January 2016
Y
C A REPORT ON WHAT IT TAKES TO MAKE A HEALTHY COMMUNITY
 W
The One-in-a-Million ER
Table Mountain
Rancheria Trauma Center
1 MILLION PATIENTS
2007-2016
LIFE SAVER.
SAFETY NET.
SAVING GRACE.
Shortly before the calendar turned to 2016, the
one millionth patient was treated in Community
Regional Medical Center’s emergency department.
When the Table Mountain Rancheria Trauma
Center opened in 2007, its football-field sized
emergency department was the largest in
California. It quickly became one of the busiest
serving an average of 355 patients a day – 17 on
average for trauma care.
In 2013 to expedite treatment, Community
Regional’s ER staff began triaging patients in
waiting areas. Now, more than 62% of patients
start their care here and 56% of those patients
can be treated and discharged without using an
ER bed. Community Regional also opened a new
Prompt Care Clinic with extended hours to care
for those with less critical needs. And a patient
flow command center was set up to increase the
daily capacity to treat patients from an average of
600 to 630.
Community Regional sees more
critically ill patients than any other
California hospital – 25,000 last fiscal
year in need of immediate, critical care
Community Regional serves as the region’s hub
for higher level care, with 25 outlying hospitals
transferring 1,074 trauma patients to it last fiscal
year. The hospital’s 57 emergency beds are nearly
always full, many days requiring another 60 hallway
beds to temporarily address the overflow.
Much of the increase in patients results from the
expansion of insurance coverage through the
Affordable Care Act (ACA) – particularly MediCal. Community Regional, the state’s fourth largest
hospital in terms of beds, has more inpatient MediCal discharges than any hospital in California,
surpassing even Los Angeles County/USC
Medical Center. “Medi-Cal patients are always
the highest utilizers of emergency departments,”
said Dr. Gene Kallsen, a UCSF clinical professor
of emergency medicine. “There are not enough
doctors accepting Medi-Cal.”
The Many Threads
of a Safety Net
Level 1 trauma
& burn service
area includes 2.5
million people in
9 counties
San Francisco
Fresno
2nd
busiest ER
in California,
caring for 10,000
patients a month
Los Angeles
MAKING CARE ACCESSIBLE:
CommunityMedical.org/about-us
After crashing, Ryan Gravelle, 19, walked half
a mile to a friend’s house with a broken neck,
facial fractures and a potentially fatal swelling
in his brain. Kaiser’s Fresno hospital sent him
to the trauma team at Community Regional.
Within three months of the Aug. 1, 2015, auto
accident, Ryan was back at college full time,
working part time and driving a new car.
Safety-net hospitals treat
the most vulnerable patients
who might otherwise have nowhere else to
go. Of the more than 5,600 hospitals in the
U.S., only a fraction meet that designation.
Community Regional Medical Center in
downtown Fresno is one of them, ranking
among California’s leading safety-net
hospitals in the amount of acute-care
services provided.
The downtown Fresno hospital is the only
provider for many medical specialties for
Medi-Cal patients, taking referrals from
federally qualified health centers and
outlying hospitals. We provide certain
services considered “optional” by MediCal, including dental services. Community
Regional also cares for a significant amount
of uninsured and undocumented patients,
including about 22,000 annually in its clinics,
collaborating with various health providers
to address chronic health needs.
$169 million
“Community benefits” last year for
uncompensated care, charity care,
medical education, healthcare
outreach and other services for
which Community was not paid
of Community
Regional’s patients
are covered
by government
insurance – more than
55% by Medi-Cal which pays
only about 68% of costs for care
80%
Fresno Fire Captain Pete Dern was rushed to Community
Regional after he fell through a roof of a burning house.
Burned over 70% of his body, he spent 165 days at the
hospital’s Leon S. Peters Burn Center. He walked out on his
own in September 2015.
Only
Just six days after 70% of his cancerous
liver was removed and his colon reattached
to his intestine, Rick Hatton, was ready to go
home cancer free. The 56-year-old tile layer
had ignored his initial symptoms. By the time
an ambulance brought him to Community
Regional’s ER in March 2015, he had stage
4 cancer and needed emergency surgery to
remove a bowel blockage.
FIND THEIR STORIES AT: COMMUNITYMEDICAL.ORG/NEWS
WANT TO KNOW WHY YOU WAIT SO LONG IN THE ER?
WATCH THE VIDEO: CMC.NEWS/WHYUWAIT
52%
of the region’s
primary care
physicians accept
new Medi-Cal
patients
“Community Regional continues to develop
innovative partnerships to provide higherquality care to overwhelmingly low-income
communities,” said Catherine Douglas, CEO
of Private Essential Access Community
Hospitals, California’s safety-net hospital
association. “It is a critical part of our state’s
healthcare safety net.”
MAKING CARE ACCESSIBLE/BUILDING
RELATIONSHIPS: CommunityMedical.org/about-us
One Network. One Community.
Clovis Community Medical Center | Community Behavioral Health Center | Community Regional Medical Center | Fresno Heart & Surgical Hospital
WHAT HAPPENS WHEN A HOSPITAL NETWORK AND ITS COMMUNITY ARE CONNECTED? FIND OUT AT CommunityMedical.org/about-us