Life Coach in Green Valley, AZ

The 49-bed Santa Cruz Valley Regional Hospital opened seven years ago and, on average, saw about 50 patients each day in its emergency room. But despite investing in specialists and equipment for serving older patients, CEO Stephen Harris said only about 15% of the people living there used it.

“We’ve been struggling since COVID,” he said. “Our whole rural health care infrastructure is collapsing.”

The Green Valley hospital buckled under its Medicare debt for money advanced to stay open during the pandemic, Harris said, adding they were paying back about $400,000 per month.

“In September, that would have gone down to $50,000 (per month),” he said, adding that the break just didn’t come quickly enough. “That, combined with nursing agencies charging so much, just knocked us to our knees.”

He said their one hope was to be bought out by Tucson’s TMC HealthCare but that plan fell through a couple weeks back.

“We have been working with TMC since November and we thought we had a deal with them,” Harris said. “However, they are having a bad year and they pulled out at the last minute, and we didn’t have time to find another buyer.”

TMC signed a nonbinding agreement to begin the due diligence process at the end of April, and then decided not to go forward with the purchase, said Julia Strange, vice president of community benefit for TMC HealthCare. She declined to elaborate on the reasons other than to say they “took the process very seriously.”

“I’m distressed and heartbroken that it’s closing in such a final manner,” said county Supervisor Steve Christy, whose district includes Green Valley. Christy said Green Valley is not alone in this, that many rural hospitals around the country are closing.

Strange said TMC HealthCare remains interested in providing outpatient services in the community but did not provide further details.

Harris is frustrated with TMC HealthCare because, he said, after the sale fell through TMC made and then broke a promise to hire all of his 200 full-time employees. He said he let TMC HealthCare do a job fair at his hospital last Friday contingent on that plan.

Strange said they have been trying to hire people for the positions they have open but cannot create new jobs just to take on the additional workers. She said TMC HealthCare is continuing to communicate with some of the Green Valley employees who recently lost their jobs.

Santa Cruz Valley Regional Hospital in Green Valley announced Friday it will close the doors permanently at noon June 30.

The decision comes less than a week after notifying 300 employees that there was a strong possibility it could cease operations by the end of summer.

CEO Steve Harris said the decision came after they were unable to secure staffing for emergency room services over the Fourth of July weekend.

On Monday, the 49-bed hospital triggered a WARN Act notice, a federal action required at least 60 days before a mass layoff or plant closure. The hospital will pay employees through Aug. 20, in accordance with the act.

The slide to the end started in early June, when Tucson Medical Center announced it would not pursue purchasing the hospital after considering it for seven months.

Hospital owner Lateral GV, an offshoot of California-based Lateral Investment Management, sold the hospital building and land last year to Broadstone, a real estate investment trust in New York. Officials at Lateral, which continued to operate the hospital, did not immediately answer requests for comment Friday. An official from Broadstone said they had no comment.

Nearby medical buildings and physicians clinics planned for Tubac and Nogales are not affected by the closure.

The closure will leave the Green Valley/Sahuarita area with one hospital. The 18-bed Northwest Medical Center Sahuarita opened at Interstate 19 and Sahuarita Road in 2020.

The Sahuarita hospital released a statement Friday that read, in part, “Closing a hospital is never an easy decision, and we acknowledge and respect the team at Santa Cruz Valley Regional Hospital for the care they have provided to the community. Northwest Medical Center Sahuarita is strong, and we are continuously evaluating additional ways we can serve the community. We believe that it's important for patients to have access to healthcare close to home, and we will continue to provide that care locally.”

Northwest officials did not specifically address whether they would increase care options or open more beds in Sahuarita as a result of the Green Valley closure.

Pima County Supervisor Steve Christy, whose district includes Green Valley, called the hospital’s seven-year run “one of those ongoing dramas that never seemed to get better.”

“It’s been a long, painful, agonizing process basically since day one,” Christy said. “It kind of rocks you when all of the sudden you realize they expended every avenue and every pathway to try to stay open and there’s just nothing left.”

