I've been going to Tehachapi Hospital since I was a baby because I have asthma. Once or twice a year, I was admitted to the hospital for medical care regarding that. At times, the care was iffy, but for the most part, the doctors were competent and they were able to give me the treatment I needed, get me out of there and better. But yes, the place is completely antiquated and not up to code, which is why we're getting a new hospital. What disturbs me about the whole thing, is that my tax money is going toward this new facility, yet if the same people are running the new one that run the current one, I won't be able to use it. I am one of the many in this community that has insurance managed by GemCare, which the hospital is not accepting. It disgusts me that the current hospital management cannot work their problems out with HMOs so that someone like me, who could have an asthma attack at any time, doesn't have to drive an hour to get to emergency medical care when needed. It could mean the difference between life and death. A hospital should be there for emergency service for the whole community, not just those who have medi-cal or medicare. I pay good money to have my medical insurance and I pay my taxes to support this hospital - why can't they simply give me the service that I pay for?

i agree with your !00 % Mimi. I too suffer from asthma. I have never experienced this problem before with hospitals. Our hospital should serve the entire community no matter what insurance type. Kaiser has same problem in that they need to go out of town. what can we do to correct this problem?

You are all making very valid points.  Here are some things to consider.  It is absolutely true that the current Tehachapi Hospital is old, overcrowded and unattractive.  What you should expect to receive when you come to it is that the facility should be clean and that the staff (clerical, nursing and medical staff) should be compassionate, knowledgable and have the necessary skills to take care of your medical issue.  If you find problems in any of these areas, you should complain and let the management staff know about it.  We really do care and something will be done.  If you don't get satisfaction from whoever you are dealing with then let me know about it.  With regard to the construction of the new hospital, the plans were completed early in 2006 and submitted to the State of California for approval on March 29, 2006.  They were reviewed by State architects charged with oversight over hospital building plans and they were returned back to the hospital's architects on August 4, 2006 with corrections and changes.  This is normal.  The State never approves hospital construction plans on the first submittal.  Since that time the plans have been in the hands of the hospital's architects and engineers who are making the changes requested by the State.  The current goal is to resubmit the plans by early November.  As far as hospital construction projects are concerned, we doing very well.  If you are concerned that this project is taking too long, you should check with anyone familiar with the Lancaster Community Hospital new hospital project in Palmdale.  It took them years to get to the same point that we are at in just 7 months.  Will the plans be approved when we resubmit next month?  Probably not.  The odds are still against us.  But they should be approved by the next resubmittal and each resubmittal cycle should be shorter.  Our plan is to gain approval in 2007 and begin construction.  I, too, am concerned about the GEMCare contract that Mimi brings up as a concern.  With respect to emergency care, please know that no one, regardless of insurance classification, will ever be turned away from the local hospital.  In fact it is a Federal law that hospital cannot require insurance information prior to allowing a patient to be seen by a doctor.  It is also a responsibility of your HMO to pay the hospital for your care, whether they have a contract with the hospital or not.  You have a right to emergency care at the closest hospital and your insurance company cannot take that away from you.  Regretfully Tehachapi Hospital cancelled its contract with GEMCare in November of 2004.  The reason was that GEMCare would not agree to pay the hospital at rates that the hospital already receives from other insurance plans, most notably Medicare.  The hospital contracts with the health plan for Kern County employees and it also pays a much higher rate.  The other reason, however, is that GEMCare has always made it difficult for local Tehachapi residents to use Tehachapi Hospital, even when we did have a contract with them.  We had many reports of GEMCare patients that were referred to Bakersfield for services that were available at Tehachapi Hospital and that we were contracting with GEMCare to provide.  Ultimately, I believe that we do need to have a way for HMO patients to use our hospital.  We just signed a contract with CIGNA recently which allows CIGNA patients to use all the services of the local hospital.  I believe that other health plans will follow suit, including Kaiser.  Thank you for publishing your concerns so that we can address them.

