Restrictions enacted by Gov. Jared Polis to halt “nonessential” medical care so hospitals could better prepare for an influx of COVID-19 patients left rural and critical-access hospitals in Southwest Colorado with empty operating rooms and financial losses from what is typically an important source of revenue.
“Many of our patients have been suffering in pain or disability,” said Karis Morrall, marketing coordinator for Animas Surgical Hospital, in an email to The Durango Herald.
Elective surgeries are not necessarily optional, it just means patients can schedule them in advance. As COVID-19 restrictions ease in Colorado, elective surgeries and procedures unrelated to the virus, such as kidney stone removal, cataract surgery and mammogram screenings, are now allowed.
Yet patient numbers have not returned to pre-COVID-19 levels at Animas Surgical Hospital, and the Small Business Association’s rules render the facility ineligible for loans under the Paycheck Protection Program.
The small, physician-owned surgical hospital employs about 150 local nurses, doctors, technicians, clerks and other staff. However, because Animas Surgical Hospital partners with a larger health care management company, it is deemed an “affiliate” of the company by the Small Business Administration and therefore ineligible for funding.
“It’s important to note that Animas Surgical Hospital isn’t the only health care facility facing this issue,” Morrall wrote. “Many small rural hospitals across the country operate as part of a larger health system or participate in partnerships with other companies.”
Many of those smaller facilities are also the only option for care in rural areas.
Hospitals across the United States are furloughing workers because of industry losses related to dropped surgeries and procedures. In states like Colorado, where 36 of the 48 rural and frontier counties are officially designated by the federal government as Health Professional Shortage Areas, the impact is even more profound.
Southwest Health System of Cortez was down $3 million in revenue in March, and again in April, totaling $6 million in lost revenue.
But CEO Tony Sudduth said in a phone interview that the Southwest Health System has been “pretty fortunate compared to other hospitals.”
The hospital was eligible and able to procure funding from the Paycheck Protection Program, meaning none of its workers were furloughed.
“Surgeries are going up, but we are still down over 60% as far as the number of procedures,” Sudduth said.
What Congress is doing Sen. Cory Gardner, R-Colo., visited Animas Surgical Hospital last week. He said in a phone interview that the affiliation rule was created to “make sure big businesses don’t benefit from the Paycheck Protection Program.”
But he is working with Sen. Michael Bennet, D-Colo., to change PPP provisions so that hospitals like Animas Surgical Hospital can be considered independent entities able to apply for loans.
Congress designated $175 billion for hospitals in previous COVID-19 economic relief packages, but much of that funding has been directed to large hospital systems serving high numbers of Medicare patients. Community Health Systems, HCA Healthcare and Universal Health Services, for-profit hospital chains, have received more than $1 billion from the CARES Act.
The U.S. Department of Health and Human Services allocated $10 billion in funding to critical access hospitals and rural health clinics, but many of those facilities have yet to receive relief.
Hospitals work to protect patients, staff Beyond the financial toll of COVID-19, reopening elective surgeries and procedures is an arduous process as hospitals determine the best way to keep workers safe.
“Patient and staff safety is our top priority,” Morrall wrote. Animas Surgical Hospital screens and tests the temperature of everyone who enters its doors. There is also a limit to the number of visitors allowed to accompany patients and many of the clinic appointments have transitioned to telehealth.
Mercy Regional Medical Center, part of Centura Health, is “seeing a steady rise in the numbers of patients coming to the hospital,” Toni Green-Cheatwood, Centura Health Group vice president, wrote in an email to the Herald.
“We’ve had a tremendous response from the community,” Sudduth said. Osprey employees sewed masks for the hospital during the shortage of medical protective equipment, and the hospital is working with the Colorado Hospital Association to ensure it has enough masks and equipment for elective procedures and surgeries.
Morrall with Animas Surgical Hospital also said employees are “extremely grateful for the generosity and resourcefulness of the community.”
The hospital was struggling to find child-sized masks. Within days, the MakerLab and other local sewers produced a stockpile of homemade pediatric masks.
“Whenever we’ve faced gaps in PPE supplies, Durango residents have been quick to help,” Morrall said.
Emily Hayes is a graduate student at American University in Washington, D.C., and an intern for The Durango Herald.