State of Healthcare: Q&A with Northern Nevada's leaders

Northern Nevada’s population is swelling. Washoe County had just shy of 500,000 residents in 2022, and that number is expected to rise to 580,000 by 2041, according to Nevada State Demographer Matt Lawton. Douglas County, meanwhile, had 50,000 residents in 2022 and is expected to add another 3,500 in the next 20 years.
NNBW interviewed healthcare executives across northwestern Nevada to discuss how this growth has impacted healthcare organizations in the region. Their responses are below.

Thomas Graf, MD, FAAFP, chief executive officer of Renown Health

Are healthcare organizations in the region adequately sized for the region's continued growth? If so, how, and if not, what's needed at your organization and others to meet the healthcare demands of our rapidly expanding region?
As the largest, not-for-profit health care system in the state, we at Renown Health are focused on meeting the growing healthcare needs of patients across Northern Nevada with primary care, urgent care, emergency and trauma services and advanced care found nowhere else in the region. Given significant consumer demand for Renown providers and services, we are implementing a $469 million facilities capital improvement plan to ensure our hospitals have adequate bed and procedure capacity, spaces to accommodate new technology, and services to meet the needs of a growing patient base and community. In addition, we are connecting with patients in new ways for better care. We have expanded convenient, self-scheduling options so patients can make appointments for imaging and primary care via the MyChart app. In June, we launched our extended care at-home program to support people in remaining independent and in their homes while receiving extended care from physicians, nurses, therapists and other health care providers instead of having to incur a nursing home or skilled nursing stay.
Nevada continues to experience a severe physician shortage, ranking 45th in the nation for active physicians per 100,000 people. The physician workforce shortage is especially critical for pediatricians, with Nevada ranking 47th in the country with fewer than 10 pediatricians for every 100,000 people. We recently announced with UNR Med the accreditation of a new three-year Pediatrics Residency Program with the Accreditation Council for Graduate Medical Education (ACGME). The inaugural cohort of pediatric residents will start next summer, in July of 2023. The new residency will help shape future pediatric practices and fill a state and nationwide physician specialist shortage.



Thomas Graf, MD, FAAFP, chief executive officer of Renown Health

 

COVID-19 brought about a lot of new policies and some radical changes at regional healthcare providers. What worked best that will be a part of your organization's operations moving forward?
COVID-19 dramatically increased patient volumes, which made us more efficient, particularly in documenting care and leveraging automation. This good work will continue. Patients may notice advances in virtual care options and remote patient monitoring. Remote patient monitoring has allowed patients recovering from COVID-19 and other respiratory diseases to live at home safely, with 24/7 monitoring through our Regional Transfer and Operations Center. We are also incorporating virtual care into our management of chronic diseases in conjunction with our Reliable and Exact Care by Renown.


Discuss the state of the healthcare industry across Northern Nevada. What advances in technology or care are coming that will better position healthcare providers in this region to provide comprehensive care? What's the biggest need that should be addressed in our overall healthcare system?
The region is growing, and consumers have increased expectations for their healthcare providers, including making care more convenient and affordable. At Renown, we are working every day to advance technology and patient care. Across the country, and here in Nevada, there is a severe shortage of registered nurses. We are partnering with UNR and other nursing schools to expand nursing training while redesigning care around the patient, so that other supportive disciplines such as pharmacy, dietary and environmental services can be part of the patient’s care team.
Patients have asked us to expand care in four key areas so they may receive care locally and not leave the area for subspecialty expertise. The new Pennington Cancer Center at Renown is one such example. A number of cancer physicians with subspecialty expertise have joined Renown, and through close connection with local private practice physicians, we are expanding care and treatment options for patients with cancer. In collaboration with UNR Med and the philanthropic community, we will soon have the ability to care for most every person diagnosed with cancer here in Reno. We are similarly focused on expanding pediatrics, neurosciences and cardiology. Working with physicians, nurses and care teams, we are building new surgical suites, infusion centers and deploying advanced equipment to provide world-class care, close to home, with the most advanced care.
To understand what the community believes is the most important need for Renown to address, every three years, we perform a Community Health Needs Assessment and develop a community benefits plan based on the findings. As the only not-for-profit healthcare organization left in Reno, we developed our Community Health Strategy & Plan for Washoe County in collaboration with numerous community agencies and stakeholders in 2021. Renown Health has a long history of assisting those who need medical care and supporting area not-for-profit organizations. The mission of Renown is to make a genuine difference in the health and well-being of the people and communities we serve. This mission guides our efforts both within our facilities and across the community. The top issues identified include healthy behaviors (health literacy and system navigation); immunizations and infectious diseases and behavioral, youth, and adolescent health (mental health, substance abuse, and youth/adolescent health). Our plan, which can be viewed at our website, focuses on these top three priority areas, however, Renown Health remains committed to supporting positive advancements in addressing maternal and child health and other identified focus areas through partnerships and collaborations.