Christy said the hospital would be a tough sell to investors given its history of financial instability.

Sue Koeller said she’d gone to the Green Valley hospital once as a patient.

“The only time I went out there I needed an MRI and the machine was broken,” she said. They gave her a CAT scan; she had to get an MRI elsewhere.

Even so, Koeller sees a specialist who works out of the hospital and said the closure will have an adverse impact on the area.

A broken ankle sent Judy Moulton to hospital’s emergency room. She was told she needed surgery, but the appointment they scheduled her for in Tucson was set for just 15 minutes after her discharge in Green Valley.

“That was several years ago and they’ve been through a lot of ups and downs,” she said. “I am sad to see it close. It seems like it’s been in trouble since day one.”

“Tucson is available,” she said. “Sometimes, it’s inconvenient.”

Santa Cruz opened as Green Valley Hospital in May 2015, financed through the U.S. government’s EV-5 Investor Visa program.

It filed for bankruptcy in 2017, and was purchased by Lateral, the lone bidder in a deal finalized by the courts in July 2018. Shortly thereafter, Northwest Healthcare announced an 18-bed hospital in Sahuarita, nine miles north.

The Santa Cruz Regional Valley Hospital closed down last week, after years of financial struggles. Located 30 miles south of Tucson, it was Green Valley’s only hospital.

The closure occurred after TMC HealthCare, a large healthcare provider in southern Arizona, backed out of acquiring the hospital last month.

TMC Health worked with the hospital on the acquisition for seven months before it decided to back out of the deal.

“After careful due diligence, the decision was made to not proceed with the acquisition of the hospital," said TMC Health in a statement. "We are working closely with management at Santa Cruz to identify appropriate placements for as many employees as possible. We continue to explore opportunities to provide needed medical services to the Green Valley community.”

According to the Santa Cruz Valley Regional Hospital's website, the 7-year-old hospital ceased all services at 12 p.m. Thursday. The 49-bed facility served Green Valley, Sahuarita, Nogales, Rio Rico, Tubac, Amado, Patagonia and Sonoita.

On June 20, a Worker Adjustment and Retraining Notification Act notice was issued stating that 315 employees would be affected by the closure.

WARN requires “employers to provide notice 60 days in advance of covered plant closings and covered mass layoffs,” according to the state’s Department of Economic Security website.

Closure was caused by a 'perfect storm' of events

Pima County District 4 Supervisor Steve Christy said there was a “perfect storm” of factors that contributed to the closing of the hospital from debt to lack of patients.

Christy said many residents chose to go to Tucson with its state-of-the-art medical facilities, and Sahuarita, which neighbors Green Valley and has an 18-bed medical center that opened in 2020.

Even residents in communities as far south as the border town of Nogales often preferred to travel to Tucson, said Olivia Ainza-Kramer, president of the Nogales-Santa Cruz County Chamber of Commerce.

“For Nogales and Rio Rico, our hospital is Holy Cross hospital, the services ... are very good and very good staff except that it's a small hospital. Whenever they (people) needed to be treated for something else that they couldn't treat here, they would be transferred to Tucson,” she said.

Representatives from the Carondelet Network, which runs Holy Cross did not respond to requests for comment.

The Arizona Daily Star reported on July 2, the hospital’s former CEO Stephen Harris said only about 15% of the people living in Green Valley used the hospital.

Another issue facing the Santa Cruz Valley Regional Hospital was mounting debt. The Daily Star’s article reported the hospital fell behind on repaying Medicare payments advanced to keep the hospital open during the pandemic.

Christy noted that with the recent downturn of the economy, the frequent change in leadership of the hospital, and the medical complex's complicated ownership structure, the decision of TMC Health to back out of the deal was no surprise.

According to Pima County GIS maps, multiple entities own different buildings and the land the hospital sits on.

Christy said the plan for TMC Health to take over the hospital was one last effort at saving the institution after years of financial issues and ownership changes. He called the closure “gut-wrenching” after the deal fell through.

