Norton Women’s Children’s Hospital set up a triage tent in front of thier building 4001 Dutchmans Ln., it’s function being to separate and process potential COVID-19 patients. March 23, 2020
Louisville Courier Journal
LOUISVILLE, Ky. – Norton Healthcare executives said Wednesday that it’s too soon to restart elective surgeries amid a pandemic that is still killing and sickening dozens of Kentuckians each day.
They support Gov. Andy Beshear and Louisville Mayor Greg Fischer in resisting calls by some factions in Kentucky and around the country to back off social distancing and isolation, saying those measure have helped suppress the coronavirus spread in the region.
“We still believe there is some vulnerability out there,” Russ Cox, chief executive and president of Norton, said during a morning media call.
It doesn’t make sense to relax guidelines intended to stem the spread when Kentucky’s outbreak still hasn’t reached its peak and may not for another month. Concerns also involve limited supplies of protective equipment that hospitals need now, added Dr. Steve Hester, the health system’s chief medical officer.
In the last week, Republican leaders, including President Donald Trump and some Kentucky lawmakers, have grown increasingly impatient with lockdowns and stay-at-home orders public health experts recommend to battle the COVID-19 spread.
Critics insist city and state leaders reveal a game plan for rolling back restrictions, including relaxing restrictions on hospitals performing elective surgeries and other procedures. The goal is to allow the economy to rebound after more than 17 million workers nationwide filed for unemployment benefits when most factories, retailers and eateries have been forced to close.
But Cox cautioned that a knee-jerk reaction to returning to business as usual in health care isn’t the prescription. “We think it requires a whole lot more careful thought and study.”
Here’s a rundown of other key points from the chat:
Nursing home help
Norton, which is the region’s largest health system with 16,000 employees, was part of a team of specialists that assisted with ill patients at Treyton Oak Towers, the senior living community in downtown Louisville that has been hit with at least 29 residents and 14 employees who’ve tested positive for the virus. Eleven residents had died as of Tuesday afternoon.
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The work with Treyton Oak convinced the health system they could do more to connect with nursing homes. At least 30 facilities across the state have reported 256 virus cases for residents and 137 among staffers. Some 37 people linked to senior centers have died, Beshear reported Wednesday afternoon.
So they are forming a SWAT team and setting up a toll-free hotline set to launch this Saturday to offer expertise to 150 facilities. That includes strategies for testing, use of PPE, advice on isolating residents and other issues, Cox said.
Nursing homes in Kentucky and other states are at higher risk because those over age 60 are falling ill at higher rates. With less robust immune systems, the elderly risk developing life threatening complications.
Virtual hospital model
Patients who are released from the hospital, and those with some COVID-19 symptoms who are not ill enough to be admitted, are now being sent to a new virtual hospital.
It’s staffed by five doctors and two nurse practitioners who check in by phone to monitor patients, record new data and watch for any significant changes in condition. “We feel it’s a good way that we keep people healthy at home,” Cox said.
Medicare recently announced that providers will be reimbursed for virtual care at the same rate they receive for in-person visits, a response to keeping doctors and their patients safe during the pandemic.
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Norton officials said they hope the reimbursements for telehealth can remain in place after the virus outbreak passes, and they may keep the virtual hospital model running because such home monitoring is crucial.
“This is going to be something we change forever in health care,” Cox said.
No layoffs or furloughs planned, for now
Asking about layoffs or furloughs needed to keep costs in check, Cox and Michael W. Gough, chief operating officer, said they have opted instead to “flex down” some operations and send affected employees home with pay rather than trim staff or cut expenses with furloughs.
Once the outbreak is over, they’ll need all employees back at work. They also know that many employees have spouses and family members who are now out of work, so a layoff would only add to burden, Cox said, adding that “we think it’s the right thing to do.”
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Louisville’s Baptist Health announced last week it would furlough some workers and cut pay rates to keep costs in check. No numbers were disclosed.
Neither Cox nor Gough would speculate on how long Norton can keep up the spending when overall patient counts are down and after lucrative surgeries and other procedures have been nixed for weeks.
“Payroll is almost 55% of our expenses,” Gough said.
They said the health system has had a total of 838 employees in various roles who had on-and-off paid medical furloughs at some point. Some have contracted the virus. As of Tuesday, 226 people were out with the illness, placed under quarantine because of exposure or kept away due to fever or other symptoms.