As COVID-19 infection rates surge yet again, hospitals and healthcare systems are taking action. Yet many will not recover from the financial toll the virus is taking, especially our small and rural hospitals. According to the American Hospital Association, “Hospitals and health systems face catastrophic financial challenges in light of the COVID-19 pandemic.”
Why the financial burden?
Hospitals worldwide continue to escalate efforts in safety and management as the pandemic propels forward. Increasing beds, canceling elective surgeries, renting out additional buildings for makeshift hospitals, establishing COVID units and testing stations. Many go above and beyond, recognizing the heroic efforts of healthcare workers by providing childcare, transportation and even housing. All while purchasing incalculable numbers of PPE for both staff and patients.
Such measures are pulling many hospitals into the red.
Rural hospitals rely on profitable elective procedures and routine care appointments. Both elective and routine appointments were suspended March 20 through May 1 by Governor Roy Cooper. Yet even as we enter July, elective procedures are not back to normal rates. Particularly as many people are choosing to hold off even longer for fear of contracting the virus in the hospital. Numbers may be hampered further now that the virus is back on the uptick. In fact, Texas and Arizona are suspending such procedures yet again.
How is the financial burden unique for rural hospitals?
During a time when healthcare is what we need more than ever, many hospitals are closing their doors. Since 2005, 171 already have. In fact, even back in February 453 were already on the brink of bankruptcy. Data citing rural hospitals in the southeast and great plains hit the hardest.
Most rural hospitals were not set up for financial success from the start. Data from the University of North Carolina Sheps Center found the average “rural Prospective Payment System (PPS) 26-50 bed hospitals had a median of only 21.3 days cash on hand and rural Medicare Dependent Hospitals (had) 28.4 days cash on hand.”
“Cash on hand” is the amount of accessible money the institution has to tide them over if no income streams in. In other words, how long can they stay afloat while elective procedures are postponed in the pandemic? Rural centers can only ‘float’ by for 3-4 weeks, not good news when profitable appointments and surgeries are being canceled for much longer periods of time.
Does your rural hospital have an ICU bed?
This on top of the fact that rural hospitals have fewer physicians, fewer beds and especially fewer ICU beds. Just how few, may surprise you.
April research from The Chartis Center for Rural Health found that 63% of U.S. rural hospitals are completely void of ICU beds. Where will this income come from?
The lack of ICU beds is only one reason data collected by the Lerner Center urges officials to pay attention to the toll COVID-19 is taking in rural communities.
As infection spreads into rural areas, small centers will quickly reach capacity and may not be able to offer patients the attention they need and deserve.
However, many variables are influencing the number of beds available. Thankfully, they are making extraordinary efforts to be prepared for a surge in patients.
For that, we are all incredibly grateful.