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Casey Christie / The Californian

Kern Medical Center in Bakersfield on Mt. Vernon Avenue.

Kern County supervisors continued focusing Monday on the complex tangle of financial problems plaguing Kern Medical Center, and began exploring the possibility of another organization running the troubled facility.

During their regular monthly meeting the supervisors heard some good news -- KMC has paid down its general fund loan to under $100 million after it had spiked close to the maximum $136.2 million county cap -- and some bad news. It lost $3.5 million in September.

Supervisors, who have been searching for a new executive officer for KMC and pushing for the hospital's immediate fiscal reform, heard Monday that the general fund loan on Oct. 31 was $98.2 million. Despite the reduction it remains the major symptom of the county hospital's financial illness.

The loan, which fluctuates with the hospital's erratic cash flow, is expected to be back up to $107.5 million by the end of this month, said KMC Chief Financial Officer Sandra Martin.

While Martin said KMC was only budgeted to lose $1.5 million in September, much of the unexpected $2 million difference was one-time in nature.

The hospital continues to lose money despite indications that its operational challenges, such as a poor mix of paying and nonpaying customers, overruns in costs and supplies, and a lower-than-expected number of patients, might be improving.

The county is not required to run a hospital. But for decades KMC has been the county's vehicle for caring for indigent adults -- people who can neither pay for their medical care nor get care anywhere else. The county is required by state law to provide that care and is partially paid for delivering it.

Monday, supervisors heard about options available for providing indigent care, including hiring a private company to run the hospital or creating a separate public agency, such as a hospital authority, to run it.

Under the private company model, staff reports stated, there could be streamlined hiring and operations.

Creating a hospital authority would require state legislation -- something the county tried in 1997 only to be stymied in the state Assembly.

Supervisors chose not to move forward with any option because they lack critical information about indigent patient population, debt and realignment funding, which the staff has been gathering.