I have had emergency visits to Tehachapi Hospital, and have now left strict instructions with my family to take me anywhere but there.  Unless the practices and rules that are currently in play drastically change, the new hospital will be plagued with the same horror stories, albeit in a prettier package.
I will not bore you with my scary Tehachapi Hospital ER story.  We have heard so many throughout this community, and mine mirrors them all.
I am impressed that Mr. Hino took the time to reply to this thread.  It takes a LONG time to reach him via phone as he has directed people to do, but it can be done.  I believe Mr. Hino is a caring, knowledgable man who knows the depth of the issues... I just hope that there is a way to avoid them in the new facility.
One question for you, Mr. Hino--how does the Hospital Board affect the new facility?  What role do these people play overall?  How will it affect the care, should Doctors run the board?  I have heard people worried about the lack of oversight and discipline should an error happen--like the fox guarding the henhouse, so to speak.  
Thanks in advance for your reply.

Tehachapi hospital is only as good as the Doctor working that day. If you where bleeding to death and only had 20 minutes of blood left, will your strict instructions help or hurt you? In other words in a REAL emergency is Tehachapi Hospital better then no hospital? A new hospital will attract new and hopefully better Doctors, this will improve the hospital no? Don't just vote for one of the Doctors just because there a MD. Vote for the people that can do the best job. If you have an emergency and your family rushes to Bakersfield and you crash on the way is that better? Your strict instructions will get yourself killed or someone else. Hall's will be picking you up on the side of 58 and be taking you to the closest hospital> Tehachapi Hospital!

"If" there is a doctor working that day,  you mean...
When I was there, with my heart problems, there wasn't a cardiologist to be found.  And yes, I would have received quicker care if I had driven an hour.  No speeding required.  After many hours sitting in an overcrowded waiting room, and then in an overcrowded ER with 6 patients in a room designed for 2, they found an unfamiliar (and not on Tehachapi Staff)  cardiologist that prescribed a medication that I stated on my paperwork that I had a severe allergy to.  When I was given the meds, I asked specifically if it was this particular drug, and was told "NO, of course not... if you said you were allergic, then they won't give it to you".  Then I had my foreseen reaction, and Tehachapi Hospital had no idea how to handle it, but tried giving me MORE...  After awhile, the nurse figured out that they had given me that medication after all...  just a generic name.  The doctor did this all by phone, and if he was IN the hospital would have seen in big red letters that I was not to be given that medication.  The hospital never did call my primary cardiologist--I still have no idea why.  
(And as a note--I have indeed bypassed Tehachapi Hospital and driven to a more favorable facility--they took me in immediately and I was placed in a private ER room...  MY doctor was called, and he came in to take care of me.  I had a cardiac nurse at my side the entire time.  My ER experience there was impeccable--especially in comparison to my experience at Tehachapi.)
Obviously, if I had 20 minutes of blood left (interesting hypothetical), I would have no choice but to resort to Tehachapi Hospital.  My instructions are for my specific situation.  I truly doubt that I will be in the situation where I had "no" choices.
After dealing with Tehachapi Hospital's lab/x-ray departments by ordering tests there and having results and reports called in or mailed, my doctors have now asked me specifically to bypass Tehachapi Hospital if possible.  They don't want to blatantly "diss" the Hospital, but diplomatically and directly requested me to do this... One of them actually said that he saw the results of Tehachapi's testing, and wanted it repeated at a different facility because it was so bad.
Once I had my daughter's hand x-rayed because of a possible fracture... They showed me 3 films and found no fracture.  Then a tech emerged from the back, as she had looked at a film that they had thrown away because they accidentally did the "wrong angle" and then she found a sizeable break.  Just think--it was in the trash... and if she hadn't found it, my daughter's hand would have healed incorrectly.  She took it out of the trash because they had thrown it in the wrong trash can and she uncrumpled the film to see what it was...
I didn't say anything about voting for the Doctors...  I just know that most people are lemmings of the brightest sign and because of the name recognition they will be voted in as Board Members.  I will be surprised if they aren't.  I just am curious to see what the possible repercussions will be to the current Administration and to the Hospital itself.

