It is hard to keep up.
Sierra Providence Health Network, El Paso’s largest hospital operator and second-largest employer in the private sector, has announced new hospitals, urgent care clinics, executive shake ups and major renovations.
But there is another announcement to come, market CEO Sally Hurt-Deitch revealed in a recent interview with El Paso Inc.
The official announcement will be made this Wednesday, and Hurt-Deitch didn’t spill the beans. But as Sierra Providence Health Network has grown, navigating it has become more complicated. And she hinted that executives are keen to unify the network’s sprawling holdings.
Since opening Sierra Providence East Medical Center eight years ago, the network has followed with three new urgent care clinics and two stand-alone emergency rooms. It has expanded Sierra Providence East, launched a $120-million modernization plan to upgrade its existing hospitals and started construction of a new teaching hospital in Northwest El Paso.
In all, executives say it represents a more than $500-million investment by the network’s owner, Dallas-based Tenet Healthcare Corp., (NYSE: THC) one of the largest publicly traded hospital chains in the country.
The executive shuffle elevated Sally Hurt-Deitch to run Tenet’s hospital network in El Paso. She oversees almost 4,000 employees and three – soon to be four – hospitals with more than 1,000 beds total. Only Walmart employs more people in El Paso.
Tenet is developing the new teaching hospital in Northwest El Paso with Texas Tech University Health Sciences Center. Construction has started and the hospital is scheduled to open by February 2017.
Hurt-Deitch was born in El Paso at Providence Memorial Hospital where she is now CEO.
“My mother said to me, ‘You were born there and now you are back.’ And I said, ‘And if I die there, then I’ve gone full circle.’”
Hurt-Deitch is a graduate of the University of Texas at El Paso and a registered nurse. She earned a master’s degree in health care administration from Trinity University in San Antonio.
At the age of 27, she became the youngest corporate officer ever at HCA Healthcare and its Columbia Medical Center West in El Paso.
She has served as chief nursing officer at Del Sol Medical Center in El Paso and CEO of Edmond Medical Center in Oklahoma. She returned to El Paso in 2007 to lead the development of Sierra Providence East Medical Center.
Last year, she was named market president and CEO of the Sierra Providence Health Network, replacing Eric Evans, who left to run Tenet’s Texas region. Hurt-Deitch is also CEO of Providence Memorial Hospital and Providence Children’s.
The Sierra Providence Health Network includes Providence Memorial Hospital and Providence Children’s Hospital, Sierra Medical Center and Sierra Providence East Medical Center.
Hurt-Deitch recently spoke with El Paso Inc. about the network’s upcoming announcement, El Paso Children’s Hospital’s search for a buyer and why Tenet sees El Paso as an important market.
Q: Tenet is spending hundreds of millions of dollars in El Paso to renovate its old hospitals and build a new one. What’s next?
We have so many cool things coming. There’s a big announcement that will be coming this week. You’ll be seeing that.
Q: You’ve announced the new hospital on the Westside, major renovations at existing hospitals, urgent care clinics and big changes to the executive leadership. What else is there to announce?
I’m trying to think how I can hint at it without giving it away. I can say it is going to really enhance the unity of the network.
Q: It is confusing to navigate at times with hospitals with different names that are part of the same network, all owned by Tenet.
Q: The financially troubled El Paso Children’s Hospital is looking for a buyer or some other “strategic partnership.” Has Tenet made an offer?
No. Tenet has not made an offer.
Q: Any discussions at all?
Not at this time. Ultimately, we want to see the right thing done for the community and for its children. We know that in a community that is underserved, the more services you can offer the better.
Q: What do you think of the idea of creating a single children’s hospital organization? The interested parties – Tenet, UMC, HCA, Texas Tech, etc. – could have some sort of ownership share.
This community has a long history of working collaboratively, and not just in health care. I don’t think there is anything that says that couldn’t be on the table, or it shouldn’t be on the table. You have enough stakeholders in the community that you could probably design just about anything you wanted.
Q: Tenet operates the other children’s hospital in town, Providence Children’s. How did the opening of El Paso Children’s in 2012, and its subsequent bankruptcy filing three months ago, impact your hospitals?
When El Paso Children’s first opened, we saw a little bit of a decline in our market share. But there’s more access to care, so it can all be seen as a positive when you think of how underserved the city is. In the past couple of months, with the troubles at El Paso Children’s, we have seen a shift of kids back to Providence Children’s.
Q: How many jobs do you have to fill at the new hospital under construction in Northwest El Paso?
Initially, you’ll start with about 300 employees. And by the end of the first year, you’ll be between about 500 and 600 employees.
Q: How many openings are there at the network’s current facilities? About 200?
Probably at any given time.
Q: So you’ve got around 500 positions to fill.
Yes. It is quite a bit. But in the scheme of things, the Sierra Providence Health Network employs about 4,000 in El Paso.
Q: How do you fill all of those positions?
What we do is first offer the positions to our network employees, and we have a certain number of jobs set aside for that. After that, it is job fairs and posting positions and doing a lot of interviews.
