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Fallbrook Hospital CEO Kapua Conley
Fallbrook Hospital CEO Kapua Conley

CEO says Fallbrook Hospital financial state a concern

Thursday, April 4th, 2013
Issue 14, Volume 17.
Laura Taylor
Special to the Village News

On March 21, at the monthly meeting of the Fallbrook Community Forum, Gordon Tinker, director of the Fallbrook Healthcare District, introduced Kapua Conley, CEO of Fallbrook Hospital, who spoke about the history, present state, and future of the community’s hospital.

Conley first discussed the healthy funding amounts extended to the hospital during its earlier years. A handout he provided stated, "In the 1990s the hospital started experiencing financial problems, mainly due to the growth of managed healthcare and escalating costs." In 1998, the Fallbrook Healthcare district partnered with Community Health Systems (CHS) to manage the hospital under a 30-year lease. The lease has reached its 15th year. As declared in its mission statement, the Fallbrook Healthcare District "is committed to continuing services provided by Fallbrook Hospital."

Conley said over the past 12 to 15 months many Fallbrook patients seeking healthcare from their local physician have been directed "away from Fallbrook Hospital." One year ago, when their existing contract expired with Fallbrook Hospital, Graybill Medical Group (the largest medical group in the community, owned by Sharp Healthcare) started directing patients to other facilities for services. Conley said most of these patients could have received the same services at Fallbrook Hospital.

"Because of this deterrence in the flow of patients, Fallbrook Hospital has experienced a serious reduction in revenue," Conley said.

Even though a new contract was established between Fallbrook Hospital and Graybill Medical, the volume did not return, so the concern is even greater now, it appears.

For patients to use Fallbrook Hospital’s services, they evidently have to insist on it with their physician, rather than take it for granted that they will be sent there.

Another negative impact to the hospital has been the growth of healthcare services over the past two years in North San Diego County and Southern Riverside County. The region has gone from experiencing a bed deficit to a bed surplus. Some of the providers that have newer facilities in the region include Loma Linda Hospital, Universal Health Services, and Palomar Hospital. It is rumored that Kaiser Permanente is currently scouting for land in the nearby Interstate 15 corridor. These entities are working diligently to entice Fallbrook patients.

When asked specifically about the volume of loss experienced by Fallbrook Hospital, Conley said, "These Advertisement
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hospitals have aligned with managed care companies and physicians groups to bypass Fallbrook Hospital, therefore dramatically deteriorating Fallbrook Hospital’s volume of patients. He said on a year-to-date basis, surgeries at the hospital are down 50 percent and outpatient services down 20 percent.

"If an increase in patient volume is not seen within one or two years, Fallbrook Hospital will likely be forced to close," said Conley.

Discussion ensued as to if the hospital were to close, it could have a large, negative economic impact on the community, its residents, and property values. It also would mean the surrendering of an emergency room, which could lead to loss of life due to transportation times to out-of-town facilities. Conley alluded to concern because it is the only emergency room within a 17-mile radius.

Conley said it could mean the loss of 400 jobs, loss of access to primary care services, and the loss of physicians who would deem it necessary to relocate. Fallbrook Hospital is said to be the second largest employer in town.

When asked if local physicians are aware of the problem and how they may be contributing to the hospital’s downfall, Conley said, "These physician groups have developed comprehensive relationships through managed care contracts that [provide incentives] for them to bypass Fallbrook Hospital and use other facilities instead."

Ironically, it is Fallbrook Hospital that has funded the recruitment of new doctors to the town for the past six years, to help better meet the needs of the community.

The financial dilemma is undoubtedly a challenging one. Conley explained that he "doesn’t want to cut the core services that Fallbrook Hospital offers."

"The bottom line is that Fallbrook Hospital needs the community’s physicians to support this facility (with business), which will result in an increase of patient volume," he said.

Conley indicated there had been talk between Fallbrook Hospital and other entities to "partner," but thus far the indication is other partners would want to force Fallbrook’s closure.

