Cash-Strapped Hospitals Weigh Resumption of Elective Surgeries

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Hospitals across the country are laying out plans to return to normal operations, restarting elective surgeries and other lucrative procedures put on hold by the outbreak of the coronavirus.

Some hospitals are vying to be among the first wave of the U.S. economy to reopen after weeks of focusing largely on caring for Covid-19 patients and keeping others away to avoid infecting the healthy. This shift has cost the hospital industry billions of dollars in revenue and resulted in the loss of roughly 100,000 health care jobs since March, according to Labor Department figures released Thursday.

Industry leaders argue many U.S. hospitals have large payrolls and were designed to have a steady flow of patients coming through their doors. The $100 billion in federal emergency funds meant to buoy the health-care system amid the outbreak won’t go far enough, they say.

Photographer: Daniel Acker/Bloomberg
An exam bed sits in a room at a hospital in Princeton, Ill.

“This is an industry built to serve many patients,” said Chip Kahn, president and CEO of the Federation of American Hospitals, a group that represents investor-owned hospitals. “If they’re shuttered they can only sustain themselves for so long.”

On March 18 the Centers for Medicare & Medicaid Services recommended a halt on “all elective surgeries, non-essential medical, surgical, and dental procedures” to preserve needed medical supplies to fight the outbreak of Covid-19. The agency left it up to individual state and local health departments to determine what procedures could be permitted, and all but 16 states directed hospitals to limit or cease elective procedures, according to the Association of State and Territorial Health Officials.

Widespread Testing

State officials and health departments are just now developing their plans to reopen the economy and draw back stay-at-home orders. John Wiesman, Washington state’s secretary of health, told reporters Wednesday that process will first require widespread Covid-19 testing that includes tools for determining who is potentially immune to the virus.

One major impediment to restarting elective surgeries and other procedures shuttered during the outbreak is the main reason they were halted in the first place: a lack of medical supplies and personal protective equipment, Rachel Levine, Pennsylvania’s secretary of health, said Wednesday. Levine said the state will need a stockpile of gloves, gowns, and other equipment before starting the state’s economy to ensure another major increase in Covid-19 cases could be handled.

In North Carolina, the state’s hospitals voluntarily paused elective procedures and are working with state officials on when they can resume them, said Cody Hand, senior vice president for government relations and deputy general counsel for the North Carolina Hospital Association. He said the process could be regional and hospitals would wait until they’ve seen drops in the reports of new cases in the area.

Some rural hospitals in the state aren’t seeing major outbreaks in the communities they serve, Hand said, but have ground their operations to a halt. He said these facilities are now struggling financially and need to reopen soon.

“Statewide our hospitals are losing about $1 billion per month total,” Hand said. “At some point they’re not just having to do layoffs or furloughs.”

Moving Cautiously

Hand said hospitals in his state are moving cautiously, aware that a fumbled start could potentially mean spreading the virus to patients.

“If you move too quickly and then you have a spike or resurgence you’re basically back to where you were before,” he said.

Some state hospital associations are focusing on asking state and federal agencies for more financial assistance. In Florida, hospitals are documenting their losses as the virus spreads across the state in hopes of showing how much more federal funding they’ll need in coming weeks, Amy L. Alexander, a spokeswoman for the Florida Hospital Association, said in an email.

“The CARES act funding is only a down payment on what are monumental (and growing) costs,” she said, referring to the last coronavirus-relief bill (Public Law 116-135) enacted by Congress that created the $100 billion emergency fund.

To contact the reporter on this story: Alex Ruoff in Washington at

To contact the editors responsible for this story: Paul Hendrie at; Robin Meszoly at

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