The first time El Paso Inc. sat down with Nicholas Tejeda, his office was in a construction trailer, and the hospital he was CEO of was a $180-million construction project with a tight deadline.
Two years later, the hospital in Northwest El Paso is built and busy, and Tejeda, who passed the CEO job to Tasha Hopper, now leads Tenet Healthcare’s sprawling hospital network in El Paso. He was named market CEO in April.
“That trailer changed my life,” he says, laughing.
The city’s largest hospital network and second largest private-sector employer, behind Walmart, The Hospitals of Providence operates five hospitals and a microhospital in the El Paso area, along with many urgent care centers, stand-alone emergency rooms, imaging centers, teen centers, surgery centers and physician clinics. By Tejeda’s count, it adds up to 53 health care access points.
Since the mid-90s, Tenet has invested more than $1 billion in El Paso. That includes the Northwest hospital, a $120-million project to update the Sierra and Memorial hospitals and the construction of the Far East hospital, which was later expanded.
Construction done, Tejeda says his focus is on things that are less visible: improving quality and the experience of everybody who walks through their doors, including patients, families, doctors and employees.
Tejeda, who goes by Nico, grew up in Wichita, Kansas, the youngest of five kids. His dad was a pharmacist, and Tejeda began working for the family business when he was in high school. He became CEO of his first hospital, Doctors Hospital of Manteca in California, at the age of 32.
Tejeda, now 39, has a master’s degree in health services administration from University of Kansas Medical Center and a bachelor’s degree in business management from Wichita State University.
He recently received an alumni award from University of Kansas Medical Center for early career achievement in medicine. In August, he was named to the Becker’s Hospital Review 90 Healthcare Leaders Under 40 list.
Tejeda and his wife, Elena, have two sons, ages 6 and 8.
A movie buff and “Star Wars” fan, Tejeda has a new office at Providence Memorial in Central El Paso that’s equipped with a remote control BB-8 and plenty of Nerf blasters and various noisemakers to keep things from becoming too serious.
He sat down with El Paso Inc. and talked about what’s next for the health network, what young leaders can learn from his failures and playing DJ at meetings.
Q: How does Tenet view the El Paso market?
Last week, the executive team from Tenet Healthcare visited El Paso, including Ron Rittenmeyer the CEO. They were here specifically to evaluate the growth in our market and how we are performing on all of our pillars, including quality, safety, growth.
It was a phenomenal visit because they had a chance to see El Paso. They had a chance to see all of the investments we have here and to meet the team and to hear our plan.
Q: What did you tell them and what was their impression of El Paso?
As has been said before, this is one of the most important markets to the company. So, many of the people who were visiting had been here before. What they’re most excited about is to see the growth.
I can’t tell you exactly why the pie is growing. I do see our civic leadership has made wonderful investments in El Paso, whether that is the ballpark or the investment in roads that leads to entities like Topgolf wanting to be here. That all makes a huge difference on people wanting to move to El Paso.
Q: How busy are the El Paso hospitals?
The Northwest hospital is doing exceedingly well. Not a surprise given the community and the growth we are seeing out there. The East Campus has a capacity of 182 beds and, essentially, every day it’s at 182 patients. So we are looking at expansion out there.
All of our hospitals in El Paso had been Level 4 trauma until yesterday. We went through the survey and passed, and now the East Campus is a Level 3 trauma center.
The Downtown-area hospitals are growing quite well. Last Wednesday, we received a letter notifying us the Sierra Campus received the Comprehensive Stroke Center Certification.
And here you have the children’s hospital, which is doing exceedingly well.
If I were to put that all in terms of numbers, for the most recent measurement period for which we have data, our market share in El Paso has grown about 3 percent, which is very significant year-over-year growth.
Q: What’s next?
Our next has very little to do with bricks-and-mortar and has everything to do with how we deliver care for the patients who come through our doors. We can build all we want, but unless people who walk through our doors feel it is the best experience they have had in a hospital, it is all for naught. That’s not just for patients. What about employees, our physicians and visitors?
If we just delivered on one thing, the experience they have, we’ll be in a great position, and El Paso will be better for it. This is what we have to work on.
Q: What are some concrete ways you can do that?
We have a couple of challenges that any organization has. We have to improve the level of expectation we have for ourselves. And when I say ourselves, I don’t just mean The Hospitals of Providence. I mean as a community for the health care that is provided in the area.
There are seven or eight hospitals in El Paso. There’s only one acute care hospital that is rated as an “A” by Leapfrog (a nonprofit that publishes health care safety ratings) and that’s our East Campus.
What we hear a lot, especially lately, is El Paso is a hidden gem. I completely agree. But now I want to go beyond that. El Paso is becoming less hidden, but I want it to be a place that people are absolutely proud of.
Q: What’s another rating that El Paso hospitals can improve?
The Centers for Medicare & Medicaid Services star system. It goes from one to five stars.
Q: Last I checked, no local hospital had five stars and most were at or below the national average.
Exactly. That’s what I mean. We can do better, and we are going to take a leading roll in that.
Tenet is a nationwide organization with more than 100,000 employees. The Hospitals of Providence is in the Top 2 in the company for employee retention.
Q: Why do you think it is so high?
