With elective and non-essential procedures on hold due to the pandemic, hospitals across the nation haven’t just shed patients and services.

They’re also losing millions of dollars weekly, sending workers home and sinking deeper into a financial hole that had many facilities perilously close to closing even before the novel coronavirus came to town.

Nationally, the American Hospital Association estimates individual hospitals are losing as much as $1 million per day. Now multiply that by 10 hospitals and 60 clinics within a health network like M Health Fairview.

“We have delayed procedures on approximately four thousand patients,” said M Health Fairview spokesperson Aimee Jordan on Friday. “The result of that is a $30 million loss in revenue per week.”

In an April 9 letter to Congressional lawmakers, the Minnesota Hospital Association predicted that hospitals and health systems across the state will lose $2.9 billion over the first 90 days of the crisis beginning in mid-March.

“Even though it sounds like a big number, we believe it’s still a conservative estimate,” said association president and CEO Dr. Rahul Koranne.

SHARP NEW COSTS

In addition to deferring non-essential operations, there’s sharp new costs associated with reconfiguring hospital rooms and other hospital spaces and buying new equipment such as ventilators and personal protective gear, he said.

There’s also a financial gap between staff costs and patient revenues obtained through tele-medicine or the relatively few in-patient visits that are still trickling in. Small hospitals have been especially hard-hit.

To offset some of those losses, Congress this week included $75 billion in emergency funding for hospitals and $25 billion for virus testing in the fourth round of pandemic relief legislation.

But the long-term prognosis? Uncertain.

“This pandemic is going to change everything,” Koranne said. “What the world looks like after it’s over still remains to be seen.”

Rather than resort to outright layoffs during the orchestrated statewide slowdown, Twin Cities hospitals and clinics are furloughing employees — asking them to take unpaid time off — by the hundreds.

HOSPITAL WORKERS SENT HOME

In a written announcement Thursday, HealthPartners officials said they expect to furlough 10 percent of their overall workforce, or 2,600 employees. Those workers will retain health benefits, according to the statement.

Region’s Hospital in St. Paul, a HealthPartners site, furloughed roughly 30 nurses, doctors, lab technicians and other staff from the emergency department alone on Wednesday, according to staff there. Nurses were the hardest hit.

HealthPartners CEO Andrea Walsh said she would reduce her salary by 40 percent, and other leaders throughout the health network would see salary reductions of up to 30 percent depending upon position.

Rick Fuentes, a spokesman for the Minnesota Nurses Association, said Children’s Hospital in St. Paul is letting go 100 to 200 nurses.

“They’re basically shutting down everything except the emergency department and the intensive care unit and moving everything to Minneapolis,” he said.

WORKFORCE REDUCTIONS, STAFF REDEPLOYED

HealthPartners’ Methodist Hospital in St. Louis Park will also furlough workers, though the exact number is still under negotiation with the union.

“Same thing with St. Mary’s Hospital in Duluth, which is owned by Essentia,” Fuentes said. “They’ve laid off some workers already, but not nurses.” Mayo Hospitals are also rolling out furloughs, he said.

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Minneapolis teen charged in shooting death of campaign worker In other areas, however, it’s all hands on deck. Even as workforce and operations are reduced and care sites are consolidated, HealthPartners has created a central staffing pool to redeploy team members to prepare for a potential patient surge.

Similar redeployments and retrainings are happening across healthcare organizations, Koranne said.

“The world we are in today is completely different than three months ago,” Koranne said. “Right now, what I see hospitals and healthcare systems doing is preparing 100 percent for a COVID-19 patient surge.”

BAD TIME FOR THE INDUSTRY

For hospitals, the pandemic arrived at an especially bad time in the industry.

In St. Paul, two M Health Fairview sites — St. Joseph’s Hospital and Bethesda Rehab, a long-term acute care site — had trimmed beds or services in response to declining net revenues even before the virus, leading to widespread concern that either site could soon be shuttered.

“We are not on a sustainable path,” said M Health Fairview CEO James Hereford in December.

Since then, the health network has confronted the pandemic by adding back dozens of beds it had just removed at Bethesda and converting the hospital into a 90-bed COVID-19 critical care site. Another 100 COVID beds will soon open up at St. Joe’s.

HOSPITALS OFFER CURBSIDE TREATMENT

As a result of the governor’s stay-at-home order that took effect in late March, hospitals and clinics began postponing non-essential medical procedures in favor of tele-health online consultations.

The governor’s order officially delayed elective procedures, though it’s up to hospitals to determine what care is still considered essential. The goal is to free up resources — from patient beds to personal protective equipment — and keep non-coronavirus patients from getting infected.

The result has been a dramatic drop in patient counts, and revenue. To the frustration of healthcare providers, many patients needing serious care have even avoided emergency rooms, which medical experts say is unnecessary given the degree to which hospitals have now segregated patients and put other precautions in place.

On April 20, M Health Fairview launched a new “curbside care” program for non-COVID patients at its Woodbury and Brooklyn Park locations. The appointment-only services take place in large outdoor tents and include immunizations, blood pressure checks and select injections.

‘STILL QUIET AT MY HOSPITAL’

For nurses and other front-line staff, some temporary shift work has opened up at assisted living and long-term care facilities, which had high turnover rates even before the pandemic. The state of Minnesota is compiling a list of nurses, nursing assistants, EMS workers and ancillary staff who are willing to be deployed throughout the state.

In a recent interview, a nurse in a medical-surgical floor at a suburban Twin Cities hospital said most surgeries had been moved to a sister location, and patient counts on their floor were down to about a fourth of their usual number.

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Coronavirus Tuesday update: 513 new infections and 10 more Minnesota deaths “People are not coming into the hospital, or when they do come in for non-COVID reasons, we’re finding ways to get them home as fast as possible,” said the nurse, who asked not to be identified because they were not authorized to speak to the press.

In other words, “still quiet at my hospital,” said the nurse, who admitted to feeling “anxious, and a little bored.”