Rural community hospitals in Oregon have seen huge drops in revenue with elective procedures banned due to the coronavirus outbreak and are having to lay off workers to survive, even as many beds sit empty.
Oregon Gov. Kate Brown on March 17 ordered all elective and non-urgent medical procedures be canceled or rescheduled until June 15 or beyond in order to preserve masks and other protective equipment for the state's COVID-19 response.
Added to that, there are fewer visits to emergency departments, with some people doing virtual visits with a medical professional, fearing an ED could expose them to coronavirus.
Becky Hultberg, CEO of Oregon Association Of Hospitals And Health Systems, says consequently, hospitals have experienced an unprecedented decline in revenues of 40% to 60% in one month.
"Staffing is one of the hospital's most significant cost. So as revenue declines, some hospitals have been forced to furlough or lay off staff," Hultberg said in a telephone interview.
She did not have statewide numbers on jobs lost, either permanently or temporarily.
But claims for unemployment insurance reflect the scope of the problem. In only one week in late March, the state employment department received 7,600 initial claims for unemployment insurance from workers in healthcare and social assistance fields, up from 396 two weeks before. Of all job sectors, only workers in accommodation-food services filed more claims.
Local news reports show that, from the wide open spaces of eastern Oregon to the rugged coast, rural hospitals are feeling the pinch, and are taking drastic measures.
In Oregon's remote southwest corner along the Pacific Ocean, the Curry Health Network has laid off, furloughed or cut back the hours of 192 employees. That's more than half of the staff who work in the network's hospital in Gold Beach and several medical clinics. The management team also took a 20% reduction in pay.
"We are not alone in this," Curry Health Network Chief Executive Officer Ginny Williams told the board of directors. "It's impacting all hospitals in rural places."
Sara Dickerson, a family nurse practitioner, was laid off from the Curry Health Network as of April 7.
"What is most upsetting to me was the treatment of my medical assistant, who was terminated on March 31," Dickerson the Curry Coastal Pilot newspaper. She said the assistant now has no medical insurance this month.
The Oregon Association of Hospitals and Health Systems and several elected politicians are calling for bailout bucks to be released to hospitals, an emergency transfusion of funds to ensure they can keep servicing the public.
"The need for direct assistance to the hospitals as we have said must be a #1 priority to sustain current medical procedures already on hold, and sustain any potential surge requirement from the virus," state Sen. Brian Boquist, a Republican from Dallas, Oregon, wrote to Brown and her chief of staff.
The Oregon Association of Hospitals and Health Systems on Tuesday asked Brown, a Democrat, for $200 million in new state funding to be allocated directly to hospitals "to address initial urgent needs of hospitals so they can continue providing services."
The state is expected to have a lot less money to spend because the newly unemployed are no longer paying income taxes. Hultberg said her group recognizes that significant budget challenges lie ahead, but added: "People count on hospitals in a crisis."
U.S. Rep. Greg Walden, a Republican representing a wide swath of eastern and central Oregon, has urged that rural hospitals be prioritized for money coming from a funding increase that Congress recently passed.
"Our rural community hospitals are struggling financially right now in large part because the governor shut down any elective procedures," Walden said.
Oregon is not expected to see a big spike in COVID-19 cases as long as people keep staying home and maintaining social distancing when out on urgent errands, state health office Dean Sidelinger says.
"We know it comes at a huge sacrifice," Sidelinger said in an interview. "People have lost their jobs. Our small and large businesses are suffering."
At the peak of the outbreak, expected around April 22 in Oregon according to a projection by the Institute for Health Metrics and Evaluation, there will be more than enough hospital beds and ICU beds available.
But the hospitals association is not advocating that restrictions on elective procedures be relaxed.
"I would rather be having the conversation today about hospitals sustainability than the conversation about mortuary capacity," Hultberg said. "It is too early to talk about changing course."