In January 2023, Blair Kent stepped into his role as CEO of Long Beach Memorial and Miller Children’s & Women’s Hospital. One year in, Kent sat down with reporter Brandon Richardson on Tuesday, Feb. 28 to talk about the job, its challenges and the future of the city’s largest hospital. This interview has been edited for length and clarity.

Brandon Richardson: You just wrapped up your first year as CEO. How are you liking it, both working in Long Beach and the job itself?

Blair Kent: I absolutely love it. I love the city. I love the feel. I love the history of what Long Beach is. And I love the diversity of people, of opportunities. Long Beach as a city, it’s incredibly endearing. What we are and who we are, I think it’s really a unique opportunity.

BR: What are some of the greatest challenges that you’ve been facing in your role, both specific to this institution as well as the medical industry in general?

BK: Globally, almost wherever you’re going to go, health care right now is challenged in staffing and the economics of health care continues to get more and more challenging as the expense to deliver and the demand for health care [increases]. How do we manage healthcare in 2024? It’s really different than it was in the ’50s. Or back in the early 1900s. The progression of where we are and what we need to do is real.

BR: There have been nursing shortages across the country, so I’d imagine you guys are still facing that. Are there other types of positions the hospital is short on?

BK: One of the things that I think we’ve done a great job on is we had to rely on travel [nurses] in the past and we have been able to stabilize by getting local people hired. Nursing is always going to be an opportunity, but I think we’ve done a wonderful job of reducing that reliance on outside by bringing more people that are from our area here full-time as part of the staff. So staffing, I think, is kind of leveled out. It’s an ongoing [issue] like any other business, it’s about recruiting and retention.

BR: What kind of strategies have you guys employed for hiring nurses?

BK: We have a wonderful legacy relationship with Cal State Long Beach and their nursing program. At any given time, maybe as high as 25% of our nurses come from CSULB, which is a wonderful connection. So, we’ve tried to build that relationship and that has helped immensely to be really focused and intentional on what partnerships look like and how we can [hire local].

BR: Aside from the staffing, you mentioned the financials of health care in general are becoming more challenging. How did Memorial close out last year and what are some of the challenges that the hospital is facing?

BK: Much like other systems nationwide, we were not immune. We were in the red last year, we lost money. And the things that we’re focused on to make sure that we address that is — we look at the stability of our staffing. How do we provide better access and utilization for our current resources? Strategically, we have focused on those kinds of things. With stabilizing our staffing, we’ve been able to significantly impact unnecessary additional costs.

BR: So, you were in the red last year. To what extent?

BK: We were losing north of $5 million every month. And that’s just simply not sustainable. I love the fact that there is a legacy here. I want to make sure that Long Beach [Memorial] and Miller [Children’s and Women’s Hospital] are going to be here for the next 75 years. I feel an obligation to the community to make sure we are a little bit more stable financially. We’ve made huge strides this year. If we continue on this path, we will cut losses by half or more by the end of the year.

BR: In terms of those net losses, what are some of the driving factors?

BK: The expense of running hospitals continues to go up, and trying to keep pace with the payers that we partner with, you don’t get really great raises all the time from reimbursement. And so we need to manage toward those — especially the governmental payers in the community like MediCal and Medicare. We need to make sure that we match what that revenue looks like.

BR: Your expenses keep going up but reimbursements are not.

BK: And part of that is: What should a hospital look like today? And how do you measure efficiency? It’s in throughput, it’s in access — kind of all of those things.

BR: There’s at least one major expense in the seismic retrofits that are looming over all California hospitals. Can you talk a little bit about that?

BK: We are actively engaged with a local architect to really look at how we do this. It’s for 11 different buildings on our campus, not just two. They are all at different levels of preparedness and consistency and what’s going to be required, so we’re in the process right now with that architect and then we will be putting that out to bid. The most important thing is we’re safe. We 100% are safe right now.

BR: The main building is the oldest one on the campus, so I would imagine just for this building, the price tag’s gonna run up.

BK: It will. We know what’s going to be required, but understanding what’s in the best interest of the community — we will be looking at all options for making the fixes. If it’s needed, what would a different building look like? Maybe one story, two stories, whatever it might be. All of those things are in play. MemorialCare has reserves that we’ve put aside to help cover this.

