Centers of Care
by Doresa Banning
Tahoe's two local hospital systems, with offshoots in Gardenville and Incline Village, provide state-of-the-science care.
Healthcare around The Lake has changed a lot in the last 50 years. Once, a handful of family doctors covered the area and treated everything from croup to colitis, even making occasional house calls. Today, we have scores of specialized physicians at our disposal, and we visit them in busy town offi ces. Our local hospitals have seen similar growth. Since their genesis in the twentieth century, Tahoe's hospitals have evolved from small, individual facilities to large systems that encompass multiple entities and offer numerous services. Here's an overview of the area's offerings.
TAHOE FOREST BECOMES A HEALTH SYSTEM
In 1952, the residents of Truckee completed Tahoe Forest Hospital on land donated by a local, Richard Joseph, in memorial to his son Lavon, who was killed fighting in World War II. The hospital was a 10,000 square foot building that housed 11 beds.
Today, the hospital spans 117,000 square feet, contains 25 medical/surgical beds, a 4-bed women and family unit, a 6-bed intensive care unit and 37 skilled nursing beds. It employs about 600 people and is in the midst of a $30 million, 43,000 square foot expansion called the Western Addition. The first 2 phases have resulted in a new medical/surgical unit, gift shop, conference room, cardiac rehabilitation space, main lobby, imaging center (Briner Imaging), magnetic resonance imaging (MRI) machine and café. In the fi nal phase, the outpatient surgery center will be expanded. The new lab and intensive care unit are slated to open this spring. But the hospital is only part of a system that includes ten ancillary entities spread throughout the North Shore community. Tahoe Forest's shift from a hospital to prevention education for job-related illness and injuries, work site safety evaluations, immunizations, OSHA-mandated compliance exams, drug testing, physicals and back-to-work assistance.
• CHILDREN'S CENTER This wait-listed program provides educational day care for infants to 11 year olds.
• HEALTH CLINIC Services include primary care, family planning, nonemergency injury care and diagnostic testing for people with Medi-Cal or limited or no health insurance.
• HOSPICE Offering in-home hospice care, including grief support for families.
• HOSPICE GIFT & THRIFT STORES The three busy locations of this Tahoe Forest–run shop donate all proceeds to the Hospice.
The Tahoe Forest Hospital Foundation is integral to much of the hospital's expansion and vision. It raised just under $4 million for the recently-launched Center for Health and Sports Performance. Started in 1987, the Foundation generates resources—philanthropic dollars, grant money or partnerships—to support the health of the community. As the hospital has expanded into a system, the Foundation's mission has grown with it.
"Now our mission is much larger," says Maia Schneider, the Foundation's executive director. "We're engaged with the elected board in envisioning the future of health care for our community."
In line with that role, the Foundation is currently recruiting a leadership council that will be "a community outreach group, a conduit between the health system and the community," Schneider says.
INCLINE VILLAGE COMMUNITY HOSPITAL GROWS
Since opening in 1981, Incline Village Community Hospital (IVCH) has changed owners and gone out of business several times. When Tahoe Forest took it over in 1998, it was in bad shape. For the subsequent few years, it remained unprofitable.
Since 2001, however, Tahoe Forest Hospital System has revitalized IVCH, and it is now turning a small profi t. TFHS added a pain management program and physical therapy services, recruited a wellknown orthopedist and installed new, digital x-ray machines and a computer-aided tomography (CAT) scanner.
"Because the hospital was closed several times before Tahoe Forest bought it, many in the community were unaware the hospital was open and certainly unaware of the services we provide," says Pam Stock, director of IVCH. "We're constantly trying to educate the community on what we really do."
More changes are in the works. TFHS is looking at partnering with Washoe County to open a rural health clinic in the Incline Village area. It also has plans for a three-million-dollar, three-phase remodel to IVCH. The fi rst phase will change the entrance, gift shop and waiting area, the second phase will build an emergency room waiting room and the third phase will retrofi t the existing emergency room.
"Sometime in the next 10, maybe 15, years, this hospital is going to have to be replaced," says Fred Pritchard, IVCH administrator. "In a year, we'll embark on envisioning what kind of replacement health care facility should be at Incline."
In anticipation of the major changes to IVCH, in 2004, the health system started a foundation specifi cally for IVCH. The Incline Village Community Hospital Foundation (IVCHF) supports and assists with maintenance of the hospital's equipment, enhances the hospital's programs and helps build funds for the hospital's remodel and eventual replacement. IVCHF is reviewing the facility planning for the next 20 years, discussing how to achieve and pay for the necessary infrastructure.
BARTON MEMORIAL HEALTHCARE SYSTEM'S WIDE REACH
Barton Memorial Hospital opened in 1963 after Alva Barton and Faye Ledbetter donated its 6-acre site and other community members gathered the resources to build it. It originally encompassed 38 beds, and 8 staff members provided medical/surgical, pediatric, obstetric and emergency services. It is now a 240,000 square foot facility housing 24- hour emergency care services, 71 licensed acute care beds, 48 skilled nursing beds and multiple departments.
In the late 1990s and early 2000s, Barton Memorial Hospital evolved from one entity into several, all contained under the Barton HealthCare System umbrella. Barton purchased several physician practices and opened many outpatient facilities.
