State’s rural hospitals turn to local communities

Frances Shaw grew up sewing. It used to be quilts, clothes, her own wedding dress — but now, it’s masks for her husband’s hospital.

David Shaw, CEO of Nor-Lea Hospital District in southeastern New Mexico for just over 20 years, asked his wife for help a couple of weeks ago to see if she could make patient masks out of surgical drapes. Frances Shaw offered group sessions to about 20 or 30 people in Lovington and a YouTube tutorial.

“Names kept coming in. Now there’s close to 120 people,” Frances Shaw said. “Not all of them are sewing. Some run deliveries. Others cut material into 8-inch by 8-inch shares or twist pipe cleaners for the nose bridge.”

The quilters and sewers in Hobbs and the surrounding area delivered about 1,500 masks for patients to the hospital Monday and are working to deliver 5,000 to 10,000 more.

David Shaw said the masks are sanitized at the hospital and already in use.

“My number one concern right now is personal protection equipment and the health of our staff,” he said. “If we don’t have them, we have a really big problem.”

Nor-Lea Hospital District isn’t alone.

Rural hospitals around New Mexico are relying on community connections to prepare for the impact of COVID-19, whether that’s innovation around personal protective equipment or looking for buildings in case of a surge.

Stephen Stoddard, executive director of the New Mexico Rural Hospital Network, said rural hospitals already work to share resources and face significant threats to their existence outside of the pandemic.

“You don’t have lots of patient volume to bring in additional revenue, so the question is: How do you justify a high-cost service in a smaller community with low volumes?” Stoddard said, adding that more rural hospitals are closing every year for financial reasons.

Low volumes and high fixed costs are just one part of the problem. There’s also lower recruitment and retention. But in the pandemic, everything is compounded by concerns about the supply of personal protective gear.

David Shaw said Nor-Lea Hospital District received hundreds of N95 mask donations from nearby oil and gas fields, auto body shops and carpenters.

Nor-Lea Hospital District also operates clinics in nearby Hobbs and Tatum and is pulling some of those staff members to start manning the emergency room floor, David Shaw said. He said that in the event of an emergency, the hospital could isolate eight patients — two in isolation rooms and six in the now-repurposed sleep lab. He said the hospital has 31 acutecare beds.

“The limiting factor is ventilators,” David Shaw said, adding the hospital has five ventilators for long-term use but would need to keep something in reserve.

He said he expects to burn through $2 million to $3 million per month, but the hospital is financially healthy, with a little more than 170 days of cash on hand.

“Before this happened, financially we were pretty healthy,” David Shaw said. “There are a lot of rural hospitals that don’t have cash on hand like I do.”

CEO Bill Patten, who has run Holy Cross Medical Center in Taos for just under five years, said he’s concerned about finances.

Patten said the cuts to elective surgeries, which he said was the right call by the Governor’s Office, means a big hit to the hospital’s cash on hand.

“Surgery is one of our stronger departments. We do physical therapy and imaging for a lot of Northern New Mexico,” Patten said. “With lower volumes, we’re going to have a significant issue with our cash flows. That’s where I’m very anxious, and I’m not the only one facing these issues.”

As of Friday afternoon, Patten said, the hospital had enough cash in the bank for two payrolls.

When it comes to personal protective gear, Patten said the community support from Taos is invaluable. Car shops and carpenters offered N95 masks, and the hospital received donations of smocks from salons.

But it’s supply that’s a problem, Patten said. Vendors cut a shipment of equipment by one-third because of increased demand.

He said the hospital has six intensive care units and will use a separate surgery wing if there is a surge. While Holy Cross’ bed limit is usually 25, Patten said it can be increased to around 30.

For a worst-case scenario, he said, the hospital has been looking at a city-owned former detox center and the elementary school up the street to use in the event of a surge. He also said officials might ask for beds from the Philmont Scout Ranch.

“We’re looking for something as close to the hospital as it can [be], spaces with large open areas to create wards, rather than separate rooms,” Patten said. “We have to be creative as we plan for something that we hope will never happen.”