BR: What level are those reserves at?

BK: Last I had heard it’s in the hundreds of millions of dollars that they have been able to set aside over decades. The only lens we look through every day is quality and safety. That’s exactly what we want.

BR: I was driving by the hospital the other day and took note of all the empty land on Spring Street.

BK: We own that property north of us now up to Spring. We closed on that and we’re just trying to figure out what’s the best use. A high percentage of the hospitals in California don’t have what we do. We have land, we have options. And so for us, we want to make sure whatever we do next, we’re wise stewards of the property because they’re not growing more dirt.

BR: Could that be a building that could replace this one that we’re sitting in as the main hospital?

BK: No, it would most likely complement it. It wouldn’t be a one-to-one replacement. That’s what we’re looking at with this whole master campus design. I’m probably not as interested in 2030, as I am for the next 25 years, the next 50 years. What we do now will have a lasting impact.

BR: Is there potential for any open space for staff, patients and the community?

BK: In some of the preliminary designs that we’ve been thinking about, … it is a little bit more open space concept to keep green, green. There are very few things that are as healing as open space.

BR: The hospital recently made a decision to lay off 72 people and terminate 19 vacant positions. Can you talk a little bit about that decision and how the hospital is moving forward?

BK: We took about three to four months to go through that process — evaluating positions and comparing them. So it wasn’t just random, it was very thoughtful and deliberate. We did comparisons of what other hospitals are doing as far as their resources, how they’re deploying those. Moving forward, we’re going to continue to balance our staffing to our volumes.

BR: And those were not patient-facing positions, correct?

BK: The vast majority of those were not. There were some leadership positions. Looking at how we’ve been functioning financially, a lot of this will go toward minimizing the losses. We’re not going to be able to reinvest all of that to new things.

BR: When the layoffs were announced, staff and community members voiced concerns about impacts to patient care. Can you address those concerns?

BK: First, quality and safety is what we do. Everything we do is with that in mind and in focus. For us to be able to do things differently in a leadership path, we have not seen any change in our quality and safety — it has not been negatively impacted. We still provide really amazing, safe care here.

BR: Let’s talk a little bit about Memorial’s performance metrics — wait times, length of stay, mortality rates — and how the hospital last year compared to itself in previous years as well as the industry standard.

BK: We see over 300 patients a day in the emergency room. A wide range of people. One unique example of what you’re getting at is when people are having a heart attack, the national standard is 90 minutes from the time you get in the emergency room to having a procedure to resolve that. Over 93% of the time for us, we are better than 90 minutes. Almost 75% of the time, instead of 90 minutes, we’re at 60 minutes. Minutes count when it comes to those things. That means great outcomes. The other thing that I think we provide incredibly well here is we treat almost 2,300 trauma patients a year. Those are the hardest, most challenging patients, and we compare very favorably in all of those outcomes and measures.

BR: Are there any metrics that you are looking to improve?

BK: Length of stay — the amount of time it takes for us to progress a patient. We are doing really well in that. We have reduced our current length of stay since last September by over a day. For family members, they get home sooner and that’s exactly what we want them to do.

BR: How do you reduce length of stay?

BK: It starts with the emergency room and identifying the right place to put people, what additional service they might need. Once they’re here, we have an amazing staff that coordinates incredibly well together — physician to physician, nurse to doctor — all of those things. The more efficiently we run internally, we can get patients to a certain point. And then we rely very heavily on post-acute care. After they’re here, if they need to go somewhere else, how are we partnering to make sure we can get them there sooner. Those are the things that we do internally. Then how do we make sure patients understand what’s going on? And we listen to what they’re experiencing.

BR: Looking to the future, what is your overall vision?

BK: For me, it’s a focus on building on the legacy of people who, for a century, have relied on us. What my vision is for the next century is consistent access with the right way of balancing artificial intelligence, technology and services at home. How do we balance that and evolve with what medicine requires for us nowadays? Most of all, it is to make sure every person that lives in Long Beach knows one thing: this hospital will be here when they need us and we will gladly meet them wherever they are.