I appreciate Mr. Hino's response...
(First, I want to say that I am rather uncomfortable with the foxes guarding the henhouse, with no accountability...  we can see with the state of our current school board that the voters don't take the time to recall anyone...  but that's another topic.)

Are you saying that Tehachapi Hospital has exactly the same staff/equipment/services/technicians as do the other local hospitals (with perhaps the exception of KMC)?  I doubt that this is true--we are so understaffed and do not have local doctors in house or closeby.  The technology of the x-ray/ct/mri/etc., is not comparable to other hospital, trauma center or not.  I worked at AV Hospital, and remember when we had auto accident victims, child abuse victims, drug od's, etc., and the specialists were in house usually before the patients arrived at the hospital (this was night shift).  We had a huge nursing staff, and lab techs/radiology techs/pharmacy all there, 24/7.  (We had far more than the basic minimum requirements of an ER.)  I do not think that the current facility nor the upcoming one can compete with this.  If, as you say, the same doctor who might see you Bakersfield is the same that might consider you in Tehachapi, then he is local in Bakersfield (as we only have a few doctors here, I can assume that we agree that he would be located off-site from Tehachapi).  That doctor would only have to commute a few minutes to arrive at the Bakersfield hospital, vs. driving up the 58 freeway and making his way up the mountain to Tehachapi.

The patient/nurse and patient/physician ratios are not comparable, either.  In Tehachapi, we have understaffing problems across the board--in larger areas, the ratios are well below those madated by law.  The specialty nurses and doctors are all but unavailable here.  

You're right--this facility might stabilize a patient before they require a transfer to a more qualified hospital.   But why is it that it is "right" that people are forced to make the stop at the "ER" that cannot really help them?  If it is accepted that the ER here is only a stopping point, why do we call it an ER?  That same patient that might see a doctor in 10 minutes, only to be placed back into an ambulance or helicopter will be cared for by an EMT on the journey.  I know how traumatizing it is to be under the care of one doctor, to be transferred to a new doctor, to be moved to a new caregiver, etc... it is very destabilizing and downright scary for the patient (especially if they are elderly or young, or are having serious medical problems).

I just believe that this ER should not be called an ER, but an Urgent Care.  It seems to me a matter of a bottom line for the Hospital, not a matter of patient care.  

Thanks for taking the time to debate this--I would have never thought it possible, to have an open discussion about these issues.

Why 30 mins with an EMT or Paramedic is not better then going to Tehachapi Hospital? Well lets go back to that guys post above. You are bleeding to death, you only have 20 mins to live, Bakersfield is 45 mins at top speed code 3, EMT's Paramedics don't carry blood in the ambulance. If you stop at Tehachapi 1st you can get that blood for that transport to Bakersfield...That's just one example of why Tehachapi is better then a 45Min drive to town! TPA is a drug that can save your life "IF" given in the 1st hour. Do EMT's have it ? no! Does Tehachapi? yes!  We can go on and on. Urgent Care's have blood and TPA no! Get educated before you cry about something!!!!!!!!!!

Hey RAY don't respond to anonymous anymore she/he will never be happy with any answers anyone gives her/him. She/he has there mind made up, no one will ever change it, beside if he/she is not there when I need to go it will make my stay better! Go back to AVMC its way worst a hospital then Tehachapi! How many specialist do you think will want to live in this little town? Do you think they will make any money? AVMC is in Lancaster/Palmdale way more people, way more Doctors!

Whats more traumatizing driving 1 hour each way to get care or getting care here in town and being home that much sooner? Plus I will be closer to my family.  The one person on here is dead set on not liking the hospital. They think they deserve the same care as in a big town hospital. Tehachapi Hospital is not going to be like KMC or AVMC because this town can't support that type of care or the MD's that provide that type of care. I for one am very happy that Tehachapi is not like KMC or AVMC. Whats the wait at KMC these days 4 hours? The longest I have waited at Tehachapi was maybe 10 minutes. I am old and have been at Tehachapi 5 times a year for the last 4 years. Good care, Yes! Best care No!

Wow, this town is full of angry people.  If you disagree, the people *at least those who are posting here* just yell and call names and tell you to move.  No wonder your town of Tehachapi is going nowhere!

