Frequently Asked Questions

1. What are your thoughts around Tulare County having all of these nursing home outbreaks? We are not seeing this in other counties and it is very disturbing.

Residents of nursing homes account for 1/3 of all deaths nationwide. These facilities have a legal obligation to report their outcomes to the County. Unfortunately, not all of nursing homes are doing that. Our nursing homes are doing a great job of reporting their cases. This could be why our numbers are higher than other locations.

1. A CE member had this experience yesterday. Her son and his girlfriend tried to get a COVID-19 test at the KD Urgent Care on Court Street. They told them at the beginning they did not have a fever, gave their insurance info, they took their vitals, then they waited in their car for over an hour only to be told they did not meet the algorithm and would not be tested.
   1. Shouldn’t they have been told that at the beginning?
   2. Her son was exposed at work. He works next to a man that tested positive but remains asymptomatic and that man’s wife works at Ruiz Foods and tested positive.
   3. Her son’s girlfriend’s employer said she needs to be tested as she is the manager of two Starbucks in Visalia and has 40 employees and a lot of contact with the public.
   4. Why did KD not test them?
   5. Is KD’s testing criteria different than the County’s criteria?

I fully understand the concern of patients and their exposures. Our protocol at the Urgent Care Center mirrors that of the County, which is no testing on asymptomatic patients. In this case, the patients were not showing any symptoms. Unfortunately, the intake nurse cannot make the notification of whether or not they would be tested; only the physician, physician’s assistant or nurse practitioner can make that determination. The physician could have seen something in their work up, even though they didn’t meet the algorithm, that would warrant them to be tested. I don’t have the answer as to why they waited for an hour, however, I reached out to John Leal, Director of our urgent cares, and he stated we have been short staffed. We have cut the hours of our Demaree site, which has caused the Court Street location to become busier.

With the outbreak at Ruiz Foods and two new nursing homes added to that list as well, is the hospital concerned about attempting to open up for elective surgeries and other services while our numbers of infected individuals in Tulare County are seeing triple digit per day increases?

Yes, we do remain concerned. One thing to point out is Kaweah Delta has never stopped performing surgery. We have continued to run 6-8 operating rooms for things such as open-heart surgery, neurosurgery, cancer and trauma surgeries. The hospital is probably one of the safest places to be right now with the amount of disinfection, hand washing, and PPE. We also have the COVID patients in specific areas so we do not cross contaminate.

We did deliberately stop non-essential surgeries to create capacity within the hospital should there have been a COVID surge, which did not materialize. We had approximately 800 surgeries that had to postponed, but are still important to get done. We are targeting May 18^th to resume outpatient and short stay surgeries. It will be a methodical and slow return over the next four weeks, with our longer inpatient surgeries taking place last. We will continue to keep some beds open in case there is a COVID surge. If we see a rise in COVID cases, we may cut back. If we see a decline in cases, we could ramp up. We will reevaluate as we go.

We understand that hospitals need elective surgeries to produce revenue and it seem we will come to a point when the hospital has to open up that service line in spite of COVID?

This is the whole focus of our demobilization team. We have created a team led by two of our Vice Presidents, Ryan Gates and Jag Batth. They are meeting with every service line including Cardiac Rehab, Pulmonary Rehab, and Endoscopy, to create a plan for reopening in a way they could pull back or expand if needed. We do want to get the hospital back up and running again. First and foremost, we need to be available for the community when they need us. We will make this transition as smooth and efficient as we can, keeping the community informed as we go.

Planning for current and future patient care coupled with the hospital’s financial position is dependent on forecasting our financial position not only immediately but in future years. The costs associated with COVID have placed a strain on the hospital’s financial position, which was only at a 2% margin last year, how do we determine the best course of action to continue providing for the health care of our community?

Kaweah Delta’s focus is providing healthcare to the community and our employees when they need us. This has had a devastating financial impact on our organization. We had a very significant operating loss in March and expect the same in April and May. This hasn’t been due to the added expense of COVID, but to our loss of revenue. We are still hopeful that we will receive some money from the federal stimulus bills earmarked for hospitals. We are currently in our budget process for the new fiscal year that starts July 1 ^st, forecasting what the next 12 months will look like. After that, we will forecast what things will look like over the next several years. There will no doubt be a tightening of the belt due to the uncertainty of what lies ahead. It will take time for us to recover financially as an organization.

Chat - Is Kaweah Delta being consulted by local agencies in plan for reopening local economy?

No, not in a formal way. We are in constant communication with the county and city. The decisions to re-open are made by the Mayor, with the County Board of Supervisors and the Governor.

Chat - As we re-open local economy, are we expecting surge?

If you take New York out of the mix, the virus is on the rise throughout the United States. It could be because we are testing much more than at the beginning. We have seen a high percentage of asymptomatic positive tests. I don’t envision a surge happening. The fear is that everyone will relax and go back to the way things were before, not washing hands, not social distancing, which could cause a surge. Being deliberate about opening slowly and watching for surges will help.

Chat - When is the Lifestyle Center reopening?

Unfortunately, they are in phase 3 of the Governor’s plan so they will be one of the last things to open. We will have to demonstrate how we will social distance within the gym, which could be moving equipment farther apart. It will be a slow roll-out.

Chat - How do individuals over the age of 65 that have followed the shelter in place rules, still manage to get the virus?

Unfortunately, there are many people that are asymptomatic and spreading it. Many young people feeling invincible because this is not a young person’s virus are out doing all they normally do. They become infected without knowing it or showing any signs, and in turn infect their parents and grandparents.

Chat - Why after so many weeks, are the number of recovered patients not higher?

The County considers someone recovered if they are testing negative with the PCR molecular test. We have been doing that at the hospital level with our employees. After their 14-day quarantine, they must have two negative tests to return to work. However, you can still have traces of the virus in your body for 3-4 weeks after the initial 14 days. This could be why there is a delay in the reports of recovered patients.