This is Carson City: Carson Tahoe celebrates 75 years of community health

To read this year's This is Carson City! go here

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Over 75 years, Carson Tahoe Health has been defined by critical moments in the lives of human beings. To the residents of the capital city and the quad-county area the hospital serves, those moments have been painfully personal: the birth of a child, the aftermath of an accident or injury, the death of a loved one.

Other moments have defined the community. Like in 1968 when the first hospital building caught fire, and the community rallied to care for patients. Like in 2005 when ambulances took turns transporting patients from the second hospital building on Fleischmann to the new facility in north Carson. Like in 2024 when a real need among community youth spurred hospital and state leadership to invest in behavioral health facilities.

“We know our community, and we can make decisions based on what does our community need,” said Carson Tahoe Health President and CEO Michelle Joy. “I think that has been the long history of Carson Tahoe.”

That history informs the present as the world grows no less complicated. What began as a county hospital in the 1940s has become a not-for-profit health care network with a vast medical center in north Carson and multiple regional locations. It has become an economic engine, one of the largest employers in the city, and a force for positive change.

“We’re an independent, community-based hospital, and we are here for the community,” Joy emphasized.

Rustic beginnings

World War II had ended, and in Carson City, the need for a community hospital became apparent. Local family doctors, including Dr. James Thom, Dr. Richard Petty and Dr. George Ross, made house calls and even delivered babies but relied on facilities in Reno for more serious situations. And patients did not always survive the journey north, according to a history compiled by CTH.

“Understanding the critical need for a hospital in Carson City, Major Max Fleischmann pledges to match community contributions for its construction. Edith and Dick Waters of Carson Hot Springs donate 5.2 acres of land for the hospital to be built on,” according to CTH. “The original Carson-Tahoe Hospital opens (in 1949) with a 10-bed facility, costing $80,000.”

The first hospital on Fleischmann Way was rustic, resembling a rambling ranch house with log posts supporting the front entrance. Carson City attorney George Allison remembered his mother and father, George Sr. and Helen, arriving to the capital city after being recruited from a company hospital at a copper mine in eastern Nevada.

“We came from a place called Kimberly, over in the eastern part of the state,” Allison said. “My dad was a lab and x-ray technician; my mom was a surgical nurse.”

Allison recalled his boyhood in the first building of Carson Tahoe, eating meals there after school and eventually being hired by his mother to clean the toilets and floors. The family lived nearby in a house off Division Street. In 1957, Helen Allison became the hospital’s first female administrator “by unanimous board decision,” according to CTH.

Carson Tahoe Health President and CEO Michelle Joy on the front patio of the Carson Tahoe Regional Medical Center on Aug. 13, 2024. Scott Neuffer/Nevada Appeal

Growing up, George Jr. completed law school and served in Vietnam as a U.S. Army JAG officer. In 1968, the same year he cofounded the law firm known today as Allison MacKenzie, the first hospital was severely damaged by a roof fire. Fortunately, hospital leaders had already broken ground on the next iteration of community healthcare located along Mountain Street and Fleischmann.

“It wasn’t long. This (the second hospital) was almost open,” Allison remembered of the fire’s aftermath.

According to Nevada Appeal archives, patients in the first building were moved to a convalescent center on Highway 50 and to the infirmary at the Stewart Indian School in south Carson. A makeshift emergency department in nearby doctors’ offices and a MASH (mobile army surgical hospital) were also established.

“It is probably the most I ever saw the Carson City community come together in a major emergency,” Bernard Sease, deputy fire chief at the time, recalled in 2018.

George Allison has seen that community spirit flourish. He saw his own children born in the first and second hospitals. The law firm he cofounded represented Carson Tahoe in its formative years and still represents the organization.

Now 86, Allison volunteers at the Carson Tahoe Regional Medical Center. He helps staff with hospital activities.

“Personally, I am proud of the community history of that hospital,” he said.

A transformation

By the time Ed Epperson came on board as CTH’s chief operating officer in 1994, the community’s needs were outstripping the capacity of the second building. The 77-bed hospital that opened along Mountain Street in 1968 had grown over the decades with an extended wing, 24-hour emergency service, an intensive care unit and a heliport, but it still wasn’t enough.

“Upon arriving in 1994 it was immediately clear that the hospital team and the community at large envisioned expanded clinical beyond the basic hospital services available,” said Epperson. “But the old campus had no room for expansion and no plans. We developed a master plan that would provide for cancer care, cardiac surgery, expanded behavioral health, and others. That plan identified the costs and time frames to 1) develop in place, and 2) develop on a new campus. It was clear that the advantages of creating a new campus were overwhelmingly the better alternative.”

