Surgery Ban Ends, but Few Go to Hospital

Surgery Ban Ends, but Few Go to Hospital
Vince Leist, CEO of North Arkansas Regional Medical Center of Harrison.

Dr. Gerry Jones thought that after the ban on elective procedures was lifted, there would be a surge of patients. There wasn’t, dealing another blow to hospitals in Arkansas.

“We’ve seen an increase,” said Jones, chief medical officer for CHI St. Vincent Infirmary. “The increase has not been as dramatic, I don’t think, for any hospitals as perhaps I would have predicted back in mid-March when we closed things down.”

Even though some operations are being performed, Arkansas hospitals “are still struggling,” said Jodiane Tritt, executive vice president of the Arkansas Hospital Association.

Hospitals have faced rising expenses incurred in fighting the coronavirus while their revenue plummeted. Elective procedures were postponed, forcing hospitals to furlough employees.

In April, the CHI St. Vincent system in Arkansas lost an estimated $600,000-$800,000 a day, Jones said.

On April 27, the Arkansas Department of Health lifted the ban on elective surgeries that was put in place on April 3 to slow the spread of COVID-19. The Department of Health first allowed hospitals to perform some procedures, mainly on relatively healthy patients who didn’t require a stay in the hospital. The first phase also permitted imaging services and diagnostics.

North Arkansas Regional Medical Center of Harrison resumed approved elective surgeries on April 27. The hospital used guidelines from the American College of Surgeons and the Department of Health to develop a reopening plan, said Vince Leist, CEO of NARMC.

“And then those physicians went through the surgeries that have been scheduled and chose the patients who were the most urgent,” Leist said. “So we started there.”

Still, after the first week of restarting procedures, the hospital was at about 40% of its capacity, he said.

On May 11, another directive from the Department of Health opened Phase 2 of elective procedures, allowing for stays of up to 48 hours, which permitted services such as hip or knee replacements. Phase 3 will allow the remaining services, but a date for its implementation hasn’t been set yet.

After Phase 2 went into effect, NARMC reached about 60% capacity, Leist said on May 15. “We need to generate some revenue to keep the lights on,” he said. “I’m satisfied with 60%. Obviously, I’d love to have 100%.”

NARMC lost more than $2 million in April and is projected to lose about $3 million in May, Leist said.

To cut expenses, NARMC furloughed 32 employees in March, and another 10 employees are on a voluntary furlough, he said. It has about 800 employees.

Patient volume has not returned to a level that would allow the hospital to recall employees, Leist said. The furloughed employees remain on the hospital’s health plan and it has helped them obtain government benefits, he said.

Government stimulus money has also helped hospitals’ financial health. NARMC received about $1.8 million in government stimulus funds.

And the Coronavirus Aid, Relief & Economic Security Act provided CHI with a little more than $20 million, Jones said. CHI is “grateful” for the money, but it didn’t offset the March and April losses, he said.

Leist said he thinks patients are staying away from hospitals because they fear they might catch COVID-19. “We just have to make sure that people who need health care understand that we are doing everything possible to make sure it’s safe for them to come back to the hospital and to come back to the clinics,” he said.

Jones added that he thinks that some people might have lost their jobs — and health insurance along with it — causing them to delay a procedure even longer.

AHA’s Tritt said emergency room visits at Arkansas hospitals were down 47% in the last two weeks in March and in April compared with the same period a year ago. But health emergencies haven’t ceased, “so we need to encourage people to seek care if they need it,” she said.

She said trips to the emergency room in May “might have increased a little bit, but not enough to change the percentage a whole lot.”