Hospital has a turbulent past

The Arizona Republic reported in May 2020, that in 2018 Lateral Investment Management took over ownership and gave the hospital its current name after it emerged from Chapter 11 bankruptcy.

Then, during the COVID-19 pandemic, the state of Arizona gave Santa Cruz Valley Regional Hospital one-time funding of $3.6 million from the COVID-19 Crisis Contingency and Safety Net Fund in May 2020 after hospital leaders said they were on the brink of closure due to a drop in revenue during the first months of the pandemic.

Hospital leaders told The Daily Star the hospital, which leaders estimated cost $79 million to build, had experienced “turmoil and financial mismanagement” in its early days.

Before the facility was built the area did not have a hospital or emergency room, and residents had to travel about 30 minutes by car to get to an ER.

“It’s very sad because in 2015 it opened with such high hopes and great expectations,” Christy said. “It’s a beautiful facility. I think it's indicative of what many rural hospitals are experiencing right now.”

Christy said there has been no talk about what will become of the complex that housed the hospital.

Hospital administrators could not be reached for comment.

Coverage of southern Arizona on azcentral.com and in The Arizona Republic is funded by the nonprofit Report for America in association with The Republic.

The learning disability causes difficulties with misspellings, sound awareness and relating to letters and words.

Author Yasmin John-Thorpe, who winters in Quail Creek, never planned to write specifically for young readers with dyslexia. But, when she met Cheryl Anthony, a dyslexia consultant who has run several businesses catered to people with dyslexia, it opened her eyes.

“In 2019, she approached my table during the craft sale and she bought my books and then she made me do a podcast,” she said. “I asked why we are doing a podcast and she said, 'Well, your books are too hard for my students to read.' And I have to say I went home and it bothered me that there would actually be students who couldn't read my books.”

From there, the pair got to work on creating a series of decodable books — designed to help young people decode words rather than guess.

“These types of books are specially designed to just include specific letter to sound patterns that students have already been taught and they contain very few academic words,” Anthony said. “You only give kids the words you've taught them, the patterns you’ve taught them. We're not going to ‘guess and go,’ we are actually going to decode or read those words.”

When they reached out to Anza Trail School second-grade teacher Becky Hill, it was a project that spoke to the teacher’s heart. She has dyslexia herself.

“I understand the struggles,” she said. “Even though some aren't diagnosed I can tell who's dyslexic in my class. They’re my people and I just understand the emotional struggle they go through. It's like helping them not just with reading, but also the emotional side.”

Through a donation by the Caring Hearts and Hands of Quail Creek, Hill will now have a set of the books to use with her students who are struggling with reading.

John-Thorpe and Anthony have now created several sets of 11 books each, which all build off each other. Their next goal is to get them into the hands of children at local schools.

John-Thorpe said writing the books is a challenge, given the set parameters given to her by Anthony, who created a binder of guidelines for writing with dyslexia in mind.

“It's the hardest thing I've ever had to do because I can sit and write a book in two or three hours and get them illustrated,” she said. “She gives me this binder and I can only use certain words. Sometimes it takes a week to write a line for an eight-page book.”

Anthony said the guidelines are based on a system called the Orton–Gillingham System.

“I took that scope and sequence and that's what I gave her to say we are going to start here at this beginning level and we will follow the scope and sequence of instruction so every new book that comes out is built on a prior pattern,” she said. “Now, we're going to increase the difficulty or knowledge base a bit and continue. It's layered instruction and practice that correspond.”

The goal isn’t to have students memorize words or use pictures to guess how a word might sound, it's about learning patterns.

“The brain will map it and retrive it but we want students to have the letter to sound pattern so whenever they see that pattern or word they can sound it out,” she said. “It's not that they have memorized words."

Hill knows first hand how important decoding is for a young person who's coping with dyslexia.

“At a young age I started accommodating myself by making little symbols to show me these letters make this sound,” she said. “That's how I taught myself, so I understood how important it was using decodable patterns to read."

Anthony, who also lives in Quail Creek, has been working with students with dyslexia for years and runs the Southern Arizona Educational Services, providing screenings for dyslexia, advocacy and training.