There is only an ER doctor at Tehachapi Hospital and he/she is there 24/7! There's not even a Cardiologist full time in the whole town of Tehachapi. Should the hospital the size of Tehachapi have one on full time? How about an OB/GYN? No hospital has that not even in Bakersfield!  You summed it up by saying you went to a larger hospital and got what you needed. Tehachapi Hospital is small and will be small until the new one is built. You will never ever get the same care in Tehachapi then you would in like LA or Bakersfield. Why? because Tehachapi has a population of 40,000 in the greater area. The hospital will never have the need for a full time cardiologist. Maybe when town gets to like 100,000. Whats next you will want a full time trauma staff on call? Come on we are a small town, we will have a small hospital that will serve a small town. It's the same as you can go to Walmart and Kmart in Bakersfield because they have a full time need for both! Here in Tehachapi we have the need for only K-mart! When we have the full time need we will get more! If you fill your to far from a real hospital then move to LA or Bakersfield.

The new hospital will bring new and better doctors. Will it bring on full time cardiac care and trauma doctors?  Hell NO!

Lets talk about bad Bakersfield hospital stories, they are so over worked they tell ambulances to go away. Remember when Mercy and San Joaquin sent that 16y/o kid away for being sick, he finally went to KMC where he was told he was bleeding to death inside. He died and he was seen at 3 different Bakersfield hospitals. your story is not confined to just Tehachapi Hospital. I can and will post 1000's of stories of bad medicine at many many big hospital all over the world!

Just for your info. my dad had a stroke last year. We decided to take him to Mercy in Bakersfield, why? because we thought he would get better care there. He got good care but didn't get the care ( clot buster meds) we wanted. I was told Tehachapi does this clot buster treatment and he would have gotten it there.  So was it worth the drive?

Hey I didn't mean to upset you...  I apologize if I have hit a nerve.
I do not think it to be too much to ask, to have the local hospital have specialists on call who are willing to come in (or at least be ready to take calls) 24/7.  I grew up in a small town of 25,000 people, and we not only had staff on call, but often in house.  So whoever gave you the impression that it was unreasonable to have specialists on call/in house in a town the size of Tehachapi is underestimating the possibilities.  
You are right, most hospitals have lists of bad stories and disgruntled patients.  But, in my (and others') defense, there seem to be a higher ratio at this facility.  I think the Grand Jury's investigation report reflected many of the deficits.  
I believe that if Tehachapi Hospital, as you say, cannot afford or chooses not to supply, specialists at least in a reliable on-call situation, that they should not be listed as an Emergency Room, but rather as an Urgent Care facility.  This makes a huge difference when it comes to billing insurances, patient expectation, etc.
I really didn't mean to make you so upset.  I am sad to think that you'd rather take tax-paying, law-abiding neighbors and tell them to move away simply because there is a deficiency in the Hospital...  ;)  There are many of us folks who just take a nice drive down the hill to see our docs...  and we don't complain.  
I don't have any indication that a larger hospital will bring more doctors to Tehachapi.  Is there some factual evidence that I am missing?  I have seen some lovely hospitals that remain short-staffed.  This is not because of the lack of facilities, or the beauty of the buildings, but rather a short supply of housing and amenities.  We already have a huge shortage of registered nurses all across the State, and many doctors are opting for out-of-California practices due to the large cost of malpractice insurance.  Even large established respected hospitals in the San Fernando Valley are having to offer huge stipends to incoming new hires on the nursing staff, and are offering all sorts of initiatives to doctors that sign on.
Again, I'm sorry that I have said something that you have taken personally.  

Neither the Board nor the admiinistration is 'holding things up' - Eventually there will be specialties here -  Have you looked at where we live - 40 miles from anywhere and not too many medical professionals like to commute any more than you or I do.
There is a national shortage of nurses,  Doctors can work efficiently only so many hours a day .  The specialties are in short supply. 
When there is a sufficient population base that will support a specialist - and believe me, you could not pay the fees that specialist would charge you now- and your med-insurance wouldn't hold still for it either-the doctors will become available when the patients are there -...Mostly specialists are not paid staff of a small general hospital -the price just isn't right.
Give Tehachpi Hospital a chance - moan and groan if it makes you feel better - go where you must for care until it can be given here,  
Just pray tjat there will not be any more delays in building a bigger facility.

