Just when the full breadth of its services could be most needed, the staffing and some departments of Healdsburg District Hospital (HDH) are being cut back due to sudden and steep revenue losses.

The drop in revenue is caused by cancelations of non-emergency surgeries and other services as the hospital prepares for a promised surge of COVID-19 patients in coming weeks. Average weekly revenues in one week in March dropped from $2.8 million to just over $200,000.

Just when the community was rallying with a honking car street parade last week and local civic clubs and others started a fund to buy hospital workers free meals, the longer-term outlook keeps getting bleaker.

“The leadership of North Sonoma County Healthcare District and the Healdsburg District  Hospital has been tasked with vetting all available resources, both locally and federally, to fill the shortfall in our funding. The extreme economic instability created by this pandemic has resulted in a budget deficit of around $2 million dollars each month,” said the hospital’s CEO, Joe Harrington.

“I had to tell the board this was looking pretty serious, that we were going to need a long lead time, which is why we had to do layoffs now,” Harrington said. “Nobody knows when this is all going to get back to normal,” he said, referring to weekly conference calls he has with the county’s other five hospital executive teams.

Harrington said recent COVID-19 surge models have lowered the expected caseload.

“It’s a little better now,” he said. “We have the beds and the protective equipment we need. If we’re scared of anything, it’s if we’ll have adequate staffing. Will our furloughed people be here when we might need to call them back?”

Also impacting the hospital’s finances is the increased number of canceled appointments at its primary care, physical therapy, wound care, gynecology and cardiac specialty services. Patients are canceling appointments out of a fear of contracting the virus and are opting to postpone services and care.

However, HDH physicians and staff have greatly increased their use of various forms of telemedicine.

“We were doing a few of these a month and now we’re doing something like 50 telemedicine treatments per day,” Harrington said.

He said the advent of how telemedicine is being used may become one positive factor from the COVID-19 pandemic. A task force, led by chief of surgery Dr. Joseph Tito, is exploring possibilities for reopening the operating rooms and allow for more non-emergency procedures. The task force has also proposed a policy to set specific criteria for evaluating the operability of surgery cases currently backlogged. This policy will allow the Surgical Review Committee to consider each case using the finalized set of criteria to make their go/no go decision.

“While we are one of many hospitals across the nation being forced to make these extremely difficult decisions, we are dedicated to navigating our way through this crisis with keeping as many services available for our district as possible,” said Board Chair Erin Gore.

Meanwhile the Noon Rotary Club of Healdsburg, coaxed by retired physician David Anderson, is donating funds for hot meals for hospital frontline workers over three upcoming days. On-duty staff are eligible to participate by presenting HDH badges and physicians are excluded.

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