Clean­ing up after Irene's mess

Hos­pi­tals cal­cu­lat­ing costs fol­low­ing hur­ri­cane

Modern Healthcare - - Front Page - Me­lanie Evans

The full weight of costs that Hur­ri­cane Irene dropped on East Coast hos­pi­tals won’t be known for weeks or months, even though most es­caped without sig­nif­i­cant dam­age. New York hos­pi­tals that emp­tied out be­fore the storm quickly re­opened, but many beds re­mained vacant. In Mary­land, a hos­pi­tal lab­o­ra­tory flooded through a dam­aged roof. Hos­pi­tal work­ers in Ver­mont moved into nearby ho­tels after storm dam­age length­ened com­mutes from 30 min­utes to three hours.

Hos­pi­tal fi­nance chiefs face a com­plex task in tallying the costs of prepa­ra­tions, evac­u­a­tions, re­pairs and lost rev­enue. The storm, which claimed dozens of lives and dev­as­tated some com­mu­ni­ties, made land­fall Aug. 27 in North Carolina as a hur­ri­cane and reached New York City the next day as a trop­i­cal storm be­fore con­tin­u­ing north.

In com­mu­ni­ties that suf­fered the most dam­age, hos­pi­tals may see a sus­tained drop in de­mand for med­i­cal care as res­i­dents tem­po­rar­ily move else­where or strug­gle to re­build, said George Whetsell, a man­ag­ing di­rec­tor with con­sul­tants Huron Health­care, who worked with Bap­tist Hos­pi­tal in Pen­sacola, Fla., after Hur­ri­cane Ivan in 2004. “Seek­ing health­care will be fur­ther down the list of pri­or­i­ties,” he said.

St. Clare’s Hos­pi­tal cam­pus in Sus­sex, N.J., re­mained closed at the end of last week, though its emer­gency room was pre­pared to re­open, said Chief Fi­nan­cial Of­fi­cer Mark He­bers. The cam­pus evac­u­ated 14 pa­tients to its Denville, N.J., cam­pus Aug. 29 after a gen­er­a­tor failed. Con­tam­i­nated wa­ter forced the hos­pi­tal to re­main shut­tered.

For the hos­pi­tal, the con­se­quences of clos­ing are “no dif­fer­ent than any other store­front,” He­bers said. “I still have to pay the mort­gage,” he said. “I still have to pay the light bill. I still have to pay peo­ple’s salaries.”

St. Clare’s Hos­pi­tal will bear the ex­penses of pay­ing over­time and re­pair­ing dam­ages and will see rev­enue drop from its closed emer­gency room, He­bers said, but he has yet to start adding up those costs. “It’s way too early,” he said. Ex­ec­u­tives con­tinue to work on reopening the Sus­sex cam­pus and ad­dress­ing pa­tients’ needs.

The storm did less dam­age than ex­pected to New York City, but ex­ec­u­tives at North Shore-Long Is­land Jewish Health Sys­tem face lost rev­enue after clos­ing two hos­pi­tals ahead of the storm. How much is not yet clear, CFO Robert Shapiro said.

The Great Neck, N.J.-based sys­tem evac­u­ated 673-bed Staten Is­land Univer­sity Hos­pi­tal and 296-bed South­side Hos­pi­tal in Bay Shore, N.Y. Roughly 1,000 pa­tients were trans­ferred through­out the 11-hos­pi­tal health sys­tem.

The mea­sures dis­rupted hos­pi­tal ad­mis­sions that oc­cur when pa­tients ar­rive in the emer­gency room or are trans­ferred from other fa­cil­i­ties, and each hos­pi­tal was left with a de­pleted cen­sus be­yond the week­end evac­u­a­tion. Most pa­tients emp­tied from those hos­pi­tals did not re­turn, ei­ther be­cause doc­tors sent pa­tients home or pa­tients were held at new fa­cil­i­ties to avoid the risk of med­i­cal com­pli­ca­tions from an­other trans­fer. Shapiro said he ex­pects elec­tive pro­ce­dures to be resched­uled.

Robert Power, CFO for the sys­tem’s South­side Hos­pi­tal, said of­fi­cials ex­pect to an­a­lyze hos­pi­tal data from Au­gust 2010 and the prior six months of 2011 to cal­cu­late the lost rev- enue dur­ing the storm.

Power said South­side, on an av­er­age day, has 250 to 260 pa­tients. Days after reopening, the hos­pi­tal had roughly 200 pa­tients.

South­side also hired sand­bag­ging crews and land­scap­ers to trim back trees to pro­tect against flood­ing and high winds. The hos­pi­tal rented a gen­er­a­tor on a flat-bed truck as backup should waters dam­age South­side’s ex­ist­ing gen­er­a­tors. Me­chan­ics for the gen­er­a­tors and el­e­va­tors re­mained at the hos­pi­tal, as did op­er­at­ing room staff, sur­geons and spe­cial­ists be­cause South­side’s emer­gency room re­mained open, Power said.

Shapiro said he is un­aware of a source that might cover the costs of trans­fer­ring pa­tients to hos­pi­tals out­side of coastal New York’s most flood-prone ar­eas. The sys­tem also faces over­time ex­penses for em­ploy­ees who slept at work to en­sure enough staff through­out the storm.

In Cam­bridge, Md., a dam­aged roof forced the evac­u­a­tion of 44bed Dorch­ester Gen­eral Hos­pi­tal. The hos­pi­tal’s lab­o­ra­tory flooded with nearly a foot of wa­ter from rains. Early Aug. 28, 21 pa­tients were trans­ferred to 107-bed Me­mo­rial Hos­pi­tal at Eas­ton, said Patti Wil­lis, a spokes­woman for Shore Health Sys­tem, which owns the two hos­pi­tals. “You can’t run a hos­pi­tal without a lab­o­ra­tory,” she said.

The hos­pi­tal was sched­uled to re­open Fri­day after roof re­pairs and the lab­o­ra­tory’s walls, ceil­ings and other wa­ter-dam­aged ma­te­ri­als were re­placed, she said. All the trans­ferred pa­tients have since been dis­charged, Wil­lis said. Fi­nan­cial of­fi­cials are work­ing to asses the cost of dam­age and lost rev­enue, she said.

Rut­land (Vt.) Re­gional Med­i­cal Cen­ter did not close dur­ing the storm, but se­vere flood­ing that dam­aged roads, washed out bridges and left some Ver­mont towns stranded also cut off most roads to the 137-bed hos­pi­tal.

Pres­i­dent and CEO Thomas Hueb­ner said ac­cess to the hos­pi­tal im­proved through last week but em­ploy­ees con­tin­ued to find trav­el­ing to and from work a chal­lenge. Rut­land Re­gional has rented ho­tel rooms for 20 to 30 work­ers a day, Hueb­ner said. It’s not clear how long that need will per­sist, but Hueb­ner said he be­lieves hous­ing costs will be the hos­pi­tal’s sin­gle largest ex­pense from the storm.

Some work­ers’ com­mutes have length­ened from min­utes to hours. “That’s not re­al­is­tic,” Hueb­ner said. Some em­ploy­ees can­not re­turn home once they leave, he said. “Ev­ery­thing’s harder.”

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