By Richard H. Hart ’70, President, Loma Linda University Health

Well, the Dennis and Carol Troesh Medical Campus is finally open, and all the concerns we harbored and challenges we faced are already receding in the rearview mirror. But it is important to remember the decisions we made, and those we chose against, as life begins a new normal at Loma Linda University.

This journey began nearly 15 years ago as B. Lyn Behrens ’63-aff started considering how to respond to the California state seismic mandate before she retired in 2008. We originally spent time working on plans to retrofit the cloverleaf towers to make them seismically compliant. After we had to give up on that approach due to cost and interference with patient care, we considered plans to build a new pediatric and maternal academic complex on the vacant land west of Loma Linda Academy. We eventually abandoned this idea as well based on the cost of connecting to our utility plant on the other side of the railroad tracks and the difficulty and cost for staff to adequately cover two separate acute care facilities.

When our focus came back to the main campus as the best building site, we knew parking would be one of our most difficult and expensive issues to solve. Over the past 10 years, we have built three new parking structures with over 2,500 parking spaces at the cost of nearly $30,000 per space—and we already need at least one more! All this needed to be accomplished before we could start construction on the parking lot in front of our existing hospital.

Another fear I remember discussing early on with H. Roger Hadley ’74 and others was whether we could fill the new hospital. What if we built a new hospital and had only 50% occupancy?

Did we have enough doctors, with enough specialized services, to keep our beds full and meet our financial obligations? We started a recruiting plan that has resulted today in around 1,200 providers, including over 1,000 physicians in our Faculty Medical Group. I credit our School of Medicine and the Faculty Medical Group leadership with exceeding our recruitment goals and having patient demands ready and waiting for our expanded capacity in the new hospital. Within a week of opening, our emergency departments and adult tower were already full!

Another huge question we struggled with as we considered the campus transformation was what will medicine look like in 10, 20, and 50 years? What will require inpatient care vs. outpatient

procedures? Private rooms have become the expectation, but what will be the balance of services and their respective bed needs? How big should we make this new hospital? We had our critics, most of whom thought we were planning too large a building. We actually ended up with roughly the same number of beds as we had before, though with greater capacity because they are all private rooms—we already wish we had more beds! As I write this, the children’s tower has room, but the adult tower is full. This should improve after the increased patient load due to COVID-19 subsides. Nonetheless, we continue to be the hospital of choice for many and, fortunately, we can greatly expand our outpatient services into the “vintage” cloverleaf towers.

The final big issue we encountered during the planning and design phase was how to deal with the fact that Loma Linda University campus sits near two major earthquake faults. We engaged special architects to design a “base-isolated” system that sits on 126 large discs hooked to shock absorbers that allow the hospital to remain stable while the ground moves up to 42 inches in any direction. While this was costly, we felt it was necessary in our situation. We were greatly disappointed when the state authorities reviewed the base-isolated system and said, “Thank you, but we still want you to ‘harden’ the building with huge amounts of extra steel rebar,” pushing our estimated costs up by $200 million, to our new total of nearly $1.3 billion. We held to that total, and I am deeply grateful to Kerry Heinrich, JD, our (previous) hospital CEO, and Eric Schilt, our project manager, for holding us to that budget and keeping us on schedule. Countless others were essential for various aspects of the financing and construction, including our past and current CFOs, Kevin Lang and Angela Lalas.

With much rejoicing we transferred 301 patients on Aug. 8, 2021, to their new rooms. This was the largest movement of patients our consultants, Yellow Brick Consulting, Inc., had ever done, and it went smoothly and without incident. Allison Ong, one of our nurse managers, along with her team, orchestrated the move. By the following day, our emergency departments, now greatly expanded and separated into pediatrics and adults, hit record numbers and have remained crowded every day since. It appears this is more than a COVID-19 surge—we are not sure whether this is our new normal or if some patients are just wanting to try out the new hospital!

What’s next? We are working to determine which outpatient services should move into the old cloverleaf towers, which provide around half a million square feet of usable space. We can’t afford to do substantial remodeling at this time, so we will primarily move services that can utilize the existing floor plans. We also have $135 million allocated for pediatric services from the state’s Proposition 4 bond fund. Extensive planning is underway on how best to utilize these funds to meet the needs of pediatrics, our largest clinical department with over 200 pediatricians. Children’s health is a key commitment of our institution, and now with our new pediatric inpatient tower, we need to expand our general and specialty pediatric outpatient capacity and make accessing our services more convenient for our families.

The opening of the Dennis and Carol Troesh Medical Campus truly begins a new era for Loma Linda University Health. Just as the move from Los Angeles and the opening of the cloverleaf towers in the 1960s transformed Loma Linda University into a modern medical center on a path to national and global recognition, this move to an amazing new hospital building gives us an equally great opportunity. With plans in development for a modern “University Village” around the hospital and expanded research capacity, Loma Linda University continues to grow its influence, both locally and globally.

The real heartbeat of this place is not our buildings, but our people. I am immensely proud of the 17,000 employees who make up our organization, supporting the 2,000 faculty members at the core of Loma Linda University. They are the ones who continue our mission “To make man whole” by extending the teaching and healing ministry of Jesus Christ. And thank you to the thousands of alumni who believed in these strategies and helped accomplish the impossible!

Dr. Hart serves as president of LLUH. In addition to his medical degree, he holds a doctor of public health degree in international health from Johns Hopkins University. Dr. Hart is board-certified in preventive medicine.