In summary

In Kern County, gyms are avoiding prohibitions against indoor workouts by citing membership in an association for medical fitness centers.

As the pandemic forced Terry Delamater’s two Bakersfield-area fitness centers to shut down for months, the pharmacist-turned-gym-owner in desperation turned to his county supervisor for help. Maybe, Delamater suggested, the gyms could reopen as an essential business? 

After all, Delamater said, he had kept up his pharmacist license. And he and his daughter had been working since last year with a national organization, the Medical Fitness Association, to certify the Sculpt 365 gyms as “medical fitness centers.” 

The Kern County supervisor, Mike Maggard, in turn appealed to the county’s public health agency. Three days later, a health official approved the two gyms to open for indoor workouts – even though the rural county with widespread coronavirus transmission remains in California’s most restrictive “purple” reopening category, and gyms may only offer outdoor workouts. 

The reason? Delamater’s membership with the Medical Fitness Association, a group that helps specialized facilities that work closely with hospitals and doctors to offer medically supervised fitness training for elderly, ill or disabled people.

“We feel they meet the definition of an essential ‘healthcare/public health’ service, and therefore are ok to operate,” Brynn Carrigan, assistant director of the Kern County Public Health Services Department, wrote in an Aug. 10 email. 

Surprised but delighted, Delamater promptly reopened his gyms with socially distanced equipment, pre-workout temperature checks and extra cleaning. 

“To tell you the truth, I was blown away that they deemed me essential without walking into the club and looking at anything,” Delamater told CalMatters. About half of his members have returned, he said, and he doesn’t ask them to wear masks while they’re working out. 

The owner of five Planet Fitness gyms in Kern County, perhaps in response to seeing Sculpt 365 gyms open, also convinced county officials to deem them essential, again citing membership with the Medical Fitness Association. The gyms reopened in late September.

“To tell you the truth, I was blown away that they deemed me essential without walking into the club and looking at anything.”

terry delamater, owner of Sculpt 365 gyms

Since then, the North Carolina-based association has been deluged with calls from gyms in California and 24 other states hoping that some kind of affiliation will help them convince local officials to let them reopen as essential health services. It added about 375 new members in two weeks, doubling the association’s membership, said CEO Bob Boone, a former hospital administrator. 

It isn’t hard to see why. The pandemic has shuttered fitness centers nationwide for months, bringing many to the brink of financial ruin. Earlier this year, the fitness chains 24 Hour Fitness and Gold’s Gym announced they would close some locations and file for Chapter 11 bankruptcy protection. In California, most gyms remain closed or have reopened at only 10% to 25% of capacity under public health orders — prompting some to sue the state for jeopardizing their businesses.

The association does officially certify medical fitness centers, including those affiliated with hospitals, but that’s a years-long and expensive process requiring the gyms to have physician oversight. Only 45 U.S. centers are currently certified, including one in California, Boone said. 

“A lot of commercial (gym) folks are claiming that exercise is good for people’s mental health and that is true, but that’s not what makes them essential. What makes them essential is that they’re embedding themselves as part of the medical system,” Boone said. “If all you’re trying to do is join MFA so you can pull the wool over the county’s eyes and reopen, we don’t want you as a member.” 

He added that he hoped that the new members would learn about the value of medical fitness — aimed at helping people recover from heart attacks, strokes and other illness or injury — and add to their services. 

Boone said politically conservative counties such as Kern are more likely to view mere association membership as something on paper that gives them bureaucratic cover to allow gyms to reopen. 

“Fitness and well-being is important right now but we also have to ensure these facilities are reopened safely and slowly.”

saskia popescu, infectious disease epidemiologist at the University of Arizona

Planet Fitness franchisees are considering establishing physician advisory panels to provide “oversight” in Orange and Los Angeles counties in hopes of reopening as many gyms as possible, Boone said. And that’s happening, he says, because California leaders have deferred reopening decisions to county health officials.

“They’re looking for any advantage they can get,” Boone said. “My fear is they’ll say anything to get it.”

New Hampshire-based Planet Fitness, whose gyms are nearly all operated by franchisees, declined to comment on the medical fitness issue. “While we cannot speak to what individual franchisees may be exploring, what we can tell you is that every Planet Fitness franchise will fully comply with local county orders and open safely only when approved by their county in compliance with state protocols,” McCall Gosselin, senior vice president of communications, said in an emailed statement. 

“I do worry about this being misused,” Saskia Popescu, an infectious disease epidemiologist and adjunct professor at the University of Arizona, told CalMatters via email. “Fitness and well-being is important right now but we also have to ensure these facilities are reopened safely and slowly. Essential ones, like PT (physical therapy), need to be the top priority and if people are gaming the system, it could stress existing resources and I worry about what other corners are being cut.” 

Earlier this year, Popescu teamed with other health professionals to delineate the risks of various activities during the pandemic in a widely circulated chart. Working out in a gym ranked as a medium-high risk, more dangerous than exercising outside but less risky than drinking inside a crowded bar or going to a movie. 

COVID-19 outbreaks related to fitness centers have been reported in Hawaii, at Equinox clubs in Southern California, and at a gym in San Diego County that had operated in defiance of county health orders.  

Kern County health officials appear to maintain their view that Medical Fitness Association membership means the gyms somehow have physician oversight, even though Boone said he spoke with them and let them that was not the case. 

Michelle Corson, a spokeswoman for the Kern County Public Health Services Department, on Thursday told CalMatters in an emailed statement that “Both Sculpt 365 and Planet Fitness have communicated that they are members of the Medical Fitness Association and therefore ‘physician supervised.’ … Because they state they are ‘physician supervised,’ they meet the State’s definition of an essential ‘healthcare/public health’ service, and therefore are ok to operate indoors with modifications.”

Kern County health officials appear to maintain their view that Medical Fitness Association membership means the gyms somehow have physician oversight. The association itself disagrees.

But in emails to the county supervisor, Delamater never said his clubs have physician oversight – although he maintains that “as a registered pharmacist I am well qualified to operate a health club, including being classified as ‘essential.’” And Neil Galon, a manager for a Planet Fitness site in Bakersfield, said he’s aware of no physician supervision there. 

In Redondo Beach, home to California’s only actual certified medical fitness center, Jackie Berling was surprised to hear that other fitness centers had been allowed to reopen because of their membership with the Medical Fitness Association.

“Boy, that’s a reach,” said Jackie Berling, chief operations and innovation officer for the Beach Cities Health District in Southern California, which operates the Center for Health and Fitness. “That, to me, is such an abuse of the intention of being certified” as a medical fitness center.

The taxpayer-supported health district spent 18 months and between $60,000 and $70,000 to become certified by the Medical Fitness Association. It now offers medically-supervised programs for recovering heart attack patients and pre-surgery programs for people needing knee replacements. Unlike Planet Fitness and Sculpt 365 in Kern County, it does have an advisory board of physicians, Berling said.  

The center remains closed during the pandemic and its leaders have no intention of trying to get permission to reopen, particularly because nearly 70% of its members are older people most at risk from COVID-19, Berling said. Instead, it has redirected its staff to offer COVID testing. 

“We’re only going to open,” Berling said, “when we know it’s safe to do so.”

This story also has been updated to correct the percentage of older members of the Center for Health and Fitness, and to identify the speaker in a pullquote as the owner of Sculpt 365 gyms, Terry Delamater.

Our health care reporting is supported by the California Health Care Foundation, Blue Shield of California Foundation, and the California Wellness Foundation.

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Barbara Feder Ostrov, Contributing Writer for CalMatters, has reported on medicine and health policy for more than 15 years. She most recently covered California and national health issues for Kaiser Health...