I don't know if this has been addressed yet...

Thank you, Mr. Hino, for taking the time to respond to all the comments on here, whether good or bad.  It shows that you truly care for the residents and customers in the healthcare district's coverage area.

If only other leaders in our public safety sector had the courage to respond to sometimes difficult questions.  Not only do you respond in a timely manner, you put thought into ensuring that your answers are respectful, well-stated, honest, and mature.

Again, thank you sir for caring.

Have you ever thought about becoming a city manager or fire chief? 

Other community leaders could learn a lot from the example you're setting.  Keep up the good work!

Bill- AGREED!  I second the motion... ;)

To Anonymous above: Who is yelling and calling names on this blog? You've obviously never been to other blogs that actually do have those kinds of situations and far worse. I think this is an awesome and productive blog. Mr. Hino is taking some time out of his life to answer some questions and address concerns that people have in this community regarding the hospital. I haven't seen a name thrown or seen anything that would indicate yelling in here, nor do I even see anger. I see some frustration, but that is what a blog is for - to express emotion. We are trying to get answers to be able to make those decisions we need to around voting time so that we can make our community a better place. How else can that get done without some constructive discussion? And how can you sit there and say our town is going "nowhere"? It's going everywhere, and fast! I don't know what you're reading or where your opinion is even coming from, but I think this is a great blog!!

Thank you Bill, ChiChiBug, Mimi, Toothy and all of you that have logged on and posted your comments.  I appreciate your kind words.  Staying in touch with the community is extremely tough to do and this blog site is a wonderful tool.  And one last comment to Anonymous, I agree with you that Tehachapi Hospital does not at the present time have all of the same capabilities as larger hospitals in metro areas.  Since they see higher volumes they, of course, have more of everything.  Doctors, nurses and equipment.  My point was to say that Tehachapi Hospital has all of the personnel, equipment and supplies required by the Federal government and State in order to maintain a licensed ER.  And our capabilities greatly exceed the capabilities of urgent care.  When I said that it may be the same doctor that will see you in Bakersfield what I meant is that some Tehachapi Hospital ER doctors also work in Bakersfield.  Almost all of our ER doctors come from outside of our community and most of them work at other hospitals besides Tehachapi (in Bakersfield and larger markets too).  When our ER doctors are on duty, they are not permitted to leave the building.

I think this is a good opportunity to inform all you who have been involved in this discussion that I will soon be leaving Tehachapi Hospital.  By Monday, October 16, I expect it to become very public that last week I informed the Tehachapi Hospital Board that I have decided to take another CEO position at a larger hospital in our State which offers more services.  In fact it already has the panel of specialists that we need so badly here.  I did not take this decision lightly.  And I did not seek it out.  They came to me and ultimately they made me an offer that is far more than I ever expected.  Although I did not seek out this opportunity, I have thought for some time that perhaps it is becoming time for me to pass the torch of leadership at TVHD to a new CEO.  The hospital is now in far better financial condition then when I came here in 1998 and in the near future, construction will begin on a new (and very badly needed) new hospital.  The disharmony between the hospital and some of the doctors in our community weighs heavily on me.  It is my hope that my replacement will be able to forge improved relationships that ultimately will improve medical care and improve the health system of our community.

As everyone likely knows, there is a Hospital Board election coming up on November 7.  I would urge everyone that cares about the future of our health care to become as informed as possible.  There will be a candidates forum held at Kelseys on Wednesday , October 18 at 7:00 p.m.  Also, I have been informed that Channel 23 News in Bakersfield has become interested in our Hospital Board election and plans to air a story on the Hospital Board race during the evening news on Monday, October 16.  This will be another great opportunity to become educated on the issues.  In the meantime I will keep checking this blog site and I will keep trying to answer questions so that you all can make the best informed decisions.  Thank you.

