It’s not hard to tell that Hank Hernandez, the longest-serving hospital CEO in town, is also a nurse.
Hernandez has an easy bedside manner that puts one immediately at ease, and he’s not easily fazed – a skill that has come in especially handy over the past four years during the roll out of the Obamacare health care law.
Last Monday, the deadline for enrolling in a health insurance plan expired – mostly. There is a grace period for those who had trouble enrolling because of technical glitches on the website HealthCare.gov.
For almost two decades, Hernandez has been the chief executive of Las Palmas Medical Center. In that time, the hospital has grown a lot, opening a $40-million emergency room and intensive care unit, as well as launching the area’s only kidney transplant center.
And the hospital has plans to grow more.
Las Palmas, located at 1801 N. Oregon on the Westside, is one of two hospitals in El Paso owned by Nashville-based HCA Healthcare, the largest for-profit hospital chain in the country. The company also operates Del Sol Medical Center on the Eastside.
While many hospital CEOs make their way to the executive suite via an MBA or master’s in hospital administration, Hernandez started his career in health care as an Army staff nurse.
Hernandez is known for making the rounds of the hospital and sometimes even scrubbing in to watch the hospital’s surgeons at work.
Hernandez, 60, grew up in San Antonio. His mom was a seamstress and dad was a route salesman for RC Cola. He spent 20 years in the Army – 10 of those years as a nurse.
The first in his family to attend college, he earned degrees in nursing, health services management and hospital administration. In 2010, Modern Healthcare magazine named Hernandez a Top 25 Minority Healthcare Executive.
HCA is one of two major for-profit hospital operators in El Paso. The other is Tenet-owned Sierra Providence Health Network, which operates four hospitals in the area.
Hernandez sat down with El Paso Inc. and talked about the Obamacare rollout, growing up – not out, and the rise of the machines.
Q: What are the big issues for HCA right now?
In this market, our biggest challenge is just keeping up with the demand for health care services. Particularly in El Paso, we are seeing a lot of growth in the younger adolescent side, plus you’re beginning to see a lot of young retirees.
Those folks are retiring a little bit early, and as a result of that many need much more orthopedic support – knee and hip replacements and those kinds of things.
Folks nowadays are living longer and are more active older, so they are incurring more knee and hip injuries and those kinds of things. Quite frankly, our two operating rooms stay very busy.
Q: How has health care reform impacted the hospital?
The initial impact is many patients who were underinsured or had no insurance at all now have access to health care.
Q: One of the primary aims of Obamacare is to get more people insured, and El Paso has a lot of uninsured people. Have you recorded an increase in the number of insured patients seeking care?
It’s too early to tell. To this date (April 1), people are still lined up trying to enroll. We haven’t seen an increase yet, but we feel confident that as more and more patients are able to access health care through the Affordable Care Act, those patients are then going to have the wherewithal to seek treatment.
Q: How much charity care does the hospital provide?
We do a tremendous amount. In 2013, Las Palmas provided more than $21 million in uncompensated and charity care. We see all patients regardless of payer class; we are duty bound to take care of you.
Q: Why is it so expensive to visit the hospital even for routine procedures?
I get asked that a lot. When you’re looking at accessing a health care system, there is a tremendous amount of cost. We are here to take care of a patient regardless of whether they have a headache, all the way to if they need major surgery. There is a lot of cost for the facility to do that.
You are entering a system that is composed of highly trained physicians and staff members, so you are basically paying to ensure that, as minute as you may think your problem is, if it turns out to be something else, you have a whole complement of physicians and staff and folks who are highly trained to take care of you.
Q: El Paso has long had a doctor shortage, and waiting rooms here can be quite crowded. Is there going to be even more demand for health care in El Paso as more people have health insurance and seek care?
I think there is. We are looking at expanding the number of beds at this campus, and I know my counterpart Jacob Cintron (CEO of Del Sol Medical Center) is doing the same.
At least for the next 18 to 24 months, we feel that we have the right bed capacity. But our three-year strategic plan does look at us expanding our footprint. El Paso is a very strong growth market for HCA.
Q: How many beds does Las Palmas have now, and how full is the hospital?
