Beaufort hospital didn’t see coronavirus surge but could borrow $20M to help stem losses
Over the past two months, Beaufort Memorial Hospital officials have overseen a full-scale mobilization against the growing coronavirus outbreak, setting up triage tents and field hospitals while scrambling to secure stocks of protective equipment and increase COVID-19 testing capacity
The hospital was ready. But “we never saw a surge,” CEO Russell Baxley told the hospital’s publicly appointed Board of Trustees on Wednesday. Coronavirus and respiratory patient volumes are down this week, he reported. A University of Washington model shows South Carolina past its peak of COVID-19 deaths and close to its projected maximum for hospital resources needed.
But the cost of protecting public health has hit Beaufort Memorial’s own finances.
In March, the hospital barely broke even and is preparing for a loss in April, according to Baxley. On Wednesday, the board approved opening a $20 million line of credit with Regions Bank, allowing it to borrow money Baxley said he didn’t think the hospital would need but was preparing to access “just in case.”
“This is just an exercise in precaution,” said Baxley in an interview, saying the hospital is in a “very good cash position” but wanted to secure credit while interest rates were low.
The final vote on the measure was inadvertently added to the board’s agenda only at the last minute, said Finance Committee Chair Kathryn McDonagh, who cited the COVID-19 pandemic as the emergency circumstance allowing the addition without prior public notice or opportunity to comment.
Following state and federal guidelines to cancel money-making elective surgeries, other South Carolina hospitals have laid off and furloughed workers citing financial hardship.
Nine hospitals smaller than Beaufort Memorial and located in rural parts of the country have closed in 2020, according to the University of North Carolina’s Cecil G. Sheps Center for Health Services Research.
Baxley told board members Beaufort Memorial is now conducting only 10 to 12 time-sensitive surgeries per day, down from its normal volume of between 50 and 60 total daily procedures.
Starting next week, the hospital plans to resume performing elective procedures at its surgery center separate from the main hospital building, Baxley said. All of its COVID-19 measures will stay in place, he said. “Vaccines are a long ways away,” he said at the board meeting, adding that a second wave of coronavirus patients is still possible.
Elective surgeries set to resume as testing capacity expanded
Baxley said Beaufort Memorial was planning to resume some elective surgeries next week under strict protocols to protect patients and staff from COVID-19 exposure.
The hospital will test patients for the virus three days before their scheduled surgery and require them to isolate themselves and log their body temperatures before coming into Beaufort Memorial’s ambulatory surgery center, which Baxley described as a “COVID-free operating suite.”
On a Wednesday teleconference, Hilton Head Regional Healthcare CEO Jeremy Clark said Hilton Head and Coastal Carolina Hospitals have also begun to resume elective surgeries.
Following plans it made weeks ago, Beaufort Memorial is almost ready to begin conducting COVID-19 tests in-house, rather than sending samples to outside labs. Baxley said capacity will initially be limited to about 120 tests a week and will be prioritized for surgical patients, EMS personnel and healthcare workers who are displaying coronavirus symptoms.
Beaufort Memorial is not testing staff members unless they show symptoms, but it is requiring workers to wear masks and protective equipment at all times.
To date, the hospital has collected samples for 1,133 tests, of which 112 have come back positive — just under half of the confirmed cases reported by state health officials to date in Beaufort County. Only 38 tests are currently pending, Baxley said during Wednesday’s board meeting, with 983 tests yielding negative results.
When will hospital operations return to normal?
To move forward confidently toward resuming normal hospital operations, Baxley said the facility would need greater testing availability, likely including COVID-19 antibody tests that detect an immune response to a coronavirus infection, as well as the ability to conduct contact tracing, tracking down people who have had contact with diagnosed patients.
These steps are in line with guidelines the Trump administration issued to states last week on when to loosen restrictions on residents.
Baxley said the hospital needs to move away from what he called the “wild, wild West” of medical supply chains hospital officials are currently experiencing. Supplies have been “severely interrupted,” with N95 respirator masks selling for up to $5 each, more than five times their going price last year, said Baxley. Beaufort Memorial has had to turn to “off-brand” vendors it has vetted through the state hospital association and other sources, he said.
At the moment the hospital’s stocks of medications, ventilators and protective equipment are at a “green” level, indicating the facility is “not in danger of running low,” said Baxley.
Beaufort Memorial has suspended hiring new nurses while flexing staff hours during the COVID-19 response, the CEO said.
As of Wednesday morning there were five admitted patients diagnosed with COVID-19 and five more under investigation, he said. COVID-19 patient volumes are down and have remained consistently lower than what the hospital has seen over the past two weeks.
On April 15, the hospital discharged its first two COVID-19 patients to recover after treatment, the Island Packet and Beaufort Gazette reported.
“We never saw the surge, but we don’t want to see the surge,” Baxley told board members. He said Beaufort Memorial’s field hospital, established in the Beaufort Middle School gym will remain open, though it has not been used, as will triage tents set up outside the emergency room and the hospital’s drive-thru testing site.
McDonagh called the hospital’s execution of COVID-19 preparedness measures “flawless.” Board member Bill Himmelsbach also praised hospital leaders for absorbing extra costs in the name of public health and the ability to care for patients.
Beaufort Memorial is currently working to secure a new round of federal relief funding, which will be allocated according to COVID-19 patient admission numbers, according to Baxley.
“Financially it’s not going to be a great month for us,” he said during the board meeting. Many patients are delaying care, which will “cause more problems down the road,” he said. But, as surgical volumes begin to increase, he said he hopes the hospital will be “back on track” soon.
With the board’s approval, Baxley will begin to finalize documents to secure the credit line. “It’s not something we feel like we need today,” he said in an interview.
Baxley said he was “cautiously optimistic,” but sees this moment as “half time” in the fight against the virus, stressing the importance of continuing social distancing measures. “I don’t think we’re out of the woods yet,” he said.
This story was originally published April 22, 2020 at 3:06 PM.
