At the same time it is dealing with a series of high-profile executive departures, Clinica Sierra Vista is also struggling with the more practical challenge of keeping the lights on.
The Bakersfield-based chain of community medical clinics said Tuesday that patient visits have dropped as much as two-thirds since the start of the coronavirus crisis, resulting in a revenue decline estimated at $1 million per week.
Some of the gap is expected to be covered by a shift toward telemedicine, Clinica spokesman Tim Calahan said. But it's unclear how many patients are willing to use videoconferencing instead of face-to-face medical consultations.
If Clinica is unable to get more patients to use telemedicine, Calahan said, it may have to close some of the 23 clinics that remain open after eight were closed recently because of the cancellation of "non-essential" dental and behavioral health services.
The challenge is not unique to Clinica: Many medical providers are having to scale back financially as patients stay home during the crisis.
Meanwhile, two more senior executives stepped down this week following the departure Thursday of CEO Brian Harris.
Calahan said Chief Financial Officer Marko Horvat is out along with Chief Compliance Officer Joseph Ohens.
It was unclear Tuesday whether their exits, including that of Harris, were voluntary and whether they were related to Clinica's financial troubles.
Calahan declined to comment on the departures, saying it was a personnel matter.
Chief Human Resource Officer Stacy Ferreira has been named interim CEO during a search to find a permanent replacement for Harris. Ferreira joined Clinica in 2006.
Harris had been a controversial figure at Clinica, having been sued for alleged sexual discrimination before his arrival 2018 arrival in Bakersfield.
A former Clinica board member said Harris' first year on the job was chaotic. Later, a former CFO at the organization filed a lawsuit accusing Harris of age discrimination.
Two Clinica board members did not return requests for comment Tuesday.
Former Bakersfield City Councilman Mark Salvaggio said in a widely distributed email Tuesday that Clinica needs to "come forth with a new vision of service" following Harris' departure.
"Clinica Sierra Vista needs to recruit a seasoned, competent leader for the future. Someone who can come (aboard) and fix (its) inherent problems. Someone who can provide immediate leadership with calm, stable hard work," Salvaggio wrote.
Between mid-March and early April, Calahan said, visits to Clinica's network of medical offices fell from an average of about 9,500 to about 3,500.
The expectation is that perhaps 40 percent of the organization's patients will begin to participate in telemedicine — and that they will continue doing so after the crisis.
But as things stand, only about 8 percent of Clinica's patients use telemedicine, he said.
Clinica is allowed to bill Medicare and Medi-Cal — the organization's biggest funding sources — the same rate for telemedicine consultations as it does for in-person visits, Calahan said, though he noted that not all appointments can be handled using videoconferencing technology.
The organization's transition toward greater use of telemedicine has already begun.
Much of the more than $3 million in federal dollars awarded to the organization recently is being invested in technology that will put more patients in virtual contact with family doctors and other medical providers, he said. More federal money appears to be on the way, Calahan added.
Clinica serves about 200,000 people in Fresno, Inyo and Kern counties. It was founded in 1971.