Roy Moosa, owner of Sun Realty, said if Fallbrook Hospital closes, "the community would be set back at least 10 to 15 years."

Conversation included an idea for a Town Hall Meeting to be held so that more residents could be made aware of the current situation.



Comment Profile ImageBorn and raised here
Comment #1 | Thursday, Apr 4, 2013 at 11:31 am
For all those who champion health care overhaul, here we go. Obama-care will necessitate such "partner" programs so the bigger, better financed health care facilities are expanded at the expense of outlying facilities such as ours. We have given control over to "for profit" health care corporations located out of state and really not connected in the least to our community. So, Fallbrook is a casuality of converging forces, universal health care and capitalist economy. Sorry, Roy- 10 to 15 years back would be wonderful. Try more in the 60+ years back. At least we had a hospital. Allot like the good old USSR, start lining up and waiting for marginal help. Citizens like us out in the sticks? Hitch a ride on the hay tractor to the next town over when you need medical help.
Thank you Obama-care.
Comment Profile ImageFallbrook Resident
Comment #2 | Thursday, Apr 4, 2013 at 1:52 pm
"If an increase in patient volume is not seen within one or two years, Fallbrook Hospital will likely be forced to close," said Conley
A great way for the CEO to notify Fallbrook Hospital employees to start looking for a job someplace else!!
Comment Profile ImageHeads Up
Comment #3 | Thursday, Apr 4, 2013 at 5:29 pm
I hate to be the bearer of bad news but the reason I personally will never go back to Fallbrook Hospital is due to the very bad experience(s) I've had in the past! Hurray for their sign on Fallbrook Street proclaiming how many minutes you have to wait in the Emergency Room but I've sat in their ER for over 2 hours with my husband with no help. I then took him to Escondido where he was promptly hospitalized with e coli. Minutes matter and there was no help to be found there. Obama care had NOTHING to do with their demise.
Comment Profile ImageTom Odendahl
Comment #4 | Thursday, Apr 4, 2013 at 7:35 pm
In February last year I drove myself to Fallbrook Hospital emergency suspicious of a rapid heartbeat. I received an EKG, two pills and three injections plus a blood test. On duty was one doctor, one nurse and three young women I took to be aides. I was always in the ER on a gurney and monitored for that heartrate. When it subsided about 4 or 5 hours later I was released and drove myself home with a prescription in hand. The doctor would look to the pulse monitor every half hour or so and instruct the nurse to administer another pill or shot. The nurse spent most of the time entering what I suspect were codes into a computer terminal. The bill I received the next week was for about $5500. My insurance paid about $3500 plus my $100 copay.
Why might some local doctors send patients elsewhere? It seems obvious to me.
Comment Profile ImageFallbrook 101
Comment #5 | Thursday, Apr 4, 2013 at 8:57 pm
I cant belive they dont make a profit as they get enough business from the illegal population, not long ago I had to take my wife to the ER,the sign in town on Fallbrook St. stated only 15 min wait. We finally got treated 7 hours later and I for one have insurance and coustomer service if you want to call it that was less say not so good. The folks that couldnt speak english were waited on first well after we arrived and been here over 20 years and my family have always used FBH, not any more will go out of area as it cant be any worse.
Comment Profile ImageA.H.
Comment #6 | Thursday, Apr 4, 2013 at 9:39 pm
So just over 140 shootings, wrecks, and health related emergencies in Fallbrook and Bonsall combined in less than a year and 132 of them go to Palomar for care. Includes a dozen airlifted within 4 miles of the Hospital. Perhaps thats because of the lack of Trauma care available at Fallbrook? Seems to me this Hospital is nothing more than a glorified medical center by these standards. 5 major hospitals in a 25 mile radius is clutter and obviously Fallbrook is not state of the art and further from the masses than any other. I personally like going there being from Bonsall as I can easily make my way to Palomar, Kaiser, Tri-city or Temecula. Obama has nothing to do with it nor does the co-op. Low man in the totem pole loses. :(
Comment Continued : The comment above was written from the same location.
Post Continued
Comment Profile ImageA.H.
Comment #7 | Thursday, Apr 4, 2013 at 9:42 pm
RE: Fallbrook Resident

Unfortunately the truth hurts but fortunately the employees are given a notice to start looking unlike many companies that close the door with no notice. Abandon ship now while you can.
Comment Profile ImageFallbrook Blues
Comment #8 | Friday, Apr 5, 2013 at 7:41 am
They should work out some agreement with Kaiser. Anyone with Kaiser has to go all the way down to Mission Valley for the E. R. Kaiser does have a contract with Palomar but has to be life threatening/ambulance trip.

