“Lord, nobody could have anticipated this,” said Floyd Medical Center President Kurt Stuenkel about the COVID-19 pandemic that has transformed the healthcare industry into a singularly focused network of providers from Key West, Florida, to Prudhoe Bay, Alaska.
“Nobody has ever imagined a scenario where all 50 states are going to have to deal with this,” Stuenkel said.
It’s anything but business as usual at the two hospitals in Rome. Visitation is being significantly limited. Both Redmond Regional Medical Center and FMC are enforcing infection prevention protocols at entrances to their facilities.
Redmond’s director of marketing and communications, Andrea Pitts, said the hospital has positioned supplies at points of entry. That’s so any symptomatic patient who arrives can be properly masked and immediately isolated to protect both staff and patients.
Redmond also is encouraging alternative methods of communication with patients, such as a phone call, FaceTime, text or email.
Harbin Clinic CEO Kenna Stock said that, wherever possible, Harbin looks for ways to improve access to care for patients.
“For example, several of our practices are now offering telehealth appointments to established patients and we have plans to further expand this option in the near future,” she said.
“Other examples include offering curbside pharmacy pick-up, and drive-up services to our Coumadin management patients.”
Stuenkel said every sector of the economy is being affected in one manner or another, “and it certainly is affecting healthcare and hospitals.”
A week ago, FMC stopped doing elective cases, which means scheduled operations from knee replacements to any nonemergency procedure that can be put off. It also includes some diagnostic tests that are not urgent.
Well-patient visits to physicians for regular checkups also are being rescheduled.
“Our volumes are down a lot,” Stuenkel said.
Looking out of his third floor office window Thursday morning, Stuenkel said the parking lot at the hospital was only 40% occupied.
“We’re also seeing people not come to the emergency room in the same numbers. We’re experiencing this at Floyd, Polk Medical Center and Cherokee Medical Center,” he said.
Pitts said Redmond is following the recommended guidelines from the Centers for Medicare and Medicaid Services to review scheduled procedures based on a number of factors. Those include the urgency of the procedure, the clinical judgment of its physicians as well as the current circumstances in the facility and the community.
“Over the last two weeks, there have been hundreds of canceled surgeries and procedures,” Pitts said.
The Harbin Clinic physicians continue to treat patients in outpatient office settings but have postponed surgical procedures when it is safe to do so.
“These decisions are being made with the utmost consideration and in consultation with each patient,” Stock said.
As patient volume has declined, Stuenkel said FMC is reevaluating staff that have been devoted to those areas and getting them retrained for other areas of the hospital.
“If it’s a registered nurse that works in the recovery room of our outpatient surgery center, we’re probably going to need her (on a regular ward),” Stuenkel said. “We’re planning for what potentially is coming.”
He said FMC would reach out to other hospitals across the region to compare projections and get the best information related to future needs.
FMC has already leased the third floor of the former Kindred Hospital and is planning to take the second floor as well. That would give the hospital 45 rooms dedicated solely to patients with the highly contagious COVID-19.
Harbin is also seeing fewer patients in most of its facilities as people choosing to shelter in place are rescheduling noncritical medical visits for a later time.
“Because of this trend, the majority of our staff is working less than usual at this time,” Stock said. “While we have taken every precaution to protect our patients from coming in contact with the coronavirus in our offices, we do support the communitywide effort to decrease unnecessary activities until we can flatten the curve.”
Redmond’s emergency planning efforts started months ago.
“Our priority is to protect our frontline clinicians and caregivers so they are able to continue to care for our patients and our community,” said Pitts.
“While we have the supplies and equipment we need at this time, we are doing everything possible to secure products, as the worldwide shortage of personal protective equipment including masks, face shields, and gowns is a reality that we are addressing with realistic, workable solutions.”
Redmond has a clinician specifically assigned to oversee its PPE inventory and ensure it is conserved in accordance with steps recommended by the Centers for Disease Control and Prevention, Pitts said.
One of the particularly challenging aspects of the crisis is that so much of the personal protective equipment that hospitals are racing through has historically been made in China. They’re looking at alternate supply options.
Stuenkel said FMC has enough surgical masks for about another month, based on current estimates. They’re not in need of the homemade masks that so many well-intentioned people are taking it on their own to sew, he said. However, they’ve contacted Heritage Sleep Concepts in Armuchee to manufacture standardized masks, made to hospital specifications, in the event the need materializes.
FMC has a cash-on-hand reserve in excess of 200 days.
“That’s significant. It’s a good place for us to be,” Stuenkel said.
“When I think about hospitals throughout the nation that are, even before the COVID crisis, were struggling financially — it’s going to be hard on a lot of hospitals, particularly rural hospitals,” he said. “Floyd is in good shape but we are going to take a tremendous financial hit.”
FMC is keeping its staff intact so its expenses will be the same. But with the loss of revenue from nonemergency procedures, income is going to fall.
Also, Stuenkel said that since the virus seems to be affecting older people the hardest, many COVID-19 patients are likely to be Medicare or Medicaid cases, which do not provide full reimbursement. That further complicates the picture and he’s asked the financial department to build a model the administration can move forward with.
“We’re not going to have a good March. We’re not going to have a good April. And our cash is going to be drawn down,” Stuenkel said.
He said there is $100 billion in the stimulus package moving through Congress but it’s still unclear how that may help FMC.
Stock did not give specifics in response to a question about the financial impact on Harbin, but she was optimistic.
“Sacrifices are being made throughout our community in an effort to keep people safe. We are happy to do our part to reduce the impact of this virus,” she said. “What we are most struck by as we navigate this new frontier is the dedication and resilience of our staff and physicians.”