Ed Epperson says the choices are clear-cut for Carson Tahoe Health.
One on hand, the healthcare network — its cornerstone is the Carson Tahoe Regional Medical Center at the north edge of Carson City — can take the steps it needs to widen its services and its geographic reach.
Alternatively, says the president and chief executive officer of Carson Tahoe Health, the nonprofit can become a part of a larger healthcare provider like one of the national groups that have been rolling up locally based hospitals across the country for the last decade.
For Epperson, the choice is all about staying close to the community.
“We always want to be responsive to the community, not to some corporation somewhere,” he said. “We could become a niche player in someone else’s system. You either become a system yourself, or you become a piece of someone else’s system.”
Carson Tahoe Health’s drive to stay independent is reflected in its physical facilities.
The 144-bed Carson Tahoe Regional Medical Center, built five years ago, is part of an 80-acre medical campus. With the opening of the new I-580 freeway between Reno and Carson City, the hospital increasingly markets itself as a convenient alternative to Reno and Sparks residents.
The north-Carson campus also is home to Sierra Surgery Hospital, which specializes in elective procedures, as well as the main office of Carson Tahoe Cardiology. Carson Tahoe Cancer Center provides oncology services from another freestanding building.
The medical campus, a collection of smaller buildings near to the big hospital operation, provides a more comfortable feel for patients, Epperson said.
Equally important, Carson Tahoe Health’s leadership believes that the days of large-scale, capital-intensive hospital construction projects have come to an end.
Instead, Carson Tahoe Health now sees a future in which it builds small buildings as needed around the campus.
“We have a lot of flexibility,” Epperson said.
The organization also continues to use the property in central Carson City that previously served as home of its primary hospital.
Behavioral health care is provided in a 30-bed inpatient and a 16-bed geriatric psychology services unit at 1080 N. Minnesota St., and continuing care services are provided at 775 Fleischmann Way.
The organization continues to extend its geographic reach.
A few months ago, Carson Tahoe Cardiac Services opened an office in south Reno — ratcheting up the competition among cardiac care providers in Reno and Sparks — and Epperson says further forays into Reno and Sparks are likely.
In smaller communities in the region, Carson Tahoe Healthcare recently opened a successful retail clinic at the Walmart store in Gardnerville, and it launched a cardiology clinic at Yerington.
Future services — perhaps with facilities of their own — might include home health care, hospice or long-term care, Epperson says.
“We want to expand our service line to include virtually all levels of care,” he said.
At the same time, Carson Tahoe Health looks to develop a clinical affiliation with one or more research and teaching facilities outside the region.
Epperson emphasizes that this doesn’t mean that Carson
Tahoe Health is looking for a financial affiliation.
Instead, the organization’s leadership believes that a clinical affiliation would further enhance its services, allow participation in research protocols and provide important career-development alternatives for medical professionals. More than 240 board-certified physicians work with the health-care network.
Expansion of the organization’s services is all the more challenging, Epperson says, given the shrinking reimbursements for medical service from programs such as Medicare and private insurance companies as well as the continued changes that surround the political issues with healthcare reform.
“There is no playbook, and leaders must be good in dealing with ambiguity,” he said.
Data collected by the state government show that Carson Tahoe Regional Medical Center posted net income of $4.4 million in 2012. Its revenues for the year totaled $198.1 million.
Its solid financial footing and its diversity give Carson Tahoe Health the resources it needs to maintain its independence, Epperson said.
At the same time, the organization is relatively small compared with the multi-hospital systems that increasingly dominate the sector. That, he says, allows Carson Tahoe Health to remain nimble.
Another strength: “The well-informed, highly engaged board of directors, which is dedicated to providing the community the healthcare it demands and deserves,” Epperson said.
He’s confident that Carson Tahoe Health will continue to set its own path through a fast-changing environment.
“Continuing to thrive in healthcare is do-able,” Epperson said. “But it is not for the faint at heart.”