Sad that our hospital is in such a financial mess. I have been treated there before a few times and the care was good.
Comment Profile Imagehmm
Comment #9 | Friday, Apr 5, 2013 at 11:16 am
Isnt this the same hospital that is going union for the nurses? Dont blame the residents of Fallbrook for being concerned about their healthcare needs..who else will?? Theres a beautiful state of the art hospital in north Escondido..a new Loma Linda and of course the ever reliable Pomerado hospital and Tri City Hospital.They all have clean doctors(many who also practice here!!) so if the hospital closes,its no ones fault but management..there have been SO MANY ethical problems there for years but everyone just says"oh..thats my sister..or cousin....."There are so many families that are working there ..and no one seems accountable for businesses running other businesses out of the hospital on hospital time!
Comment Profile ImageFallbrook Park
Comment #10 | Friday, Apr 5, 2013 at 12:29 pm
No wonder patient care and revenue has dwindled at Fallbrook Hospital. Service has been unbelievable! My daughter's Dr. insisted that she immediately go to the ER for transfusions. She called the ER to inform them of her condition and critical status. I insisted on driving her (across the street) instead of waiting for an ambulance. Once in the waiting room, we just sat there waiting, waiting and waiting........ (it was not busy ) It was over an hour before she was seen by any hospital staff person or dr. The on-call physician was so rude and impersonal; both my daughter and I feared for her safety. He spoke to us once over the next three hours no matter how many times we insisted on speaking with someone. My daughter was white as snow and shaking from shock and the blood loss. When they finally decided she needed blood and fluids, her veins had collapsed! I don't think i need to go further - patient care was a giant fiasco from then on. I personally have experienced several emergency visits, 4 major surgeries and 3 childbirths at another hospital; all with exceptional care and outcomes. Never seek even as much as a bandaid at this facility!!
Comment Profile ImageFallbrook Native
Comment #11 | Friday, Apr 5, 2013 at 12:54 pm
It is Fallbrook Hospital's OWN fault. They don't have any real emergency services (stroke patients, cardiac patients or neonatal, etc.) If you reduce your services of course you reduce your patients. People are flocking to Palomar because it is a REAL hospital! Open your eyes CEO!!!
Comment Continued : The comment above was written from the same location.
Post Continued
Comment Profile ImageShocked and confused
Comment #12 | Friday, Apr 5, 2013 at 1:47 pm
Fallbrook Hospital had months to negotiate a contract with United Health Care but chose not too. Instead they held out hoping a large company like United Health Care would pay outlandish prices for their memebers care at a facility that offers minimal service at best. Costs that would be handed down to those United Health Care patients that landed themselfs in Fallbrook Hospitals web of a money pit.

My husband was transferred to Palomar hospital via ambulance FROM Fallbrook hospital because Fallbrook hospital stated they DO NOT PROVIDE the services he needed.

If larger more successful local hospitals are aligning themselves with managed care companies and physician groups then why is the CEO of Fallbrook spending his time threatening the community with this "poor me" article in the Village News instead of getting out there and getting Fallbrook Hospital aligned with some of these managed care companies and physician groups?

Once again Fallbrook Hospitals problems are just that, their own self induced problems. Which explains why Fallbrook Hospital replaces it's CEO every 2 or 3 years.
Comment Profile Imagemarinewife
Comment #13 | Saturday, Apr 6, 2013 at 9:03 am
I work at Palomar downtown facility.