 

 

Helen Lidholm, chief executive officer of Northern Nevada Health System

Are healthcare organizations in the region adequately sized for the region's continued growth? If so, how, and if not, what's needed at your organization and others to meet the healthcare demands of our rapidly expanding region? 

Northern Nevada Health System has positioned itself to grow and meet the demands of the region’s population increase. Our team has developed and is implementing a long-range growth strategy, and many of the initiatives are now underway in the market.
In 2020, we opened the region’s first freestanding emergency department, the ER at McCarran NW, and have since announced the ER at Spanish Springs to open January 2023, along with a future groundbreaking this winter for the ER at Damonte Ranch. As we look to expand healthcare, our intent is to place facilities in neighborhoods so residents can quickly access the care they need. This type of facility offers efficient 24/7 emergency care that mirrors the services of a full-service hospital without having to leave your neighborhood.
Additionally, our second hospital, Northern Nevada Sierra Medical Center, opened in April 2022. The hospital expands services across the market and introduces labor and delivery, oncology, and advanced cardiovascular services, which are new to Northern Nevada Health System. Northern Nevada Sierra Medical Center has 170 private rooms, including our maternity suites. The patient rooms are universal, which allows us to reconfigure any room to isolation precautions without having to move patients or navigate concerns around infection control.
Northern Nevada Medical Group has also opened a new family medicine clinic in Damonte Ranch, has expanded urgent care services into both Reno and Sparks, and has continued to hire specialists to support much-needed services including cardiovascular and pulmonary disease.
Lastly, Northern Nevada Health System recently received approval from the City of Reno on a new specialty care facility. Pending purchase and some internal renovations, we plan to expand access to high-quality healthcare by converting the existing facility for use as a specialty facility that will offer medical care, behavioral healthcare and rehabilitation services. The anticipated opening will be late summer 2023. We look forward to continuing to keep our community apprised of progress.


Helen Lidholm, chief executive officer of Northern Nevada Health System

 

COVID-19 brought about a lot of new policies and some radical changes at regional healthcare providers. What worked best that will be a part of your organization's operations moving forward?
Northern Nevada Health System has earned a reputation as one of the safest systems in the country, as denoted by our ninth consecutive A-grade from The Leapfrog Group. This achievement was earned prior to the pandemic and was sustained during the pandemic. Our staff have always focused on patient safety, and the pandemic allowed us to continue best practices to keep the community safe.



Discuss the state of the healthcare industry across Northern Nevada. What advances in technology or care are coming that will better position healthcare providers in this region to provide comprehensive care? What's the biggest overall need that needs to be addressed in our overall system? 
The state of healthcare is in yet another unique transition due to the pandemic, and as other businesses experience the rise of supplies and equipment, healthcare is not immune to these impacts. One of the greatest needs to be addressed is staffing and retaining highly qualified employees.

Every industry is experiencing staff shortages, and although our organization has tools to recruit staff locally, as well as out of market, the current state of housing and inflation-related concerns make it difficult to fill some positions. We are working closely with local and statewide nursing and medical schools to grow relationships with students and support in their job search post-graduation. In addition, we work with various colleges who can help fill technical roles such as diagnostic imaging, surgical services and more.
The biggest opportunity we have is to expand access to care for all patients. One initiative we have is recruiting specialists and minimizing the window of time it takes a patient to establish with a provider. As a system, we can work collaboratively to understand where the care gaps exist, and with planning, develop solutions for patients. The goal is to ensure patients do not experience a delay in care and that we provide the resources needed to manage their care.
Northern Nevada Health System is also in the process of planning for new facilities, including family medicine clinics, two additional freestanding emergency departments, and a future planned expansion in northwest Reno. We know that as the population continues to grow, patients will seek care that is close to home and we plan to be part of the solution.

