COVID Latest Threat to Weakened Rural Health Care

To save money, more than half of rural hospitals nationally have furloughed or laid off staff, including Margaret Mary Hospital in Batesville, IN; St. James Parish in New Orleans; and Lexington Hospital in Lexington, NE, says Morgan.

San Luis Valley Health in rural Alamosa, CO, in the southern central part of the state, has not seen the expected surge of COVID-19 patients. The regional hospital, which serves about 55,000 residents, had seen only 11 confirmed COVID-19 cases and two deaths by April 28, says SLV Health Chief Medical Officer Carmelo A. Hernandez, MD.

The hospital prepared for the pandemic in mid-March by expanding its 49-bed capacity, increasing the number of ventilators, and training providers to work in different areas. The providers canceled all elective surgeries, procedures, and imaging, which has taken a heavy financial toll, he says.

“We started out in a good financial situation — we had 124 days of cash reserve — but the impact has been pretty dramatic. The patient volume has dropped by at least half in both the ER and outpatient clinics, from 50 to 20-25 patients daily in the ER, with the lowest count of 13 daily patients, and from 325 visits daily to about 150 visits in the outpatient clinics,” says Hernandez.

But hospitals don’t get paid for their services until about 60 days later, says Hernandez. He anticipates the revenue losses will show up in late May and early June. In the meantime, the hospital has put cost-saving measures in place, such as reducing full-time staff hours and asking staff to take leave without pay.

The expected surge of COVID-19 patients also hasn’t hit Ferry County Memorial Hospital in Republic, WA, a critical access hospital that serves about 7,500 people in the northern part of the state. The county has only one positive case and no deaths.

Still, the hospital had to prepare by buying extra ventilators, personal protective equipment (PPE), and medicines for intubation. Meanwhile, the hospital canceled all elective surgeries, procedures, and imaging, which has taken a huge financial toll.

“Our revenue is down 38% in late April, compared to where we were a year ago. To run the hospital costs us $38,000 daily,” says Richard Garcia, DO, the hospital’s medical director and chief of staff.

To keep patients safe, the staff ramped up telehealth visits. “We get compensated $95 per telehealth visit compared to $180 for regular visits — it’s a fraction of the previous provider payment,” says Garcia.