For its 40th birthday, The Hospitals of Providence Sierra Campus is getting a makeover.

Formerly known as Sierra Medical Center, the 329-bed hospital opened on Pill Hill in 1976. It is now undergoing a major renovation, part of a $500-million investment Tenet Healthcare Corp. is making in El Paso to upgrade facilities and build a new hospital in Northwest El Paso.

El Paso native Monica Vargas-Mahar became the CEO of Sierra in July 2014, when Tenet, the Dallas-based for-profit health care giant, shook up its executive ranks in El Paso. The company now has three hospital CEOs here who are longtime El Pasoans.

When Sierra opened 40 years ago, the machines inside were big, covered in dials and knobs, and spit out ribbons of paper. The décor was dominated by orange, green, stripes and plaid.

Two years ago Tenet announced a plan to modernize its facilities, investing $120 million in its Sierra and Memorial hospitals. About $50 million has been spent so far, Vargas-Mahar estimates.

Renovations at Sierra began in 2014 and include a new emergency room that’s set to open in April, upgrades to the critical care and intensive care units, infrastructure improvements, new waiting areas and an expanded rehabilitation unit. The exterior also got a facelift.

Sierra is part of The Hospitals of Providence, which is owned by Tenet and is the largest health care provider in the region and one of the city’s largest private-sector employers. It operates four hospitals in El Paso and several stand-alone health care facilities.

Every year at Sierra, an average of 1,400 babies are born and 48,000 people visit its ER. The hospital has 1,100 employees, including 460 nurses. More than 800 physicians practice there.

Vargas-Mahar also oversees the freestanding emergency room Tenet opened a couple of years ago in Northeast El Paso.

Tenet is building a new teaching hospital in Northwest El Paso with Texas Tech University Health Sciences Center. The Transmountain Campus is scheduled to open by February 2017 and is the company’s second new hospital in El Paso in less than a decade. Its East Campus hospital opened in 2007.

Vargas-Mahar helped develop the hospital in Far East El Paso and worked as the hospital’s chief operating officer from 2008 to 2011.

Vargas-Mahar grew up in Central El Paso. Her mom was a scientist and her dad, who still practices at La Fe clinic, a pediatric dentist. Vargas-Mahar says she knew early on that she wanted to work in health care.

One of their neighbors was Pete Duarte, who was then CEO of Thomason Hospital, now University Medical Center. Vargas-Mahar says she was inspired to go into administration after talking to him at a pool party.

“I felt like I could make a difference,” Vargas-Mahar says.

She graduated from Loyola Marymount University in Los Angeles with a bachelor’s degree in business administration and earned a master’s in health care administration from Trinity University in San Antonio.

Vargas-Mahar is a board member of United Way of El Paso and Creative Kids. She was recognized by Modern Healthcare Magazine as an Up and Comer in 2012.

She loves to receive mail, minus the junk and bills, and thanks staff by sending them handwritten notes to their home. To return the favor, hospital employees stuffed her mailbox with cards for her birthday.

“My team knows I’m a little old fashioned that way,” Vargas-Mahar says.

She sat down with El Paso Inc. and talked about the hospital’s history, what it’s investing in and its plans for the future.

Q: What are you all doing to celebrate the 40th anniversary?

We are excited that we are reaching a milestone and are going to be celebrating with our team members Feb. 10. We enlisted the help of five team members, whose service dates back to 1977, to put together some of the history. Employees have contributed to a time capsule, which will hold everything from selfie sticks to lab coats.

Q: What are you contributing?

I’ve got an old floppy disk I’m contributing. It’s been a real fun stroll down memory lane.

Q: What is the story of the hospital’s founding?

The hospital was born out of a vision of a group of physicians to create additional access to the people of El Paso. Set high on the hill, the hospital overlooked what at the time was a growing health care cluster.

Q: Known as Pill Hill.

Yes. Exactly. It was 1976. I’m struck by their original tagline, “A step ahead.” That set the path of Sierra these past 40 years.

Q: How has health care changed over 40 years?

The advances in technology have been incredible and have shaped how we deliver health care. Since 1976 new diagnostic equipment, like MRI technology, has been developed. We’re able to develop diagnoses much faster.

