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Rural Hospitals Shed Staff As Pandemic Slashes Revenue

Hush Naidoo via Unsplash

With the coronavirus pandemic stressing the health care system, you might expect skilled hospital staff to be more important than ever. But in an ironic twist of the pandemic, hospitals throughout the region are experiencing severe income losses as patients postpone routine visits.

It’s happening from Sky Lakes Medical Center in Klamath Falls to Mad River Community Hospital in Arcata. But the downturn may be felt most seriously at Curry Health Network in Gold Beach, Oregon.

Dr. Seth Giri is a cardiologist in Gold Beach, population 2,200. In fact, he’s the only full-time clinical cardiologist in Curry County. Since 2017 he worked with the region’s small, rural hospital system, Curry Health Network. 

But that changed last week.

“I was basically called to my CEO’s office at around 4:30 at night and said that my job is terminated,” he says.

Giri is one of around 200 staff, including doctors and nurses, who have been laid off, transitioned into being on-call employees, or had their hours cut in recent weeks.

In late March, Oregon Gov. Kate Brown ordered health systems to eliminate non-urgent procedures in order to conserve critical protective equipment like gloves, masks and gowns for a possible surge in COVID-19 cases. That, on top of patients avoiding the hospital, choked off funds that keep hospitals in business.

“Clinic visits are down more than 65% in the last two weeks. Our emergency rooms are both down by about 30% of normal. Our surgical volumes have all but dried up; we’re seeing a reduction of 85%,” says Ginny Williams, CEO of Curry Health Network.

Overall, visits at the rural hospital system are down by more than 50%. 

“These are significant reductions for us,” she says. “Not sustainable.”

Curry County has far fewer cases of COVID-19 than other parts of Oregon. As of Sunday night, there were just three positive cases known in the county.

Curry Health Network is facing some unique financial struggles. The health system went into debt in the last two years after opening a new freestanding E.R. in Brookings. And like Curry County, many other rural hospitals were already in trouble before the pandemic. 

“Before this pandemic began, 47% of them, that’s nearly half, were operating at a financial loss,” says Alan Morgan, CEO of the National Rural Health Association. “That was before they began eliminating all out-patient procedures, elective procedures, basically before they started cutting off the lifeblood of their facilities from a financial standpoint.”

Rural Americans are, on average, older and sicker than their urban counterparts, making them more at-risk for COVID-19, Morgan says. The impact of the current layoffs is also likely to be long-lasting since rural hospitals have a harder time attracting employees.

“It’s ironic; they’re laying off staff, in many cases, in communities where they have a shortage of staff to begin with. And when this crisis does arrive at their doorstep, they’re going to have to struggle to figure out ‘How do we keep up with it?’ at that point,” he says.

Sara Dickerson is an employee of Curry Health Network whose contract was terminated. She’s a Curry County native and worked at the hospital and E.R. since 2014, first as a registered nurse and later a nurse practitioner.

“I’ve been an RN for 10 years. I could have really helped out,” Dickerson says. “In the emergency department I can manage ventilated patients. I have a skillset that they could have used if things were to get bad.”

Like many, Dickerson is frustrated with how employees were treated – contracts voided, longtime employees laid off, severance pay and health insurance cancelled. She says there was little help offered to employees suddenly in need of filing for unemployment or health insurance.

“Even if you’re going to be laying people off, even if you had no choice, it’s how you do it,” she says.

Three other employees of Curry Health Network declined to comment for this story out of fear of losing their jobs for talking to a reporter.

The hospital can’t afford to pay their employees’ benefits, according to CEO Ginny Williams. She says even with the layoffs, if they don’t get federal or state assistance, the hospital won’t make it through the summer.

“If we got none of those things, and nobody came forth to provide us with any assistance, with our reductions we will survive until June [or] July,” she says.

For cardiologist Seth Giri, much of his frustration comes from the fact that he can’t help his patients, who are now putting off visits or his colleagues who are preparing for a possible increase in COVID-19 cases.

“I wish there was a way I could still help,” he says. “That’s really the disappointment. That’s really the frustration more than anything else. It feels like you’re in shackles and you can’t contribute.”

Erik Neumann is JPR's news director. He earned a master's degree from the UC Berkeley Graduate School of Journalism and joined JPR as a reporter in 2019 after working at NPR member station KUER in Salt Lake City.