“There’s resistance at first when you’re providing the intervention because they don't want to show you what they don't know,” she said. “They’re embarrassed, but very soon, once you start providing support they need the excitement comes and resistance goes…like, ‘I can do it.’”

She said decodable books have been around but are just starting to catch on. And, so is the educational world.

“The decodable books are kind of at the forefront of let's provide appropriate instruction in our school systems and get more kids to be literate,” she said. “States around the country are passing laws legislatively to say school districts have to test for markers or difficulties. Now we will know there is a percentage of students who have red flags. What are the instructional tools there?”

Sahuarita Unified School District has recently started dyslexia screenings and offering monthly reading connection nights on Zoom to help students and parents.

Anthony has been helping with the reading nights and has also provided training to SUSD teachers on dyslexia.

For Hill, who shares her experience at the district and provides professional development to teachers related to dyslexia, the diagnosis of dyslexia can be a huge help.

“It helps so much when your diagnosed,” she said. “It's like I’m not slow, I'm trying, oh I'm dyslexic. There's a process and that's OK. I need accommodations.”

She wasn’t diagnosed until she was 30 and in college, and said it changed everything.

“They become so happy and confident and we celebrate,” she said. “To see the growth…understanding the letter and sound pattern, and being able to use that and adopt it and further their reading…they’re like, ‘I remember I know this word.’ They relate the prior knowledge and it's just incredible. ”

They are now trying to drum up support in the community in the form of groups purchasing and donating a set of books.

Along with the Caring Hearts and Hands groups, the Jetsetters of QC have also sponsored a set for Continental Elementary School. They are hopeful to see sets of the books get into libraries and other schools in the area.

Against the horizon, few landmarks stand out in Green Valley as much as the Santa Rita Mountains, but the mine tailings to the west are a close second.

Located off the west side of I-19, Freeport-McMoRan’s Sierrita Mine spans about 60 square miles, employs more than 1,000 full-time workers and produced about 189 million pounds of copper and 21 million pounds of molybdenum – its two main outputs – in the last year alone.

But with many in the community coming and going with the seasons, the flat-topped hills can raise perennial questions with both newcomers and long-time residents.

Last week, the Green Valley Council’s Environmental Committee gave residents a chance to voice their questions and concerns about the mine, its operations and future projects directly to Freeport-McMoRan representatives.

Here’s some of what they had to say.

“We do have a 24/7/365 operation, and there’s a whole team of people, including geotechnical engineers, who manage and monitor the tailings at any one time, as well as internal and external review boards,” said David Barnes, Freeport-McMoRan’s Environment, Land and Water manager.

“We prepare for weeks in advance because one afternoon, we might have 40 mile-per-hour winds, and this is five square-miles of sand, so if you’re not prepared, it can get away from you pretty quick, so this is a continuous effort,” Barnes said.

After a significant dust event in 2018 that cost the company $230,000 in a settlement and fine, Barnes said the team stepped up their tailings and dust management operations with weekly meetings, regular site walks, and took notes about other effective dust control and mitigation techniques from other nearby mines.

Freeport-McMoRan has recently been experimenting with a rubbery, thread-like polymer (Soil Sement EF) to treat the surface of the tailings, which Barnes said holds up better against monsoon storms than magnesium chloride, a compound they currently use on the tailings.

Barnes said Soil Sement EF has been approved for use at the Sierrita Mine, and is being used in conjunction with magnesium chloride on active tailings.

From 2018 to 2020, reportable dust events dropped from 14 to four, and there have been no reported dust events in the last two years, according to Freeport-McMoRan.

The pecan groves in Sahuarita, owned and operated by Farmers Investment Co., began using water from the Colorado River via the Central Arizona Project in September 2020, after construction was completed on the $17.1 million pipeline that brought water down from CAP's terminus near Pima Mine Road.

Freeport McMoRan paid $11.2 million toward the pipeline’s construction, while FICO paid the rest. About half of the pecan orchard is now being irrigated with water from this project.