Epperson, 73, grew up in Fresno, became a pharmacist and then, with an MBA, moved into hospital administration. What he found at Carson Tahoe in the 1990s was a city-owned hospital that received no tax revenue.

“The hospital’s revenue came entirely from patient service revenue,” Epperson said. “The community was resistant to being liable for funding the new campus. Moving CTH into a not-for-profit, community-based hospital was the answer. The then-current county hospital board became the initial board of CTH. That conversion in 2001 was a very public process that was ultimately supported and still successful today.”

Epperson was offered the CEO position in 2001 and would work the next 17 years for Carson Tahoe. A new hospital and medical campus became his top priorities. With a planned 352,000-square-foot building, development of the Carson Tahoe Regional Medical Center had its challenges, like “achieving an ‘A’ credit rating as a new entity,” Epperson said.

“The budget was just in excess of $100 million, and was met,” he added.

The new medical center opened in 2005 with 144 acute care beds. Sierra Surgery stood adjacent to it. An estimated 80 patients in seven departments in the former hospital were moved via ambulance to the new site, many patients not wanting to be checked out beforehand, so they could be part of history, according to the Appeal’s archives.

“The hospital has planned Patient Move Day for years. The Saturday move is detailed in a four-inch-thick binder,” reads a Nov. 30, 2005, article in the Appeal.

The following year, the Carson Tahoe Cancer Center opened to the northwest. The new buildings were sleek and modern, with a cutting-edge feel.

Epperson said the medical campus reversed the mentality of “if you are really sick, go to Reno.”

“The community has benefitted from a very broad scope of health services that is rare among medium-sized community hospitals,” he said.

The transformation wasn’t restricted to health care.

“The campus stimulated the economic development of the northern tip of Carson City. CTH provides enormous financial impact to the community, and grew to employ about 2,000 staff,” Epperson said.

Former Carson Tahoe Health CEO Ed Epperson. Courtesy Carson Tahoe Health

A community response

When current Carson Tahoe Health President and CEO Michelle Joy took the helm of the organization in August 2022, hospitals around the world were emerging from the COVID-19 pandemic.

“I’ve seen the roller coaster ride of health care, have been through the ups and downs,” Joy said.

She added: “I think overall, from an industry perspective, health care is actually very resilient. If you look at the pandemic and lots of challenges, there are still challenges post-pandemic, but for the most part, hospitals across the country and the health care workforce were extremely resilient and were there when our communities needed us.”

Joy, 50, found her calling in hospital administration after college. She worked in Susanville, Calif., north of Reno, building and opening a new hospital, and at the executive level in various hospitals in Colorado. It was 2015 when Epperson and CTH brought her aboard as chief operating officer.

“When you look at Carson Tahoe, there are not very many organizations left like Carson Tahoe in the country, being that independent, community-based hospital,” Joy said.

Carson Tahoe’s independent, not-for-profit structure allows the organization to make decisions locally and reinvest dollars locally, Joy said. Reinvestment can take the shape of technology (e.g., robotic surgery) or hiring more doctors and specialists.

“It is looking at what is the new technology that is coming in that makes the most sense for, again, an organization like Carson Tahoe, the size that we are,” she said. “Renown (in Reno) is starting transplant. We will never do transplant here.”

The key for Carson Tahoe is matching services to community needs where there is enough patient volume to sustain those services, Joy explained. In 2017, for example, Carson Tahoe opened the Mallory Behavioral Health Crisis Center, which sees upwards of 1,500 patient visits a year for suicidal ideation, psychotic episodes and substance abuse problems.

Mallory, however, only treats adults. Recognizing the need for similar services for juveniles, especially following the pandemic, Carson Tahoe officials this year secured $3.5 million in federal funds sub-awarded through the state of Nevada to retrofit existing buildings on Fleischmann Way. The project includes 10 beds in the old hospital facility for youth inpatient behavioral health; 12 beds for a separate youth crisis stabilization center next to Mallory; outpatient offices and two mobile care units to serve throughout the region.

“As we look out over those next 10 years, the top priority that continues to rise is the behavioral health piece,” Joy said.

Carson Tahoe has a larger vision for a brand-new behavioral health facility that could cost tens of millions of dollars. But the community has rallied before, Joy pointed out, and Carson Tahoe is poised to respond.

“I think it is the continual identification of what does the community need from a health care perspective as it continues to grow,” she said.

While figuring out the best path forward, Carson Tahoe leaders and employees have also been celebrating the organization’s 75th anniversary this year.

Joy stressed the history and decisions of her predecessors “have set the organization up to continue to be successful.”