Johnson Memorial prepared to restart elective surgeries today

<p>Hospitals, for the past month and a half, have been throwing all money and resources at fighting the coronavirus.</p><p>Traditional revenue streams were shut down, and county hospitals such as Johnson Memorial Health had to make tough adjustments to make ends meet.</p><p>Glimmers of hope are on the horizon for small, county hospitals. Gov. Eric Holcomb’s most recent executive order allows elective procedures, which make up a significant chunk of a hospital’s income, to resume today. </p><p>One reason elective surgeries were halted was to make sure hospitals had enough equipment and supplies on hand to deal with an anticipated surge of COVID-19 patients.</p><p>But different types of personal protective equipment (PPE) are used in surgeries than for treating COVID-19, so Johnson Memorial officials are comfortable with the amount of PPE on hand, said Dr. David Dunkle, president and CEO.</p><p><span><strong>Surgical adjustments</strong></span></p><p>While many doctors are focusing on patients in the COVID-19 unit, surgical staff are preparing to reopen for elective procedures that have been delayed, said Anita Keller, Johnson Memorial’s chief nursing officer. Initial procedures will still be limited, focusing on patients who need pain relief and procedures that doctors and patients feel are urgent, she said.</p><p>Another reason elective surgeries will be limited is that some of the surgical staff have been reassigned to treat COVID-19 patients, Dunkle said.</p><p>Those who come in for procedures will notice quite a few changes to keep both patients and health care professionals safe, Keller said. The most noticeable differences will be visitor restrictions and personal protective equipment, she said.</p><p>Adults must come inside the hospital alone, while children can be accompanied by one parent, Keller said. Family members will get updates on their loved one’s condition and discharge instructions via phone, she said.</p><p>Patients can be assured Johnson Memorial is taking every precaution to protect both patients and staff and should not be afraid to come in for a procedure, Keller said. Surgeries are conducted in a different wing of the hospital than the COVID-19 unit, with a separate entrance and parking lot, she said.</p><p>As an added precaution, patients will also be called a day ahead of their procedure to confirm they do not have a fever or any other COVID-19 symptoms, Keller said. Staff are screened for COVID-19 symptoms before each shift, she said.</p><p>“We do everything we can to make sure that we keep everyone as safe as we can,” Keller said. “Our top priorities are keeping our staff and patients safe.”</p><p>Hospital leaders say no one should be afraid to seek treatment. The COVID-19 unit is separate from the rest of the hospital, located in the hospital’s new emergency wing, which opened early so the hospital could better isolate those patients. It also uses a different air circulation system, Dunkle said.</p><p>“We like to think that you can go anywhere in the hospital and not risk infection,” Dunkle said. “It is probably safer to be within the walls of the hospital than at the grocery store.”</p><p><span><strong>New financial reality</strong></span></p><p>Because treating COVID-19 is expensive and care has been largely focused on that the hospital has had to make some adjustments, Dunkle said.</p><p>Estimates suggest that hospitals, on average, lose $1,000 for each COVID-19 patient, Dunkle said. JMH has not calculated how much revenue is lost per patient, but knows it has definitely put the hospital in a metaphorical hole, he said.</p><p>“It’s like you are in a hole and you know it is deep,” Dunkle said. “You can’t see your way out. You just know you’re in a hole.”</p><p>When Holcomb instructed hospitals to discontinue non-emergency procedures and primary care offices to switch to telemedicine, revenues declined steeply, Dunkle said. Without those lines of business, Johnson Memorial Health has seen its volume of patients decrease by 50%, he said.</p><p>Since the hospital is a nonprofit organization, almost all revenue is put back into operations and salaries, Dunkle said. This means there was not a lot of extra money before the crisis set in.</p><p>“People don’t realize how few things people do that are profitable for a hospital,” Dunkle said. “The average profit margin for a hospital is around 2%.”</p><p>However, Johnson Memorial is doing better than some other county hospitals due to a successful 2019. Last year, the hospital welcomed five new doctors, improved billing and collections and expanded profitable practice areas such as oncology, cardiology, physical therapy and medical imaging, he said.</p><p>“It is scary for local communities. The large hospitals have more of an ability to withstand this loss of income than county hospitals,” Dunkle said.</p><p>While some hospitals are considering mass layoffs, Johnson Memorial has furloughed some, and has been able to get by with cutting hours, Dunkle said.</p><p>While Dunkle expects revenues to bounce back some with the return of elective surgeries, the hospital is a long way from returning to normal. Until physician offices open back up and all procedures are back on, money will continue to be tight, he said.</p><p>In the meantime, the community has stepped up, donating $16,000 to the Johnson Memorial Hospital Foundation’s COVID-19 Response Fund, Dunkle said.</p><p>Johnson Memorial also received money from the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which will be divided among the hospital, physician offices and nursing homes that the hospital manages. Since all the federal funds are not disbursed, hospital officials are still unsure how much they will actually get, Dunkle said.</p>[sc:pullout-title pullout-title="How to help" ][sc:pullout-text-begin]<p>The Johnson Memorial Hospital Foundation is providing a way for patients, families and caregivers at Johnson Memorial Health to help fight COVID-19. Contributions to the COVID-19 Response Fund will assist with supplies, equipment and program needs related to the virus and the hospital’s COVID-19 unit.</p><p>To donate online, visit <a href="http://johnsonmemorial.org/about-our-foundation">johnsonmemorial.org/about-our-foundation</a>.</p><p>To pay by check, mail to: JMH Foundation 1125 W. Jefferson St, Franklin, IN 46131.</p>[sc:pullout-text-end]