Jeff Prater, chief executive officer, Carson Valley Medical Center

Are healthcare organizations in the region adequately sized for the region's continued growth? If so, how, and if not, what's needed at your organization and others to meet the healthcare demands of our rapidly expanding region?
For us, the biggest problem is the healthcare workforce and finding enough staff. Carson Valley Medical Center broke ground last October on an expansion that was influenced by our Community Healthcare Needs Assessment. The CHNA is a community survey we do every three years, and it influences our strategic planning. The expansion allows us to grow our oncology/cancer care center, establish a cardiac catheterization lab, expand our emergency department, and in April we opened our new 8,500 square-foot rehabilitation and outpatient therapy center.



Jeff Prater, chief executive officer, Carson Valley Medical Center

 


COVID-19 brought about a lot of new policies and some radical changes at regional healthcare providers. What worked best that will be a part of your organization's operations moving forward?
What came to light for CVMC is the need for more telehealth capabilities and services. This is the direction of healthcare and will continue to be an integral part of our organization moving into the future.
COVID made clear that we need to address ventilation and airflow, and this is top of mind in our hospital expansion. For example, we will be able to partition our inpatient unit in half to create a standalone infectious disease unit that’s completely separated from normal operations.

Discuss the state of the healthcare industry across Northern Nevada. What advances in technology or care are coming that will better position healthcare providers in this region to provide comprehensive care?
At CVMC, we are investing in a cardiac catheterization lab, robotic assisted surgery systems, and state-of-the-art MRI, X-ray and interventional radiology technology. As an industry, we are moving towards “hospital at home.” We strive for preventative healthcare to keep patients out of the hospital. As an industry, our average hospital stay is much shorter than it has been historically.


Michelle Joy, chief executive officer, Carson Tahoe Health


Are healthcare organizations in the region adequately sized for the region's continued growth? If so, how, and if not, what's needed at your organization and others to meet the healthcare demands of our rapidly expanding region?

When Carson Tahoe Health conducted a long term (10-12 years out) master campus plan several years ago, taking into account service area demographics and projected changes/growth, there was no identified need for additional inpatient beds. However, our recent expansion on our regional medical center campus provides us with space for future growth. Additionally, with the recent opening of Sierra Medical Center, there is adequate inpatient bed capacity in the region to meet the need.


Michelle Joy, chief executive officer, Carson Tahoe Health

 


COVID-19 brought about a lot of new policies and some radical changes at regional healthcare providers. What worked best that will be a part of your organization's operations moving forward?

COVID forced us to reassess how patients, visitors and the community are greeted when entering our main hospital. The changes we made during the past few years not only provide a consistently-staffed front desk for wayfinding and information, but also add a layer of security in knowing who is on campus. Like many other providers, we quickly adapted by offering telehealth for clinic visits, and this service is still available for patients who want it.

 

Discuss the state of the healthcare industry across Northern Nevada. What advances in technology or care are coming that will better position healthcare providers in this region to provide comprehensive care? What's the biggest need that should be addressed in our overall healthcare system?

Continued expansion of remote monitoring capabilities, especially for chronic disease management, will help identify potential health problems earlier and ensure better access to timely care. This is important as access to providers continues to be a challenge not only in the more rural parts of Northern Nevada but really, across the state. We look forward to adapting with our regional providers to continue to deliver our community the best care – as they deserve our best.


Derrick Glum, CEO, Saint Mary’s Health Network

 

Are healthcare organizations in the region adequately sized for the region's continued growth? If so, how, and if not, what's needed at your organization and others to meet the healthcare demands of our rapidly expanding region?

The economic landscape of Reno as recently as five years ago is drastically different than the economic landscape of Reno today. With that, there are inherent challenges. But thankfully, our healthcare system has been able to adjust, adapt and consistently respond to our growing community’s needs. Still, the work is not done. Shortages of primary and specialty care providers, scarcity of mental health services, and an ever-increasing nursing shortage encompass some of the challenges we all are working to solve.

The juncture of the COVID-19 pandemic has been associated with increased retirement of healthcare providers, professionals leaving healthcare altogether to pursue other careers, and difficulty facilitating throughput of students – all of which place a strain on the enduring workforce who feel the effects of our region’s rapid growth.

Our organization continues to develop in stride with our region, and we remain focused on providing safe, high-quality care to patients.



Derrick Glum, CEO, Saint Mary’s Health Network

 


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