Pandemic puts strain on hospital's finances
Rocky Mount Telegram
While it may seem that a health care crisis would have a positive effect on a hospital’s financial health, the opposite is true for many hospitals across the state, including Nash UNC Health Care.
North Carolina Health News reported last week that rural hospitals in North Carolina are losing about $145 million each month due to the coronavirus pandemic, of which $118 million is from revenue not earned because the hospitals stopped doing elective procedures in March.
Nash UNC Health Care, which has been crawling out of a financial hole over the past few months, is facing similar financial impacts from the state and federal response to COVID-19. Hospitals depend upon a regular influx of patients to sustain them financially. But the new rules that are in place, coupled with the fear of potential exposure to COVID-19, is having a hefty effect on hospital income.
“Our patient volume is considerably lower than normal, a trend that is consistent with other hospitals across the state and country who have not yet experienced a surge in COVID patient volume,” said Dorsey Tobias, executive director of marketing, communications and strategy for Nash UNC Health Care.
On March 20, state Health and Human Services Secretary Dr. Mandy Cohen requested all hospitals and ambulatory surgery centers to suspend all elective and non-urgent procedures and surgeries because of the COVID-19 pandemic and the need to conserve personal protection equipment. That factor alone has had a significant effect on hospital functions and finances.
“With the cancellation of elective or non-emergent surgeries, we have 80 percent fewer surgeries occurring per week and 20 fewer patients per day on average being admitted for post-surgery medical needs during recovery,” Tobias said. “Additionally, we would typically see around 550 outpatients per day but are currently seeing only 210 per day on average.”
The hospital also is seeing fewer emergency room visits, Tobias said.
“Our Emergency Department typically sees about 200 patients a day this time of year and is currently seeing about half that,” Tobias said.
While some surgeries are being postponed or canceled, the reason for the drop in emergency room visits is less clear. Tobias said the advice for when to visit the emergency room is the same as it always has been.
“The guidance for patients with emergent medical needs has always been to call 911 or to go to their nearest Emergency Department,” Tobias said.
One change that has come to the Emergency Department is the screening process.
“Our Emergency Department is screening patients at the entrance and directing patients with respiratory symptoms into a separate area of the department for further evaluation, which allows us to prevent potential exposure to others,” Tobias said. “Currently, we are seeing approximately 100 patients a day, with roughly 20 of those being diverted to the respiratory cohort unit. Those patients with COVID-like symptoms are immediately placed in rooms that are isolated from others, and the staff interacting with those patients are in full personal protective equipment. All other patients are being evaluated as quickly as possible and placed in their appropriate treatment rooms.”
Another change affects people who accompany someone to the Emergency Department. The waiting area now is designed to encourage social distancing, proper hand hygiene and the wearing of masks. Visitors are discouraged from accompanying patients, and no visitors are allowed in the respiratory cohort unit of the Emergency Department for their protection.
All these effects come at a cost to the hospital.
“Financials have not been validated, but we are projecting a 40 percent drop in cash receipts, based on the patient volume we’ve seen for the last six weeks,” Tobias said.
The hospital has received some money to help offset the losses, but it will not nearly cover them.
“We have received a nearly $5 million grant from the CARES Act. While we are appreciative of the stimulus payment, it only equates to our expenses related to salaries and wages for one pay period. We’ve experienced decreased volume and increased expenses for about six weeks thus far, and we expect this to continue for some time,” Tobias said.
The issue is made worse by the rising costs of some supplies.
“We’ve spent $700,000 on personal protective equipment over the last six weeks, in comparison to an average of $100,000 for an entire year under normal circumstances. The demand for these items has caused prices to increase significantly,” Tobias said.