Financial challenges are not uncommon among hospitals in California. More than 70 hospitals have closed during the past 10 years for financial reasons, according to the California Hospital Association.

Billions are lost annually because of uncompensated care, while the cost of care increases, said Jan Emerson, spokeswoman for the association, which represents the interests of hospitals and health care systems.

At the same time, Emerson said, hospitals must pay for mandates only required in California, including minimum nurse-to-patient ratios and seismic safety standards. "It's a very difficult time for hospitals," she said.

At Valley Health, Harder says labor costs are high and the volume of services has not kept pace with the growth. The latest financial report showed that the district is losing about $3 million a month.

Last month, the district let go 41 employees, consolidated mental health services and made some changes in day surgery.

Some disagree with the measures. Bob Miller, a licensed vocational nurse at Hemet Valley Medical Center, said staff morale is low and the workload is worse. "I'm under a lot of pressure," Miller said. "After 16 years working in one unit, I've been moved to another and have to start all over again." Miller hopes new administration will make an effort to regain the confidence of workers and the community.

Harder predicts that by next year, the hospital will be different in terms of climate, service and finances.

"Looking ahead, I'm very optimistic," he said. "A year from now, we won't be losing money. We'll be a leaner, more efficient organization and we'll probably have experienced quite a bit of cultural change." Harder said it is likely that energy and resources will be focused on two instead of three hospitals.

At the same time, management is considering investments in clinical technology and plans to build staff in areas such as orthopedics and cardiology. Dr. Neal Simpson, a Hemet family physician since 1994, said Valley Health needs more specialty doctors in such areas as radiology and gynecologic oncology.

Simpson said that on two occasions while he was treating patients in the intensive care unit, a needed specialist wasn't available.

As for the culture, Harder said there will be a sense of ownership among hospital leaders, accountability and high levels of expectations that perhaps were not present before. Read more

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Vocational Nurse