We have 316 beds here and we stay very busy.
Q: How much are you planning to expand the hospital and in what areas?
Our biggest area is in the women’s and children’s service lines; El Paso is growing, and a lot of babies are being delivered. We think we also need to add a few more beds to meet the needs of the baby boomer population.
We have been working very diligently over the past several months to improve the patient experience. We are moving from semi-private rooms to private rooms, and that has been a big focus of ours as well.
Q: The Las Palmas medical campus is pretty tight. Where would you grow?
When we built the facility across the street, we built it so that we can add five more stories. That’s where you are going to see the vertical expansion on this footprint.
Q: Tenet is investing $120 million into its hospitals here, the county hospital is building new clinics across the city and a number of urgent care clinics and stand-alone emergency rooms have opened. I get the sense that there is more investment in health care in El Paso these days. Is that true, and if so, what is driving all the competition?
I think you are seeing a lot of investment by all the facilities. Ultimately, it is about making sure we are meeting the health care needs of a growing population.
There is a big push right now for systems to expand their footprint into the community – not expect patients to come to the main campus. So everybody is looking at it.
Q: Is HCA looking to jump into the stand-alone urgent care and emergency room business in El Paso?
We’ve certainly looked at it. We are not going to be building urgent care centers and stand-alone emergency rooms just because it appears everybody else is doing it. It could be on our planning horizon.
Q: What are the strengths of the hospital?
We do everything from deliver babies to brain surgery. In the last six months, we recruited a highly trained endovascular neurosurgeon – really the first one in the city. He is not only a neurosurgeon but is also endovascular trained, which means he can remove clots and fix bleeds in the brain by guiding wires through arteries. As a result of that, we are building a state of the art neuro lab.
We are poised to grow the hospital some more. We have brought in some really great sub-specialty services that hadn’t existed here.
Q: Which ones?
I’d like to highlight the robotic surgery. We went from having no robots to three, and we are now the fourth-busiest program in the state of Texas. We perform a tremendous amount of urology, gynecology and general surgery.
I think patients sometimes have a misconception that it is a robot operating on them. It’s not. The machine is operated by a surgeon. It minimizes the size of the incision, the post-operative pain and shortens hospital stays, but more importantly it gives the surgeon more control.
Q: Besides the rise of the machines here, what else has changed?
The other major service line is our kidney transplant program. We are the only hospital in this region that has one. A few years ago patients had to travel to the bigger cities like Houston or Dallas. Now they are able to stay in El Paso.
Q: How many transplants have been done?
There have been 41 transplants at the kidney transplant center since it opened.
Q: You’ve turned down opportunities to move other places. Why have you stayed here?
Primarily because I just really enjoy working with the medical staff here. We’ve been working together for a long time. I have tremendous support from our parent corporation, HCA, and when we can make a business case for expanding a service line, we are able to get that.
Q: How does your background as a nurse impact how you manage the hospital?
Not to sound cliché, but I hope that it helps me balance the administration of regulatory requirements and all the financial metrics with the actual patient care. I would hope I’m more aware about what it means for the person that provides the bedside nursing care.
Q: You are known for walking the hospital’s halls and spending a good part of your day visiting with nurses and doctors.
I enjoy that. It is one of the things I’ll place on my calendar, and I invite my staff to pull me out of the office and get me out on the floor because I want to know what is going on in the patient care environment.
Frequently I’ll get in hospital scrubs and I’ll go into the operating room. I love to go into the OR to see cases being done.
Q: Are enough men entering the nursing profession?
You have seen a lot more males enter the nursing profession over the last 15 years. That’s primarily because nursing has evolved over a great many years from being typically a secondary income in a family to the primary income. As the profession has become more technical, the salaries have grown.
Right now, I can say we are looking to hire more nurses.
Q: Nursing unions have made inroads into HCA hospitals in Texas, including El Paso. How are relations with the union?
We have very good relationships. We are just now renegotiating the contract, and things are going quite well. We’ve always had a very good relationship with our staff, and I can’t think of a single example where anything has really changed.
Email El Paso Inc. reporter Robert Gray at firstname.lastname@example.org or call (915) 534-4422 ext. 105.