Contact: Carey Guhlke-Falk
Lincoln County, WA - Rural hospitals and clinics are struggling around the nation right now. The perception that hospitals everywhere are being overrun by patients with COVID-19 or are unsafe due to exposure is keeping people from taking care of their healthcare needs and is placing an additional, unexpected financial strain on the rural healthcare providers.
“We have taken the precautions we need to protect our patients and our employees from COVID-19 and have made the needed adjustments to preserve our PPE, but we can’t just stop seeing all other patients,” said Tyson Lacy, Chief Executive Officer for Lincoln Hospital and Clinics. “Doing that would create a larger health crisis later on when we have patients who haven’t kept up on their preventative and routine care or who haven’t been seen for their chronic health conditions. Other illnesses still occur – even during a pandemic - and it is safe to come to our hospital and our clinics.”
Every person entering the health campus in Davenport or their clinics in Wilbur and Reardan are screened for respiratory symptoms before entering facilities. If someone has symptoms, they are asked to schedule an appointment at the designated respiratory screening clinic. In an effort to ensure healthcare is being taken care of and to curb fears about coming into the facilities, alternatives for care such as telemedicine, virtual visits, and curbside services are being provided on a case-by-case basis.
“We do not want diseases like diabetes and high blood pressure to go unchecked,” said Dr. Ralph Monteagudo, family practice physician for Lincoln Hospital and Clinics and Public Health Officer for Lincoln County. “Chronic diseases can also be deadly so scheduled maintenance of preventative visits remain important for the health of our communities.”
A decline in the number of patients seeking care at Lincoln Hospital and Clinics and restrictions on ability to provide elective services due to COVID-19 led to a recent decision to ask employees to participate in voluntary standby unemployment. “We have incredible staff who volunteered for this and we worked with them individually to maximize unemployment benefits during this time,” Lacy said. “Our goal is to keep these employees as financially whole as possible through this.” The hospital district is also covering healthcare insurance premiums in full for furloughed employees during this time.
The hospital district does not anticipate having to implement mandatory furloughs, but says the uncharted territory of the pandemic along with undetermined funding makes it hard to know for sure what will happen in the near future. “The lifespan of this pandemic, the length of the shutdown, the relief funding, and the utilization by our communities of the services we can provide will play a big part in the next steps taken,” Lacy said. “We are doing everything in our power to avoid mandatory furloughs.”
State and federal support of the hospital to mitigate income loss and added costs are still falling into place. The hospital received relief funding from the CARES Act for the first time two weeks ago and more is anticipated. The funding received was enough to operate the district under normal circumstances for about 10 days. “The funding we’ve received is something we are grateful for, but it certainly will not be adequate to get us back to where we were before this pandemic took place,” Lacy said.
Initially, Lincoln Hospital and Clinics chose to reschedule any appointments or procedures that did not have immediate effect on their patients. This included rescheduling well-child visits, annual wellness visits, mammograms, and other preventative screenings and procedures. They also chose to close the Wilbur Clinic. “Those difficult decisions were made, knowing the financial implications, because we didn’t yet have a procedure in place that would ensure we didn’t have cross-contamination between patients showing symptoms of COVID-19 and those who did not,” Lacy said. Shortly after, their respiratory screening clinic and other procedures were established. “Every healthcare provider across the nation is making decisions with the best information possible, but there’s no precedence set for this. It took a little bit to know more about the virus and what processes work best.”
The screening clinic is isolated from the regular clinic in Davenport and no walk-ins are permitted. “Now, when you come into our hospital or our clinics, you will not see a single other patient who could potentially have respiratory symptoms and even more rigorous cleaning and sanitizing methods are being used.”
The decision to close the Wilbur Clinic was made to preserve limited resources. While some resources like hand sanitizer and cleaning agents remain limited, the Wilbur Clinic will be open again starting May 4th with hours being Monday through Friday, 9 a.m. – 4:30 p.m. The clinic will have limited staff and will not offer MA visits, but provider visits will be available and they will be following the same precautions implemented at the Reardan clinic: patients need to call upon arrival and staff will come out to their car to do a temp check and screen for COVID-19 symptoms. Any patients with symptoms will be asked to make an appointment with the screening clinic in Davenport.
Additionally, in March the hospital district had started new construction on an $8-million Davenport Clinic. That construction was halted when Governor Inslee restricted non-essential construction projects even though the building qualified as essential. “The decision to pause the building allowed us more time to understand the circumstances surrounding the virus containment and how it would affect us long term,” Lacy said. After the regular board meeting on April 16th, the Lincoln Hospital District Board of Commissioners decided to proceed with the building. It would have been more costly to delay the project further or cancel it altogether than it was to continue. Also, the location of the current Davenport Clinic is in the process of being sold. While the hospital district’s contract with the current owners is good until the summer of 2021, any need for extended time in the building is not guaranteed and the new clinic is essential for clinic services to continue in Davenport.
“In the midst of all the chaos, we are still the 5-Star rated facilities we were recognized for just a few months ago!” Lacy said in reference to the recent rating given to Lincoln Hospital and Clinics by CMS, making them one of only 400 hospitals in the nation with the sought-after safety and quality rating. “We will weather this and are grateful to our communities for the support they have given us through donations of PPE, gifts of food for our staff and words of encouragement during this time.”