I have heard of layoffs at our hospital as well. Our department has reduced workforce and has also been asked to find a way to reduce expenses by 10-15%. Reimbursement by Medicare has dropped and caps put in place. We have a brand new facility, which has to be paid for.

No one holds the key, everyone is courting everyone. Whoever has the best plumage and mating dance will win.

The smaller facilities will suffer most, of course.

I don't know the answer....I just want to bring to light that even the big guys are scared.

There is this family called Jones. They had the fanciest house, cars, toys. Everyone would look at them and wonder how they did it! So successful! No one knew they were borrowing money from out of town and maxing their credit. Basically, we are the Jones family...all of us. We had a good time, but now we have to suffer.....even if we have a Phd behind our name.
Comment Profile ImageActive community member
Comment #14 | Saturday, Apr 6, 2013 at 4:40 pm
Mr. CEO Please tear that sign down. Your timing is way off. I don't go to Fallbrook Hospital anymore. The wait time is very long and if you are unlucky to be admitted there isn't anybody to help you.
Comment Profile ImagePink
Comment #15 | Saturday, Apr 6, 2013 at 7:21 pm
I too have had some bad experiences at the emergency room but I would hate to see it close down. My children were born there, it was a pretty hospital then. It is a shame. Once Obamacare kicks in we will all be standing in line at some third rate care facility anyway.
Comment Profile ImageBrookie
Comment #16 | Saturday, Apr 6, 2013 at 7:53 pm
I know that people have not stopped getting ill so that can't be the reason. I have had a few visits to the ER in the past few years and the waiting room was filled with non English speaking patients. They use this place as a "urgent care" facility. Urgent care places will see you for less than $100 yet they go to the ER which is at least $1,000. Not to mention, they probably don't have insurance and can't pay. There ya go....
Oh yes, by the way, their sign showing wait times for the ER.... Do you think that someone will sit home till its down to 5 mins or so to go to an ER!!!
Comment Profile ImageA concerned senior
Comment #17 | Sunday, Apr 7, 2013 at 9:14 am
This article and the Marinewife's comments makes me wonder if the hospital administrators predict hard times coming down the road. They should be predicting more business from an aging population, but for some reason they are pessimistic about the future.

The end goal of the Progessive movement has always been a single-payer healthcare system. I think Obamacare will eventually accomplish this goal by making all other healthcare options unaffordable. Initially, healthcare providers will try cutting costs and streamlining their operations. Eventually, the progressive's are counting on them all to fail so that the government can come to the rescue and run the whole show. This model has worked for them in the past and people still haven't figured out why these things keep happening. Welcome to a brave new world.
Comment Profile ImageWomen's Center
Comment #18 | Sunday, Apr 7, 2013 at 5:33 pm
It'd be a shame to see FH close, they have a wonderful women's center with caring nurses.
Comment Profile Imagejustwondering
Comment #19 | Sunday, Apr 7, 2013 at 7:55 pm
Id like to ask PUBLICALLY for the CEO and CFO to publish FACTS regarding reimbursement..what is the percentage of those using FALLBROOK HOSPITAL that pay:1. payers 2. Insurance.NOT including MEDI CAL 3.public assistance progrqams such as MEDI CAL and 4.Those that dont pay anything at all..perhaps the hospital needs to look at WHY so many are using the hospitals services as URGENT CARE providers.and id like to know what the AVERAGE is that a baby delivery costs at Fallbrook Hospital cause i see alot..and I mean alot of people born there that MIGHT not have insurances that some others have.Why are so many expectant mothers delivering at out of town hospitals ??.if the majority percentage of reimbursement at FH is government assistance..they might as well shut the doors now and allow the land to be sold for something else..and have those unions go elsewhere...
Comment Profile ImageSB
Comment #20 | Monday, Apr 8, 2013 at 10:53 am
I don't see how they could have billed our insurance for well over $11,000 (I think the total eventually came to $13,000 after everyone had their hand in) for a 3-hour stay, some pain med and tests, and still have financial troubles. Thank goodness we had insurance, but we're still paying off a credit card for our share. What we need here is a good, reasonable urgent care facility.

