Last edited Mon Jan 17, 2022, 09:44 PM - Edit history (1)
Especially if they're in a state where there's been no expansion of Medicaid (like here in NC). They're going to be really under water with uncompensated care when this is all over with. Guaranteed. Rural hospitals here were struggling with uncompensated care before the pandemic because the state refused to expand Medicaid, and a few had permanently closed. This could break even more of them, and then that will put a bigger strain on metro hospitals.
Speaking of staffing shortages, Duke had 1300 people call out sick last week, and they were already short staffed. The budget gets stretched further by calling in travel nurses to fill in. Rural hospitals which have a hard enough time recruiting regular staff, have it even worse; they will have an even harder time getting travel RNs to come fill out staffing in out-of-the-way locations.
ERs are discharging patients straight to home, because they can't admit them to the hospital: They are staying in the ER for several days as if the ER WAS the patient's hospital room.
Yes, it's true that non-critical, non-COVID patients are also being discharged sooner than they normally would, so as to make room for COVID patients. Normal patient floors are being (re)converted to COVID isolation wards.
There are several hospitals in about a 10 mile radius who are working together. All my doctors are at one who can do stents but not bypass. They are hitting days here and there, where they have to route ambulances with heart attack patients to another nearby suburban hospital who CAN do bypass if needed
This is my area of expertise (as a CT Surgery ICU and Cath Lab RN), I can enlighten/give a bit of trivia here: There are cardiologists, interventional (or invasive) cardiologists and cardiothoracic (aka cardiac/heart) surgeons. Cardiologists just see patients. Interventional cardiologists see patients and are the guys who see/treat heart attack patients at the hospital and put in stents if possible. If not, they evaluate whether or not a patient needs cardiac bypass and make a referral to the cardiac surgeon (not every patient is a surgical candidate, even if they can't put in stents).
There's no way most rural hospitals can afford the national
average salary $450k, for (at least) one surgeon, plus all the on-call surgical staff, on top of several interventional cardiologists at nearly the same pay (in order to keep a round-the-clock Cath Lab program running so as to save lives): It's cheaper to send the surgical patient who needs bypass to the closest acute care hospital (such as Duke, UNC, Johns Hopkins, etc) after stabilizing the patient in the Cath Lab.
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