October 17, 2006   To: Ray Hino, CEO   Fm: Jim Richards   Dear Mr. Hino, thanks for participating in the blog forum in the Tehachapi News which I have been following closely. I am sorry to hear you will be leaving us and you will be sorely missed. We need more professionals of your caliber here in Tehachapi.   I am a member of Kaiser Permanente and wonder about the current status of your negotiations with them?   I would like to relate this horror story to you relating to my current situation with Kaiser.   I am a senior citizen and not capable of the long drive to Bakersfield and must depend on the bus system. The buses run every 2 hours and God help you if you miss one. The bus from Tehachapi to Bakersfield ends at the downtown station on Chester and 21^st. Street.
This is truly the “pits” because it is open to all the elements (no roofing) and what few benches that are available are occupied by sleeping drunks and dope addicts. One must simply stand in the open air and avoid eye contact and hope to not get hit on for money or cigarettes more than a dozen times. Once there, one must now wait for the Medical Bus to take you to whatever facility. This wait time is usually another 20 to 30 minutes. At least it’s a free service so I guess I shouldn’t gripe too much.   After arriving at the Kaiser facility one is usually seen by the doctor very promptly. The exam might last all of 5 or 10 minutes and the reverse grind back to Tehachapi begins anew. It is not possible to gauge the timing exactly so if one misses the bus back it is a 2 hour wait..out in the elements and in possible physical danger. It’s an all day trip in any event. Just for that 5 minute exam.   I was recently diagnosed with a heart murmur and was referred to an outside Cardiologist in Bakersfield. Their testing requirements were such that I would need to see them several times over a short period. This posed a great strain on both my system and resources and I implored them to allow me to see these same Cardiologists who have a satellite office here in Tehachapi within a 5 minute drive of my home. The very same Cardiologists with the very same staff and very same equipment. They told me this was not possible because of “insurance requirements.” I requested, and received, a telephonic hearing with 6 people on the other end representing Kaiser. They would not identify these people to me. After stating all of the above problems to them, I was sent a letter the very next day refusing my request.   I know there are MANY Kaiser members living in Tehachapi who must make this trek to Bakersfield. I moved here 2 years ago from Lancaster and did not have to pay any monthly fee to them because of my Senior Advantage status. In Lancaster they have a nice and modern facility and it was within 10 minutes of my house. However, after moving to Tehachapi I am now charged $40.00 per month for my membership (they cannot or will not explain why this is, other than I am now in Kern County) and must travel 50 miles to get to their facility in Bakersfield and my doctor and lab co-pay fees have tripled!   Sorry to dump all this on you but perhaps you can shed some light on this for me and others here who are similarly situated? I will also post this on the Blog in the Tehachapi News.   Thanks for your kind attention,   Jim Richards

Hi Jim;

Thank you for your question.  I have been hearing stories like yours for years and it has been only recently that we have received some encouraging news from Kaiser.  On August 7, 2006 we signed a very small agreement with Kaiser for very limited services that, unfortunately, will not help you in your situation.  But it is a start.  The agreement of August 7 allows Kaiser home health nurses to bring laboratory specimens (blood, etc) to the laboratory at Tehachapi Hospital for processing.  When we entered into the agreement, we did it with the understanding that Kaiser is interested in having a presence in Tehachapi and this would be the beginning.  I have been told that Kaiser officials would like to have a doctor up here and a contract with the hospital.  My hope has always been that we would have the contract in time to use the new hospital in Tehachapi (scheduled to open in 2008) but if we could get the contract sooner that would be even better.  If you would like to nudge Kaiser along a good person to talk to would be Bob Lund at 661-864-3308.  He is the Area Manager for Kaiser in Bakersfield.  I hope that this helps Jim.  I will encourage the TVHD Board and management staff to continue working towards an agreement with Kaiser.

Thanks for being so patient with me, Mr. Hino. I did not realize how LONG this blog had become and it was a simple matter to click on Page #2 to continue with it. I appreciate your further comments but am not sure exactly what you mean by "Kaiser Home health nurses being able to bring in blood, etc. to the Tehachapi Hospital lab for processing?"

I have to have annual blood work done to check on my cholesterol levels as well as liver function, etc. Does this mean I can call Kaiser and have a nurse come to my house to draw the blood and they will take it to Tehachapi Hospital for processing? That would be a GREAT service since I always have to be fasting and by the time I get to the Kaiser lab in Bakersfield I am DYEING for a cup of coffee and breakfast. 

I will certainly contact Mr. Lund and do whatever I can on this end to bring Kaiser further into the Tehachapi fold.

Jim Richards