Hospital Closes Exterior ER Tent After Anticipated COVID-19 Surge is Avoided

With an apparent light at the end of the tunnel of the COVID-19 shelter in place state and federal policies, Scotland County Hospital announced it is continuing to weather the storm.

As of April 27th, hospital leaders reported that isolation and non-isolation beds were  available at the facility. COVID19 testing is being performed, with xxx of tests already being administered by SCH. There have been x of positive tests with xx tests outstanding, There have been zero COVID-19 related deaths in Schuyler, Scotland, Clark or Knox counties.

ER:

The ER tent has been taken down that was located outside of the hospital to screen all ER patients. The tent came down due to the lack of surge in COVID testing/patients. COVID symptom patients need to call the COVID Hotline and if asked to come in, be screened outside, in their automobiles. Patients entering the Hospital and Clinic will continue to be screened at the entrances with a temperature check and questioning.

COVID Hotline:

SCH will continue to manage the COVID Hotline 24/7. That number is 660-956-6820.

There are now 3 options available for COVID testing for patients:

CDC testing (patient must qualify – costs patient and hospital nothing).
PTC commercial test (24-hour turnaround time from the time courier leaves hospital). The courier leaves each morning to transport tests to Columbia. If a patient is swabbed in the afternoon, the test will not go out until the next morning.

Once the lab receives the test, there is approximately a 6-8-hour turnaround time on results. Patients opting for this test will be asked to sign an intent to pay stating that if they do not have insurance or if their insurance does not cover the testing, they will be billed $200.

Quest commercial test (3-5-day turnaround time). Patient can opt for this test. With this test, patients will be asked to sign an intent to pay stating that if they do not have insurance or if their insurance does not cover the testing, they will be billed $60.

Hospital officials continue to seek clarification from Federal and Commercial Insurers that this costly testing will be covered as long as requested with a doctor’s order, as all tests administered by SCH & C clinicians, without the possibility of after-the-fact denials based on medical necessity.  Hospital officials are hopeful that any out-of-pocket payments will be unnecessary and funded by COVID-specific relief funds.  If so, any payments collected will be refunded or applied to existing patient account(s) per patient preference.

The nurse working the COVID Hotline does not give out patient information to anyone other than the patient him/herself, the clinician ordering the test, and the health department (required by law). The nurse or ordering clinician does not contact employers or other family members or contacts. If further investigation is warranted, it is done by the health department.

SERVICES:

All services are open, limitations exist-but open, at Scotland County Hospital & Clinics. Services are offered, many in a different way. If you have been in contact with your primary care provider or a clinician that determines you need a service, you will be instructed on how, when and where to get the services you need with us. The Surgery Center is open, with precautions, for non-vulnerable patients that have a more urgent surgery need from the backlog over the last month. Therapy Services Department is calling non-vulnerable patients to schedule appointments from their backlog. All of this is proceeding with caution and fluidity, should the COVID crisis change for the better or worse.

CLINICS & HOSPITAL OPERATIONS:

There are non-COVID related illnesses that need medical attention and to care for those patients there are face-to-face clinic visits and there are Virtual Clinic Visit appointments for patients that have an electronic device and the Internet. Call Memphis (660-465-2828) or Lancaster Medical Services (660-457-3655) for an appointment. The triage nurse will determine if a patient needs a face-to-face appointment in the clinic or Virtual Visit. The ER remains open 24/7 and Urgent Care is open on Saturdays 8 am – 2 pm. Memphis & Lancaster Medical Services are open until 4 pm with walk-in hours available until 5 pm. Wyaconda Medical Services is closed. The new Edina Medical Services (a partnership between Scotland County Hospital and Blessing Health System) is under construction at the former Jim Sears Building, across from Knox County Schools. The expected opening date is sometime in June.

FACILITIES:

There are two entrances into the facility. Patients can enter at Memphis Medical Services during clinic hours or patients can enter through the Main/ER entrance of the hospital 24 hours a day, 7 days a week. All patients presenting to clinics or main hospital entrance will be asked a series of questions and get a temperature check. Some visitor restrictions will be eased in the near future, with precautions and could change at any time, based on the COVID crisis situation and medical staff recommendations. Currently, no visitors are allowed, except under these circumstances: a minor may have one person accompany them, a laboring woman may have one support person accompany them, a disabled person may have one person accompany them and end-of -life patient visitor requests are evaluated on a case-by-case basis.

FINANCIAL:

Scotland County Hospital has gone to the expense and time to prepare to respond to the Covid crisis. The preparations began the first week of March 2020. The hospital staff has conducted nearly 70 tests with 5 positive results (4 Scotland County Residents and one Adair County Resident).

On the revenue side, patient volumes are down approximately 50% and more in some service areas. On the expense side, there have been staff reductions, hour reductions, salary reductions, suspension of most specialty services and contract cancellations.

Hospital Controller, Michael Brandon, MBA, made application for federal monies through several programs offered to qualifying hospitals. As of Friday, April 10, 2020, a $479,000 grant had arrived from the Health & Human Services Emergency Fund and has some stipulations to its use that hospital officials believe can be met in order to document the appropriate use.

On April 3rd, Mr. Brandon applied for $4,134,625 through the Medicare Accelerated Payment Program. $3,671,659.49 was received on April 14, 2020. This money is an advance from the Centers from Medicare/Medicaid (CMS) to help with operational expenses during the Covid crisis. Critical Access Hospitals have a year to pay back the funds at zero interest. The hospital will receive no Medicare reimbursement until the funds are repaid in full. Due to the nature of this money & stipulations for the pay back, hospital officials are attempting to not use this funding, but have accounted for it until it is time to be paid back.

Hospital officials have applied for the Small Business Administration (SBA) Payroll Protection Program (PPP) which has been replenished. On Friday April 24th, a Treasury Dept. interim rule indicated that the Hospital, despite being a publicly funded government facility and therefore previously deemed ineligible for the PPP, will qualify, since it receives less than 50% of it’s funding from local and state public sources (excluding Medicaid). The Hospital receives only about 2% of its operating budget from local taxes, and believes it qualifies.  The hospital expects to receive $160,000 over the next two weeks of State Fiscal Year 2015 unspent Disproportionate Share Hospital allotments with no stipulations. And the hospital’s CEO has signed a Memorandum of Agreement with the Missouri Hospital Association for a $5,000-$8,000 Assistant Secretary for Preparedness and Response Grant. Additional COVID related funding is expected from the Health Resource and Services Administration (HRSA) estimated at about $80,000.  All hospital and clinic supervisors are documenting additional expenses incurred during the COVID-19 pandemic for possible Federal Emergency Management Agency (FEMA) reimbursement.