SrMalcontent, (love the name, btw)
I agree with you 100%.  That's what I was trying to say in the first place.  The new facility might be pretty, but we're still left with the same staff and board.  I am NOT saying that we have poor doctors or administrators here--only that due to the location, we are and will remain short-staffed.   In fact, I believe that Dr. Horowitz is an outstanding doctor and has more talent than most "Valley" doctors...  And Mr. Daniels, his PAC--Brilliant!  But they cannot be there 24/7...  But that's another story...
A new facility will not change that.
As such, I have always thought that Tehachapi Hospital should not advertise to offer Emergency Care services, as this does limit most people to "the closest Emergency Room" according to their insurance plans.  Offering services as an Urgent Care would alleviate this.   I mean, honestly--with the inability to bring specialists or have them on call, do you think it is moral to offer "ER" care? 
You're right, due to our location, it will be far down the road before new doctors will move here.  As I said earlier, nowadays most doctors have rights at more than one hospital, and the commute is out of the question.  
I just don't want people to think that a new building will change the entire situation.   I have heard people preach about how a new facility will suddenly bring new doctors and nurses, will bring new and state of the art equipment, etc...  but the reality is, we have the people we have, and even the high end hospitals in San Fernando Valley and Bakersfield with huge staffs and a heck of a lot more funding don't have all of the high-end equipment due to the high cost--so how can we expect little Tehachapi to support such equipment?  We just can't.  I feel badly for those that have bought into the dream of a bright new shiny hospital that will draw top end physicians/specialists and equipment...  They believe that they will not have to travel down the hill for special treatments, and that their specialists will be here suddenly--all because of the new building.  We need to offer more than a new hospital--we really need city planners that will design Tehachapi as a high-end place to live (ie Big Bear), and henceforth bring people that expect and bring quality and high end care.  The Dollar Tree and K Mart aren't really setting us up for the sort of community most people want here...  Not that I have anything against these stores (or Wal Mart), but we need a larger mix...  some high end, some cheaper...   Let's hear it for Trader Joes...  Gelsons...  Pier One...  Cost Plus World Market...  you know what I mean...  but that's another thread :)
I still would love to hear from Mr. Hino about the potential changes to the board.  

If they don't offer ER care the ambulance will not be able to stop there! They to will have to drive all the way to bakersfield!

This is a great discussion and I am very happy to be invited to participate in it.  First of all, please let me say that the best way to get in touch with me without going through all the bureaucracy is to call my direct number.  It is 823-3001.  Another good way is through e-mail.  My e-mail address is ceo@tvhd.org  I would like to make a few comments about some of the observations in this thread.  First, as was said earlier, Tehachapi Hospital has 1 MD in the building at all times (24/7).  Most community hospitals have 2 types of physicians present in the facility full time.  That would be ER MDS and hospitalists.  Most other specialists, cardiologists included, have offices close to the hospital and are available to be called in, when needed.  Only University teaching hospitals are likely to have full time specialists inhouse 24/7.  But Tehachapi Hospital would like to get to the standard of most community hospitals and have specialists available on-call.  By the way, historically, on-call coverage by specialists was a service that was volunteered by physicians.  Nowdays the trend is for specialists to demand payment in order to be on-call for hospitals.  And with regard to getting more full time specialists in our community, I do believe that the new hospital will help.  We have 1 new specialist that has already come.  That is Dr. Paul Singh, an obstetrician who has moved his practice from Bakersfield and who is helping the hospital to design labor and delivery suites in the new hospital so that in the future, babies can be born here.  I believe that other specialists will look favorably at the growing population of Tehachapi and the availability of modern facilities and will move here as well.  And I agree with the statements above that "all hospitals have their stories."  We know that there are a lot of horror stories out there.  In a small town its hard to escape how fast bad news travels.  Some times the stories are true.   And we do the best that we can to fix the problem.  Sometimes the stories are not true.  And we are blamed for something that was missed at another facility.  Along with all the bad stories are a lot of very good stories too.  I can't tell you how many times I have been told, "Your hospital saved my life.  I was stabilized there and then sent to Bakersfield where they said that Tehachapi did everything right."  Let me talk about the Grand Jury report too.  That report was written by 3 people (2 of whom did not have a medical background).  The entire report is written based upon hearsay.  No facts to substantiate any of the findings.  And in looking at the findings, there are really only 2 major findings.  They are problems with the billing office and staff relations and conflicts.  Even if those findings are true (and we are treating both of these problem areas seriously and making changes, as necessary), we are gratified to see that there were no findings for the hospital and board of directors meeting their legal obligations and no adverse findings for quality of medical care.  With respect to Emergency Room designation versus Urgent Care designation, "medicone," above is correct.  Ambulances may not stop at Urgent Care Centers.  But really there is no reason why TVHD should downgrade its ER.  Our ER meets all State and Federal guidelines for a licensed Emergency room.  Finally, I have been asked by posters above to comment on the TVHD Board election.  And of course, I am limited in what I can say about the election.  The question was "how does the Hospital Board affect the new facility?"  The answer of course is that the Hospital Board ultimately makes all the major decisions for the new facility.  They decide what services are to be provided in the facility.  They decide who the contractor will be.  They decide what equipment is to be purchased.  Staff makes recommendations but the Board makes the ultimate decisions.  This Board election is critical to the ultimate completion of the new facility.   The Board can either push for timely completion of this project or they could cause it be be slowed.  Be sure and find out what the position is of your favorite candidate before you cast your vote.  Thank you again for this opportunity to communicate.