“We funded this, and in return what we get is the water rights to the water that’s still in the ground,” Barnes said.

When it comes to future cuts to Arizona’s Colorado River water allocations, Barnes said Freeport-McMoRan’s water rights will not be threatened, at least not now.

“We bought 99 years worth of Gila River Indian Community water, and it’s the top tier, so this particular project will see none of the 20% or so cut for Arizona – that'll come from the agricultural tier.”

The next stage of the CAP pipeline project is to extend the pipeline farther south, but Barnes said that project “depends somewhat on the economy,” and did not have a date for when that could happen.

As for how the Sierrita Mine uses its water, Barnes said it mostly flows through “two separate continuous re-use loops.”

“We use water to move the tailings down the tailings impoundment, and it’s also part of the process in floatation, in dust control and in a variety of other things…but it all ends up down in tailings where you drop out the solids,” he said.

“Then, we pump that water (from the tailings) straight back up the pipe and use it again, and what small percentage of it infiltrates down to the groundwater creates the plume, and we pump that as well.”

“The tailings pile was built in the 1970s, and it was built without a capture system. The pool of water in the middle (of the tailings impoundment), we pump it back to the mine and reuse that water, but some of it, over the years, filters down through into the groundwater, and that’s what the plume is – it’s dissolved sulfates in the groundwater,” Barnes said.

According to the U.S. Environmental Protection Agency, sulfate is classified under secondary maximum contaminant level standards – which are based on aesthetic effects like taste, odor and color. When sulfate is found in drinking water in concentrations of 250 mg/L or less – the same standard Freeport-McMoRan measures its plume against – almost all consumers should be protected from sulfate’s aesthetic effects on drinking water.

In order to keep the sulfate from impacting community drinking water in Green Valley and Sahuarita, Freeport-McMoRan established a well field in 2006 – a collection of over a dozen wells, placed mostly in the West Desert Trails area – to test groundwater, stabilize the plume, and pull sulfate-laden water back away from community wells for reuse in the Sierrita Mine’s operations.

The mine began pumping that well field in 2014, and is required to keep an average pace of 10,643 gallons of water per minute – roughly equivalent to filling 178 standard bathtubs – to keep the plume from expanding.

“The plume will exist as long as we’re placing tailings on top because of the way the tailings impoundment is constructed,” Barnes said.

“But once we stop mining, then you can pump out all of the impacted water over time and eliminate it, but that’s going to be quite some time.”

Based on current rates, the open-pit operation has more than 80 years of mine life left, according to Freeport-McMoRan.

Beginning in January, Freeport-McMoRan plans to drill two new groundwater interceptor wells on its West Desert Trails property, replacing two wells in the mitigation well field.

“These wells have been in service for about eight years now, and some of them just over time start to break down and you start to lose efficiency. So over time, we’re going to have to replace some,” said Kali Rhea, chief environmental scientist at Freeport-McMoRan Sierrita.

“They will be tied into the same infrastructure that’s there, and they’ll take the place of two wells that are already in the system. And again, it’s really just to keep us on the path of hitting and maintaining that target of 10,643 gallons of water per minute to continue to control the plume,” Rhea said.

The drilling for each of the new wells is expected to last about six weeks. Rhea said Freeport-McMoRan will work to notify the community, especially residents close to the wells, in advance of work beginning.

Freeport-McMoRan has also given notice to the Arizona Department of Environmental Quality (AZDEQ) of an amendment to its Aquifer Protection Program (APP) permit at its Sierrita property, which includes an intent to replace three other wells that are used to test groundwater quality.

Linda Hayes, vice president of communications for Freeport-McMoRan, said those wells were installed in 1990, and have since “deteriorated significantly.”

Groundwater levels have declined 60 to120 feet at each of these wells, according to AZDEQ, which was also cited as a reason for the replacements.

According to AZDEQ, the three replacement wells will be constructed using a corrosion-resistant PVC-pipe well casing and will likely be installed about 100 feet deeper in the immediate area of the original wells.