PVHD Board Approves Management Services Agreement With Riverside County

Starting Monday, Riverside University Health System (RUHS) will temporarily take over the day-to-day operations of Palo Verde Hospital in Blythe, providing management and clinical services, hospital leadership, staffing support and other related assistance in an effort to stabilize the troubled facility.

“This agreement gives us six months to stabilize care, restore confidence, gather facts and bring forward responsible long-term recommendations,” County Executive Officer Jeff Van Wagenen said at the February 19 Palo Verde Healthcare District (PVHD) meeting where the agreement was approved. “It is measured, it is limited, it is legally sound, and it’s focused on one thing: Protecting the health and safety of this community.”

In order to achieve the goal of stabilizing the hospital, the agreement allows the county to bring in a chief executive officer, chief financial officer, emergency department medical director, emergency department nurse manager or director, an operations/administrative manager and any other roles the county deemed necessary for the term of the agreement. The council would also be responsible for appointing a qualified physician as interim chief of staff.

The hospital’s own executives would have no operational authority over any of the members of the team brought in by the county, and their continued employment with the hospital district would be at the county’s discretion.

As part of the agreement, PVHD would remain the licensed hospital owner and retain all regulatory, licensure and Emergency Medical Treatment and Active Labor Act (EMTALA) responsibilities. There would be no change of ownership, control or operator under federal or state healthcare law.

“This is about stabilizing emergency care, not changing ownership, not assuming debt, not rewriting history,” Van Wagenen said. “It keeps the emergency department open and safe while we assess what comes next.”

The agreement also made clear that the county would not be deemed the operator of last resort if the effort to stabilize the hospital fails.

“The mandate is relatively narrow: stabilize, assess, report and recommend,” Van Wagenen said. “We’re not here to permanently run the hospital.”

Van Wagenen also told the board that the county had been having discussions with the California Department of Health Care Services (DHCS) in hopes that, with the county coming in, the department would allow PVHD to participate in the Medi-Cal Intergovernmental Transfer (IGT) Voluntary Rate Range Program.

The district had previously attempted to pay its nearly $3.5 million portion into that program with proceeds from a private loan in order to receive roughly $10 million in return, but the state disallowed that payment.

“We have a meeting scheduled tomorrow with DHCS, and that meeting is going to go one of two ways,” Van Wagenen said. “We have good news, where do you want us to wire the money, or we have bad news, and I don’t know what to tell you.”

Those at the meeting, including the board, thanked the county and the city for their continued support in maintaining emergency room and clinic operations.

“The county supervisors and staff have done everything they could to save the hospital, and our community will always remember that we are open today because the county helped us,” PVHD Board President Carmela Garnica said. “People are employed because the county helped us, and we are very grateful that we can continue providing this service to our community.”

The hospital’s situation came to head last spring when PVHD made the decision to suspend all patient admissions, keeping only the emergency department and community clinic open. Months later, the district filed for bankruptcy. At the start of this year, the situation had become so dire that the hospital required emergency loans from both the city of Blythe and Riverside County just to keep the doors open.

It was not immediately clear how much this effort would cost the county or the impact it would have on the county’s $10 billion budget, the first deficit budget adopted in four years.

The Riverside County Board of Supervisors is expected to ratify the management services agreement and discuss options for filling two PVHD board vacancies at its next regularly scheduled meeting set for March 3.