As an industry, we also have become much more integrated. The focus is on keeping people healthy.

More recently the Affordable Care Act, which has given people more access to health care, has had a major impact. There’s more transparency than ever before and a focus on quality and the value we deliver to patients. All of us have seen a shift in our health premiums increasing, so we want to make sure we spend that health care dollar responsibly.

Q: How much farther does El Paso have to go to get where it needs to be?

One of our major struggles is that the region remains medically underserved. Our biggest challenge is recruitment of physicians…

Q: Still?

When you look at the number of physicians per capita, we are still very underserved. We’ve made a lot of progress but still it is about retaining our physicians.

Q: What are you doing to move the needle?

When you come and see our beautiful city, you naturally fall in love with it. People sometimes have these ideas of what El Paso is like, and it can be quite a challenge when you’re talking to them over the phone.

Specifically, The Hospital of Providence’s partnership with Texas Tech University Health Sciences Center El Paso to establish a residency program at our new Transmountain Campus hospital is where we see an opportunity to train residents in El Paso. The hope is that they will like El Paso so much that after their residency, they will decide to make El Paso their home and establish their practice here.

It is a big investment, and we certainly think it is going to pay huge dividends to partner with Texas Tech to train physicians here in El Paso.

Q: What’s next for Sierra?

When the hospital originally opened, it had 292 beds. We are now at 329 beds. Over the last couple of years we’ve decided to become focused on four key service lines that we want to distinguish ourselves in: cardiology, orthopedics, rehab and neurosciences.

We’ve done a lot of investment and want to concentrate it in those four key service lines to serve the needs of El Paso better.

Q: How so?

We have an electrophysiology room, which is a procedure used in treating heart conditions. We were the first to bring a hybrid operating room. Basically it is an operating room that can also function as a catheterization lab and vice versa. As part of the master plan investment, we are consolidating all of our cardiology services in one area on one floor.

In orthopedics, we were the first to bring Mako technology to El Paso.

Q: Used for robotic knee surgeries.

We also used to have an inpatient rehabilitation facility affiliated with the hospital many, many years ago. Two years ago, we opened a rehab unit here at the campus and this year we are expanding.

In neurosciences we are pursuing comprehensive stroke certification and are in the process of constructing a neurointensive care unit. We really want to be known as a stroke center of excellence. If somebody experiences those symptoms, we want to be the first one you think of.

Q: What’s the key to managing a large organization like this?

The way we win in this business is by delivering excellent health care and exceptional service. My focus has been ensuring the patient experience is like no other.

Q: What about cost? How do hold down the cost of expensive procedures and treatments?

It can only be done in partnership with the medical staff, and I am blessed to have some very dedicated physicians that I sit with and talk about these very issues.

In cardiology, for example, we have a group of physicians who have partnered with us to look at not just cost but also quality. This equation can only work by also looking at quality, evaluating procedures one by one. We need to deliver value, which is high quality at the lowest possible cost.

Q: Have insurers increased pressure to cut costs?

All providers are facing increased pressure from rate adjustments – no doubt. Oftentimes the only way you solve it is to work together to ensure you are delivering great care but at the lowest possible cost.

Right before this interview, I had an orthopedist who was visiting with me and we were having this very same dialogue, talking about how to advance physical therapy services so that patients can go home sooner.

Q: Given what you experienced when you were part of establishing the Far East hospital in 2006, when there was little around it but desert, what can be expected when the new hospital opens in Northwest El Paso?

One of our favorite photos is the aerial showing what was around the East Campus before we opened and what it looks like today – the incredible growth that has occurred around there. I think we can all anticipate the same in Northwest. There is already quite a bit of housing developing around it. I don’t think it will be long before that community builds around that hospital.

Q: Tenet has expanded aggressively in the El Paso market. What is so good about the health care business here?

Tenet really believes in this community. El Paso is growing and health care is a basic need and key to the quality of life, and we are excited to be growing along with the region. The only way we are going to continue to attract people and companies to the region is for people to know they have access to quality health care here.

We believe that El Paso is really on the cusp of great things, and we are excited to be a part of that.

Email El Paso Inc. reporter Robert Gray at or call (915) 534-4422 ext. 105. Twitter: @ReporterRobby.