Or, even better, HR 676! That was my choice. "Obamacare" was a huge compromise to conservative interests and to wealthy insurance companies. It does not prevent catastrophic illness from bankrupting families. Insurance doesn't cover everything unless you can afford an HMO, and guess what, if we don't die in our sleep, we're most of us going to die very expensively under this system and leave our loved ones deeply in debt. Health care represents the most common reason for personal bankruptcy in this country.

We need universal health care - such as most other developed countries have. A system where only the wealthy can really afford health (including dental!) care belongs in the dark ages.
Comment Profile ImageA Friendly Villager
Comment #21 | Monday, Apr 8, 2013 at 1:09 pm
Fallbrook Hospital is a for-profit hospital operated by Community Health Systems (CYH), a New York Stock Exchange-listed company.

As an investor, you could have purchased CYH stock for $15.16 in 2008. As of April 8, 2013, CYH is trading at $44.79, about 200% higher than its 2008 low.

Since 2008, CYH’s stock performance outperformed the Dow Jones Industrial Average. Wall Street is very happy with Fallbrook Hospital’s contribution to CYH’s financial success. Wall Street pays little attention to Fallbrook residents’ healthcare issues. Stock price matters.

From an investment point of view, Fallbrook residents should have bought CHS stock in 2008. With the profit you would have made from investing in CYH/Fallbrook Hospital stock, you would be able travel a few extra miles and get better healthcare from a number of not-for-profit hospitals in San Diego County, e.g., SHARP or Scripps.

As long as Fallbrook Hospital is a for-profit hospital controlled by a public company, Fallbrook residents’ best interests would be secondary to CYH’s desire to please the Wall Street.

