last few years slowed growth in certain areas,” said incoming CEO Larry Coomes, whose appointment was announced May 11. Coomes is now tasked with the job of seeing the original plans to final completion. Elective surgeries declined and people with high-deductible medical plans put off procedures, he said, making it financially challenging for the new hospital to build out the maximum number of licensed beds. But Coomes said he is studying the region to understand what service lines are needed in the Antelope Valley community and which would drive more business to the new hospital. Among the possible new service lines he may introduce and expand are oncology, cardiac care and orthopedics, he said. But the new CEO is likely to face multiple challenges, including a more competitive landscape in the Antelope Valley than existed a few years ago when Universal Health Services purchased Lancaster Community Hospital and laid plans to move the institution to Palmdale and greatly expand its size. Antelope Valley Hospital has added new services in the meantime and Kaiser Permanente is in the midst of building a new 100,000-square-foot state-of-the-art specialty medical building, which will house offices for 60 specialty physicians. The county of Los Angeles also is adding more primary care services with its new High Desert Health System Multi-Service Ambulatory Care Center (MAAC). The greatest need in Palmdale and the rest of the Antelope Valley is internists and family care practitioners, said Coomes, who is working on a strategy to bring more primary care doctors into the region. But he also believes there remains an unmet need for specialty services in cancer and cardiac care. Other service lines could include urology and an expanded ear-nose-throat specialty, he added. “We’re also considering an advance into robotics and launching women’s service lines, especially gynecology and urology.” He said both are underserved needs in the region. Coomes said another of his top priorities will be attracting more physician partners and convincing them to refer their patients to Palmdale Regional. “We’re looking nationally and regionally for doctors to affiliate with us and come on board,” he said. Down the road, he is also looking to build partnerships with specialty hospitals with a recognizable brand name, a strategy that Antelope Valley Hospital recently used to provide robotic surgery for urologic cancers through its affiliation with the USC Institute of Urology. Coomes comes to Palmdale from the 213-bed Auburn Regional Medical Center in Auburn, Washington, where he was CEO. Like Palmdale, Auburn is part of Universal Health Services, a hospital system that operates more than 100 acute care hospitals nationally. He said a big focus for him at Auburn was attracting and keeping physicians, including finding ways to align physicians’ interests with those of the hospital. The term physician alignment is often code for the practice of employing doctors, which is a complicated challenge in California, but something a growing number of hospitals are doing in a bid to be competitive. Coomes said he hopes to eventually identify a way to employ doctors, especially badly needed primary care doctors. But in the meantime, he wants to make Palmdale as hospitable to doctors as possible. “We want to be honest, and responsive,” he said. “I want them to know we will always be available to them.” Coomes said that kind of responsiveness — an attitude that comes from his previous experience in the automotive industry where his last job was national director of franchising and business development for Porsche — is what’s allowed him to build trust with the medical community in his previous jobs. As chief operating officer of the 195-bed West Boca Medical Center in Boca Raton, Fla., he was instrumental in achieving year-over-year increases in both physician and staff satisfaction scores, he said. At Auburn Regional Medical Center, he said he helped take an institution with no physician employees and no plan for physician alignment to one that employed 12. Coomes admits he has many challenges ahead. For example, even though the hospital has had to put off plans to build out all its licensed beds, the hospital’s 35-bed emergency room is extremely busy and the hospital has had a tough time attracting enough doctors, nurses and other staff to meet the need. With more state cutbacks in funding for Medi-Cal looming, he will have to find ways to manage the soaring ER admissions and keep costs down. But he said he is also excited by the prospect of continuing the work that was started under Trautman, the previous CEO. “This is a great opportunity to work with a great staff in a brand new facility.”

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