The No. 1 predictor of employee engagement is feeling valued. That’s across any industry. Our human resources team and our leadership team do a great job engaging our employees. And I think our employees are proud of the growth we have had. They see the investment. They know that Tenet cares about this market.
I have musical interludes in my senior leadership meetings. I generally don’t like having an agenda. I bring my wireless speaker. Wait a second. We are going to have a musical interlude, because why not.
I usually try to triangulate people’s music tastes by asking what a couple of their favorite songs are. (“Crazy” by Patsy Cline begins to play) If someone says something about karma, when they are done talking “Karma Chameleon” is coming on. (“Karma Chameleon” comes on). Or respect, Aretha Franklin is coming on.
Oftentimes, the leadership give themselves too much credit for employee retention. Our employees like each other, they like being around each other, and they like their work environment. They want us to get better and see what is possible. I think that’s why they stay. I love our team.
Q: With the labor market tightening, how hard is it to recruit?
With employees, the best thing we can do is retention. There’s always critical vacancies in certain types of jobs across the country – in the laboratory, certain types of nursing. The bigger challenge in El Paso remains physicians. It has been often said, but I will say it again. El Paso has half as many physicians as it should.
We are gaining traction on that, though. Year-to-date we have had nearly 50 physicians start here in El Paso.
Q: Speaking of recruiting, I heard your in-laws recently moved to El Paso.
(Laughs) Man, you hear everything. Gah-lee! Actually, it is a wonderful story.
So, this is the story El Paso likes to see. You have an organization like The Hospitals of Providence that invests. It becomes appealing for somebody like me to move to El Paso. When we came to interview, we were sold on the ballpark on the restoration of the Mills Building, Downtown revitalization – all the investment.
We come here and enjoy it. Our in-laws come to visit – they are retiring – and they enjoy it, sell their home in California and move a minute away from us, which is a good thing by the way.
They love it here. When I was asked to serve in my new role here, my mother-in-law cried because she knew we would be staying here.
Q: What was it like becoming a CEO at age 32?
Looking back on that, every day I have a greater appreciation for the people who took a chance on me when I was probably not prepared for serving in that role. I better appreciate now that there were a lot of someones who looked at me and said he has the potential, and once I had the role, allowed me to fail without firing me.
I appreciate that more than you can imagine because what I see more and more is risk aversion – in any industry. Fewer want to take a chance on young high-potential talent.
Q: What are some lessons you learned as a young CEO?
Have you seen my presentations? Is this a setup? (Laughs) For the last five years, on a national level, I have given a presentation called “Effectively Leading a More Experienced Workforce.” This will be the first year I don’t give that because I’m not young anymore.
The failure points are common. You have hubris. You don’t know what you don’t know is another one. Taking yourself too seriously is a huge issue.
There’s not one success I am going to have that someone else hasn’t already had, nor is there a failure I am going to have that someone else hasn’t had. And, by the way, there are billions of people in this world who don’t care how my day is. So, let’s all have a little perspective.
Q: You lead the American Hospital Association’s Institute for Diversity and Health Equity, right?
Yes. For a long time, we’ve known there is a lack of equity in the United States with respect to health care. El Paso is no different; we are medically underserved. You, me, we have less access to physicians – our families have less access. That is an inequity. This is the best chance I’ve ever had to actually walk the talk.
Normally, our board meetings are either in Chicago or Washington, D.C. This November, I’ve convinced them to come to El Paso. I cannot wait. The CEO of the American Hospital Association is going to join us. He’s never been here. We’re going to Juárez to the FEMAP hospital.
Q: How well are Hispanics represented in health care?
Overall, Hispanics make up about 18 percent of the population of the United States but only 3 percent in C-suite leadership roles. They are underrepresented, as are Asian-Americans and African-Americans.
Q: How about health outcomes for Hispanics?
Nationally, you have issues with maternal mortality, diabetes, heart failure. Even if you take into account economic factors such as income and education, you still have disparities in care on a national level.
Q: In El Paso, there is a diverse mix of hospital executives. There are young hospital CEOs, female CEOs, Hispanic CEOs. Is that unusual?
That’s a great observation. El Paso does have a much more diverse cohort of executives. There’s opportunity in El Paso for people who want to come here and work hard.
Q: Freestanding ERs began opening across El Paso about five years ago. Now they are closing, and two of the statewide chains are in bankruptcy. How are Providence’s performing?
Our off-campus EDs are doing very well. We have a different model than those entities had. Generally speaking, they were out of network with insurance companies and, ultimately, their approach proved unsustainable. Ours are the same as any of our ERs that contract with insurance companies. So we’re not exposed to that.
I think what we are seeing now is there were too many too fast in El Paso.
10 Quick Qs
Star Wars or Star Trek?
Easy one… Star Wars (without Jar Jar Binks)
“Star Wars: The Last Jedi.” Good or bad?
Business travel essentials?
A classic movie loaded on my iPad
How many unread emails?
Last show you binge-watched?
Best business book?
“Lincoln on Leadership” by Donald Phillips
Your go-to for stress relief?
Remembering that we shouldn’t take ourselves too seriously
Sport you played as a kid?
How good were you?
If I was faster, taller and could shoot better, I would have been incredible
What did you want to be when you grew up?
Never had a plan... Still don’t