Community Health Systems 2012 Annual Report
Comment Profile ImageCheck it out
Comment #22 | Monday, Apr 8, 2013 at 2:58 pm
The Brits have universal healthcare and they ALL appear to have bad teeth. Please explain that??
Comment Profile Imageour tax dollars
Comment #23 | Monday, Apr 8, 2013 at 7:00 pm
Any of you that own property in Fallbrook better care if there is a hospital here or not since your tax dollars have been going to the healthcare district to be sure there is one. My question... since CHS has been running the hospital, where is all of our tax money for these years? Has it all been given out to all the free clinics and low income programs through grants or have the elected members of that board been tucking that money in protected savings in case CHS exits the picture? You've been paying for it, you better care what happens. What if this were local public schools shutting down? Or do you not care what happens with the money you are paying to have these items in town? If you don't care, don't whine when the bottom drops out of your property values here. We better hope there are some smart board members in these seats. Time will tell.
Comment Profile ImageOld Fallbrook local
Comment #24 | Tuesday, Apr 9, 2013 at 10:10 am
Years ago I told the district to close the hospital and develop a Medical Mall with urgent care, GI services, radiology and outpatient surgery. This would have been profitable for the district. The costs of the JCHO mandates of pharmacy, Intensive care and PT, cafeteria and the management to support them have led us to where we are. We developed such a center in a town in Kingman AZ and it has been profitable since.
Comment Profile ImageNew jobs and care close by
Comment #25 | Wednesday, Apr 10, 2013 at 8:17 am
It's sad to see that this facility is in jeopardy, along with so many jobs. Not sure if everybody on here knows, but there is a brand new hospital opening in Temecula. It's called Temecula Valley Hospital, and is being built right off of Temecula Parkway near the 15. From what I can tell from the website, it looks like it will be a sizeable facility and will offer a wide variety of services. Maybe this will help alleviate the need for healthcare for those of us in Fallbrook? The site says it will be opening in September, but they are already posting jobs, which may be something to look in to for those let go from Fallbrook.
Comment Profile ImageS500L
Comment #26 | Wednesday, Apr 10, 2013 at 11:18 am
Well ive read the above comments sone racist some political some truly accurate with my experience. Well my wife and I are new to Fallbrook. I am in Healthcare and have been for the last 17 years. Icalled our CEO to introduce myself I left a message. No return call I stopped by one day left my buisness card no return call. Iemailed him I was told that was t he best way to reach him I'm still waiting 30 days later. You ask what's my point I am an executive with a Healthcare system that owns two succesful hospitals in San Diego I am not representing myself in this message as that. I am informing you the residents of Fallbrook and surounding area how can you help soneone that dosent return calls or acknoledge the community he services.. I have buisness that will increase his bottim line if he will ever grace me with a return call. All comments welcomed as long as they are not racial
Comment Profile ImageCurious
Comment #27 | Wednesday, Apr 10, 2013 at 12:22 pm
This comment isn't racial, but I'm wondering why, if you have the education that you imply that you have, you can't spell and punctuate?
Comment Profile ImageS500L
Comment #28 | Wednesday, Apr 10, 2013 at 1:47 pm
Not that it is topic related but, I am using my cell phone as I am currently at work.
Comment Profile Imagegrunt
Comment #29 | Wednesday, Apr 10, 2013 at 5:38 pm
Racism - when it is real it is bad; but seems any comment that does not support open borders, and welcomes poor, uneducated illegal aliens is considered racist now. Kind of seems a shame to compare that to an adult black male having to stoop over to drink from a filthy water fountain marked "colored" right next to a clean one at normal height marked "White Only".
Comment Profile ImageRidiculous
Comment #30 | Wednesday, Apr 10, 2013 at 6:39 pm
I do not believe for one minute that it is "racist" to be concerned about illegals coming over the border and into our hospitals and medical centers and being taken care of at taxpayers expense, especially when a person who is here legally has to show proof of insurance before they can get so much as an aspirin. I brought my daughter, a legal citizen with insurance into the emergency room at Fallbrook Hospital several years ago, she was hemoraging blood from her throat. We had to wait over 2 hours to see a doctor because someone who did not even speak English came in after us, escorted by deputies, with a knife wound to his arm and was taken into the doctor immediately. It took an ER nurse screaming for a doctor STAT to finally get the doctor to come in and see my daughter. How do you think I feel about the care at Fallbrook Hospital?
Comment Profile ImageS500L
Comment #31 | Wednesday, Apr 10, 2013 at 9:03 pm
Wow I'm shocked, I believe a Town hall meeting is way over due. Its never been the facilities its always the management or lack of. Is their any possibility they (Management Co) would sell?.
Comment Profile ImageNoSurprise
Comment #32 | Saturday, Apr 13, 2013 at 11:05 am
I'm not shocked; my 3 year old daughter came in with a broken arm and health insurance, and had to wait while an illegal immigrant with a cut finger was rushed to the ER for stitches.
They dispute those of us who HAVE health insurance, and then claim they cannot accept us or our insurance, therefore they turn us away to our PCP's and other hospitals.
I look forward to other options...
Comment Profile ImageCardiac nightmare
Comment #33 | Friday, Apr 19, 2013 at 9:41 pm
I want you all to know that if the fallbrook hospital closes you will also lose the Skilled Nursing Facility!!!! The current hospital owners list the FHSNF as a 5 star medi/medi rating. If you investigate the Inspection you will find that there have been more complaints and resident falls. Why would they want to make the FHSNF LOOK BAD?? Is it because the want the hospital to close??
Comment Profile ImageS500L
Comment #34 | Monday, Apr 29, 2013 at 2:15 pm
You (Cardiac nightmare) hit the nail right on the head. Some of these folks don't truly realize what the effects are going to be, if the hospital shuts down.
Comment Profile Imagewatson
Comment #35 | Thursday, Jul 11, 2013 at 4:15 pm
The declining fortunes of the Fallbrook Hospital have nothing to do with immigration nor is universal health care to blame. Rant all you like and repeat all others' rants won't solve anything. In fact, universal health care would benefit Fallbrook Hospital were it not for market processes. Other hospitals, health insurance companies and medical groups are aiming for the best return FOR THEM - not YOU. The little people will get ground under and pay the freight as well.

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