Written by Elizabeth Izzo in the Adirondack Daily Enterprise on April 24, 2020

Local hospitals say they are hemorrhaging revenue as the coronavirus pandemic stretches on.

As hospital administrators continue to sound the alarm and underscore what they describe as a critical need for federal aid, U.S. Rep. Elise Stefanik is calling for funding allocated by Congress to be disbursed in a way that takes into account the needs of rural hospitals.

During a call with reporters on Thursday, Stefanik said she has spoken with U.S. Department of Health and Human Services Deputy Secretary Eric Hargan and asked that the department update its formula after the first round of funding from the $2.2 trillion Coronavirus Aid, Relief and Economic Security Act didn’t meet the current needs of rural hospitals.

“We are waiting to hear back, but they agreed that it would be updated to take into account where we are today, which hospitals were hit hardest, rural hospitals specifically and what their needs are,” she said.

The CARES Act set aside $100 billion for hospitals and community health centers, but the first 30% of that funding was disbursed by HHS based on traditional Medicare payments received in 2019, a decision that was expected to let the department disburse funds more rapidly. But that decision has since been criticized across party lines, with lawmakers in both major parties saying the way the funding was allocated benefits hospitals with larger populations rather than those most burdened by COVID-19 caseloads.

After her call with Hargan, Stefanik said she “anticipate(s) the formula for the additional 70% … will reflect the needs of the hospitals across our district and across the state.”

The House was set to vote on another coronavirus aid package on Thursday, this one including $75 billion for hospitals. The Senate already approved it, and President Donald Trump has said he supports it.

Stefanik said how that funding will be allocated won’t necessarily be in the package the House is voting on, but she will be voting in support of the federal aid.

Hospitals face deficits

Three administrators of local hospital networks — Adirondack Health CEO Sylvia Getman, Elizabethtown Community Hospital-Ticonderoga Moses Ludington Hospital President John Remillard, and Michelle LeBeau, president of the Champlain Valley Physicians Hospital in Plattsburgh and Alice Hyde Medical Center in Malone — spoke Thursday about financial hurdles facing the hospitals in a teleconference hosted by the North Country Chamber of Commerce.

Their comments shed new light on the extent of the impact that coronavirus and state guidelines — such as the required cancellation of elective surgeries, and a requirement that hospitals be prepared to increase their capacity by 50% if necessary — have had on local hospitals.

Their comments also reveal just how much federal aid may be needed to sustain the North Country’s hospital networks, many of which were struggling financially before the coronavirus pandemic.

Through the first round of funding from the CARES Act, CVPH received $6.8 million in federal aid, according to LeBeau. Alice Hyde received $1.2 million, Adirondack Health got $1.9 million, and according to Remillard, ECH received $815,000.

But for every hospital network, that aid represented a fraction of what they expect to lose in the next few months.

LeBeau said she believes CVPH will be looking at a deficit of between $27 million to $28 million by the end of September. Alice Hyde could face an $11 million deficit by then.

Adirondack Health, based in Saranac Lake, lost around $2.8 million in March alone, Getman said.

“We expect that to more than quadruple in April,” she added.

Remillard didn’t specify just how much ECH has lost or expects to lose, but she said the federal aid the hospital received didn’t cover what the hospital had already lost. ECH spokeswoman Elizabeth Rogers has said that after the state directed hospitals to cancel elective surgeries, the hospital’s revenue was cut in half.

“We think we need at least $1.5 million in additional support for each month we find ourselves in this state,” Remillard said.

Layoffs and furloughs

The losses in revenue are prompting hospitals to lay off or furlough employees.

Remillard said the hospital has now furloughed 28 people. LeBeau said if nothing changes, the hospitals she oversees could be looking at furloughing upward of 250 people by the end of May. At Adirondack Health, employees have been offered a voluntary furlough option — and according to Getman, 31 people have decided to take it.

“We will have to make different decisions the longer that this goes on,” LeBeau said.

Regardless of the financial challenges hospitals are facing, those who need medical help are still encouraged to contact their primary-care physicians if they need help, or call the local emergency department if they need urgent care. Those with COVID-19 symptoms are encouraged to contact the state’s COVID-19 hotline at 1-888-364-3065 or call their local hospital’s COVID-19 hotline.

Elective surgeries restarting

Gov. Andrew Cuomo announced a plan on Tuesday to reauthorize some hospitals, outside of COVID-19 hot spots, to conduct limited elective surgeries again.

Cuomo said New York state plans to specifically allow “outpatient procedures” — meaning procedures that don’t require overnight stays in hospitals — to restart on April 28, but only in select counties with fewer than 10 new COVID-19 hospitalizations in the last 10 days.

Surgical patients would be required to test negative for COVID-19 before getting treatment, according to the governor’s office. That might be an obstacle for places like the North Country, where testing has been restricted for weeks due to a limited supply of testing materials.

More detailed information about the state’s plan to reauthorize elective surgeries is expected to be released by the state Department of Health in the coming days.

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