Today, with an annual operating budget of about $110 million, the nonprofit healthcare system serves South Lake Tahoe, El Dorado and Douglas Counties. Its components:
• CARSON VALLEY MEDICAL CENTER This 23-bed acute care hospital opened in 1993. (Read more about CVMC on page 106.)
• STATELINE MEDICAL CENTER Barton purchased this urgent care center and family practice in 2002.
• BARTON MEMORIAL HOSPITAL COMMUNITY CLINIC Originally the El Dorado Community Medical Clinic, it provides family practice health care services to the uninsured and underinsured population.
• TAHOE FAMILY PHYSICIANS This five-physician family practice allows patients to be transferred from an outpatient to an inpatient setting with greater efficiency.
• JOB'S PEAK PRIMARY CARE What was formerly Job's Peak Primary Care Family Practice has grown into three medical practices: internal medicine, family practice and pediatrics. They serve South Lake Tahoe, Stateline and Carson Valley.
• STATELINE PRIMARY CARE Opened in 2006, this facility provides Stateline and the surrounding area with convenient family practice and internal medicine services.
• BARTON MEMORIAL CLINIC AT SIERRAAT- TAHOE AND BARTON MEDICAL CLINIC AT HEAVENLY MOUNTAIN RESORT Open during the resorts' operating hours throughout ski season, the clinics provide urgent care treatment of ski and snowboard injuries, x-rays, moderate intravenous sedation, patient ground and airlift transport, resort employee health and workers' compensation injury care.
Recent modifications within the Barton Memorial Healthcare System include cosmetic changes to Barton Memorial Hospital. With the Healing Design Project, the common areas and patient rooms have been enhanced with logs, snowfl akes, leaves and earth tones to bring Tahoe's natural aesthetics inside and transform the hospital environment into one that promotes healing and recovery.
Along the same lines, a private hospice care suite was created to give patients needed comfort, and space for 56 of Barton Memorial Hospital's current beds will be remodeled into 28 private suites by the end of 2007. The suites can be converted into semi-private rooms within 24 hours.
Additionally, Barton's rehabilitative services, mammography and laboratory departments recently expanded into Stateline Medical Center Outpatient Services, upstairs from Stateline Medical Center.
Driving the recent activity at Barton are major technological advances, particularly within medical imaging, the need to provide a friendlier patient environment and changes related to patient care and privacy laws.
"Health care is constantly changing, very rapidly," says Jaime Aust, public relations coordinator. "Barton has always adapted to meet the changing needs of its community members. The healthcare system has evolved much like most other successful healthcare organizations within the country. We will be proactively evaluating the needs of its community and hospital members in order to stay ahead of the curve."
Helping Barton evolve is its fundraising arm, the Barton Memorial Hospital Foundation, established in 1990 to assume some of the hospital's financial burden. Each year, the Foundation puts on several major events to raise money. The events, along with other fundraising efforts, yield about $500,000 annually.
Also vital to hospital operations is the Barton Memorial Hospital Auxiliary, a service organization. The Auxiliary donates several hundreds of hours every year, staffing positions that would otherwise have to be paid. It also operates the Hospital Gift Shop and the Attic Thrift Store, donating all proceeds to Barton.
CARSON VALLEY MEDICAL CENTER TRANSFORMS
Since opening in 1993, Carson Valley Medical Center (CVMC) in Gardnerville has evolved from an outpatient facility into a true community hospital.
"Carson Valley Medical Center is continuously growing and expanding," says Aust. "The service area has grown tremendously since CVMC fi rst opened, and this has been the driving factor for many of the changes."
Today, with more than 200 employees and 80 physicians on staff, the nonprofi t hospital serves more than 36,000 patients annually. As of October 31, its assets totaled $44.7 million.
CVMC began as a partnership between Barton Healthcare System and Renown Health (formerly Washoe Medical Center). At the outset, it offered limited hours of urgent care, some physicians' offices and outpatient laboratory services, physical therapy, pharmacy and medical imagingin 28,000 square feet. The second phase expansion, completed in 1995, added an outpatient surgery center, rehabilitation therapy and 24-hour emergency care, with critical care transport ability, in an additional 34,000 square feet.
In 2004, CVMC became a critical access hospital, featuring 15 acute care beds. Since, it added an infusion center for patients needing intravenous therapy; a diabetes center for consultation and treatment of patients with diabetes; a sleep diagnostics lab providing overnight sleep studies and analysis; and a 16,000 square foot administration building. It began offering interventional radiology procedures and added additional patient beds, for a total now of 23. Additional specialists, from orthopedists and urologists to general surgeons and cardiologists, also have been added to CVMC's team over the years.
Currently, CVMC is adding a bistro, boutique, education center and quiet room to its main campus. Open on weekdays, the bistro will feature coffee, specialty drinks, breakfast items, soups, salads and sandwiches. The boutique will offer unique gifts. The education center will be a resource for the community to obtain information on health-related topics and for health care professionals wanting to access continuing medical education materials. The bistro and boutique are slated for completion in early 2007.
Also next year, the hospital lobby will be reconfigured to enhance patient fl ow and comfort. The administration will continue to acquire advanced imaging technologies and expand the medical staff to include specialists lacking in the area.