People often want to come work for the new hospital. It is also attractive to those who live in that community who then say, “That’s close to home. I can be right down the street and don’t have to commute very far.”
Q: Of those 300 employees, how many are doctors?
That’s not the physicians; that’s just hospital staff. Between now and when we open the hospital, we will work with Texas Tech and recruit about 30 new physicians.
Q: How will Tenet’s partnership with Texas Tech work?
What we are trying to create is a new model in El Paso that is a public private partnership. You have the medical school, which creates 78 new residency slots in El Paso, which is huge.
So you have the teaching component and the affiliation with Texas Tech and their clinical faculty, residents, interns and students. And then you have your private community physicians who are independent and have their own practices. So you have a melding of the two.
Q: How common is it for investor-owned companies to operate teaching hospitals?
This is a relatively new model. Outside of Tenet, there aren’t many that are embarking upon this.
Q: Does Tenet operate any other teaching hospitals?
Of private companies nationwide, we have the largest teaching infrastructure.
Q: Why build a teaching hospital specifically?
We knew at one point that Texas Tech was looking to build something in El Paso. Rather than Texas Tech building something themselves, why wouldn’t we want to partner and create more synergy around the medical school, bringing the strength of the two organizations together?
Q: How much is Tenet investing in El Paso?
Over the last eight years, since Sierra Providence East was opened, Tenet will have invested more than half a billion dollars in El Paso.
Tenet has always been very invested in El Paso. Sierra Medical Center was one of Tenet’s flagship hospitals, and then with the acquisition of Providence, it became a much bigger key market for Tenet.
Eric Evans (former market CEO of the Sierra Providence Health Network) used to say, “Tenet’s making a big bet on El Paso.” While it is a big bet, I think Tenet has not only dedicated a huge amount of resources, but Tenet sees this as its model market.
Q: Model market?
Being the type of market they would like to grow in. They see a community that is growing very quickly, that is open to investment and that has been very supportive of our facilities.
You look at the history we have in El Paso, and it is deep and long. Tenet sees the legacy and calls this one of its key markets – a flagship market.
Q: Is Tenet investing in other markets as it is here?
Not to the extent that they have in El Paso. There’s been a lot of acquisition. We had the acquisition of Vanguard and those facilities that happened now almost two years ago. While that money was being invested to acquire and merge companies, Tenet was still investing huge amounts of money in El Paso.
Q: Affording health care is something many worry about these days. What are you all doing to hold down costs in El Paso?
There are several different things we have endeavored to do. We now have operating four urgent care clinics in El Paso. As a network, we see about 150,000 emergency room visits in El Paso a year. But emergency room care is the most expensive care you can receive.
We want to be there when people have true emergencies, but we also know there are a lot of people who go to ERs who could be served by an urgent care clinic. It costs less, isn’t clogging up the ER and creates more access points.
We also continue to bring in and recruit a lot of physicians. In the last five years, we have probably recruited close to 200 new doctors to El Paso, so creating access points. When people don’t have access, they end up in the emergency room and drive up costs.
Q: How much does it cost to recruit a physician?
The average cost to help recruit a physician, bring them into El Paso, is about half a million dollars. That is an investment back into El Paso. It creates economic development and more access points.
Q: Nationally, Tenet has been dogged by fraud allegations over the years. Have any of those investigations touched El Paso?
No. But it does give you pause to always cross your T’s and dot your I’s and double check everything. The compliance program Tenet has is nationally recognized. It is very, very strong. In the event they find an issue in any of their facilities, Tenet’s stance is they are going to disclose it first.
Q: Nationally, Tenet has had a good year. What about in El Paso?
We are doing very well financially, and we are able to invest that back into the community. That’s what’s really exciting. While the hospitals are healthy financially, Tenet as a company does not issue dividends to shareholders. It takes that money and reinvests it back into its hospitals and communities. El Paso is a prime example of that.
Q: Hospital companies were expected to reap financial gains from Obamacare; more people insured would mean more paying patients. In El Paso, have uninsured and charity admissions fallen?
A little bit, but not much. We were very active and worked with the United Way of El Paso when they received a grant to go out and help people get enrolled. With that grant disappearing, Tenet continues to do that here.
Q: Were you surprised not to see a greater drop in charity care?
No, not necessarily. You still have the issue in Texas that Medicaid was not expanded. It was a detriment to the state when you look at how many are uninsured and how many could have been impacted through the expansion of Medicaid.
Q: By not expanding Medicaid, the state rejected billions of dollars that were available from the federal government to cover more people. Would expanding Medicaid have affected the hospitals in El Paso?
Oh, most definitely. I don’t know the exact dollar impact, but it would have been a dramatic change for El Paso.
It is amazing when you evaluate the number that are uninsured, underinsured or don’t hit specific guidelines to qualify in El Paso, the difference it would have made.
About 75 percent of all the Medicaid and uninsured care in the city is cared for by private sector facilities.
Q: How much uncompensated care did Sierra Providence Health Network provide last year?
More than $64 million.