A question about the board:  Will the board members be disciplinarians to the doctors on staff?  The Administration?  Who are they accountable to?

Thanks!

medicone:
Why is an extra 30 minutes (or less) such a bad thing, especially with trained EMT's at your side?  They certainly have enough equipment to keep you going until you reach a more reputable and able hospital.  AND once you get there, you'll be receiving care from those trauma and specialist doctors that Tehachapi admittedly lacks.
I believe that the 30 minutes with trained EMT's, and the ultimate care in a trauma/specialty facility is not a comparison with the alternative--a 10 minute drive, to be greeted by understaffed, overcrowded, antiquated facilities that cannot offer any trauma treatment/specialist treatment, and who will probably after sending the ambulance away, will call the ambulance back to send you to that more qualified hospital anyway...  
I just feel sorry for those that have insurance that forces them to undergo this sort of situation.  If you choose to go to Tehachapi "ER", then go for it--but if it's called an Urgent Care Facility, then it's your choice, and not something that is forced on you by bureaucratic rules.  To be put through the trauma of the 911 call, the ambulance ride, the drop off and intake at Tehachapi Hospital... only to have to go through it all again simply because the hospital didn't have the facilities in the first place... well, it doesn't seem quite fair.  
Personally, I just think it's morally and ethically wrong to advertise something you cannot provide, especially when lives are at stake.

Answers.  The Board of Directors is accountable to the people of Tehachapi (registered voters anyway).  They can only be removed from office by a vote of the people (general election or special election) or by voluntary resignation.  They are charged with the ultimate level of responsibility meaning that it can possibly fall upon them,  to administer disciplinary actions to both medical staff and administration.

On the question regarding Emergency Room vs Urgent Care designation.  Please consider this.  Is a patient in a life threatening situation better off being transported in an ambulance and being sustained by paramedics for the time that it takes to get to Bakersfield, or being treated in a licensed emergency room with a physician, registered nurse, respiratory therapists and other professional personnel, who have all of the equipment, pharmaceuticals and supplies that are mandated and required by law, at their disposal?  Yes.  That same patient may need to be transported to a larger hospital once they are stabilized.  But in this case they are being treated by a physician in 10 minutes instead of in 40 minutes.  By the way, there is only 1 licensed trauma facility in Bakersfield and none in Lancaster.  The only licensed trauma hospital is Kern Medical Center.  All of the other hospitals in both markets are community hospitals and they too must call specialists to leave their office practices to come into the hospital.  So the ER doctor that you see in Bakersfield may not be any better trained than the ER doctor that you see in Tehachapi (it might even be the exact same since some ER doctors work both in Bakersfield and Tehachapi).  I respect the opinion of the previous poster.  This is just food for thought.