GVH holding strong despite the pandemic

Fully operational, financially stable and adapting to changes

[ By Katherine Nettles ]

Gunnison Valley Hospital has weathered the coronavirus pandemic for more than eight months, continually adapting to public health measures, employee health and safety concerns, coronavirus testing changes with the state, and now transitions for the winter season that will affect the senior care center.

GVH chief executive officer Rob Santilli reported to Gunnison County commissioners recently that despite the challenges, the hospital system overall has maintained a positive outlook for patient care and finances.
The hospital system finished fully re-opening all its services by April 21 after the closures related to the virus outbreak in March, welcoming back non-emergent patients for elective surgeries, procedures and health screenings. Despite an uptick in COVID cases in July and again since late October, there have not been related hospitalizations or any GVH systems under strain.

“We’re really not seeing patients being hospitalized, so it’s mostly affecting us as the screening lab,” said Santilli, as more people look to get tested with each uptick. GVH staffs the COVID screening and testing area, and manages the process of about 70 tests per week by sending out kits to outside labs for results.

 

Returning to work

Prior to reopening the various departments at the hospital, Santilli said every department came up with a “safe return” plan. GVH employs about 500 people and has kept everyone employed throughout the pandemic. Many worked from home for a while, and many still do.

Bringing employees back in after the initial shutdown caused anxiety for some of them, and Santilli said the hospital made a lot of air flow and filter changes, adding partitions and taking other measures to increase the facility defense system.

“We wanted to bring them back in a way that they could feel confident. I’m so appreciative of everybody who worked through this,” said Santilli. “As you can imagine, it was intimidating to come back to a hospital for many of them at first,” he said.

“But we were the first hospital in the state for getting a reopening plan to the governor. We keep trying to exceed expectations instead of just waiting for someone to tell us we can open up.”

Santilli said GVH was also fortunate to get a series of rapid COVID tests. “That gave us the ability to do testing on every emergency room patient. And then if they were admitted, we could put them in a part of the hospital that doesn’t have to use full PPE. That made a huge difference for us, because you burn through those materials very quickly otherwise and it’s a huge burden on the staff as well.

“Overall we feel pretty confident that the plans we have are going to keep us in good shape. Locally we have hit about 24 percent or 25 percent capacity for COVID-related care, and we hit a maximum in late March,” said Santilli.

 

Finances and relief funds

Chief financial officer Mark VanderVeer said that since April, GVH has received several general and targeted distributions totaling $7.5 million to be used to prevent, prepare for and respond to the coronavirus. GVH also received approximately $4.8 million under the Paycheck Protection Program, which is a loan on GVH’s balance sheet.

VanderVeer noted that as of September, GVH had “used” about $4 million of the CARES funds. “Thanks to the hospital’s efforts to reopen services as quickly as we did and the county’s efforts to control the spread of the coronavirus, we have not needed as much of the funds as we thought back in late March/early April 2020… We will not know the total funds used until June/July of 2021.

“If we have to return funds (which is a possibility) that just means we were successful in minimizing the impact of the pandemic on the health system while maintaining and providing all the services our community members look for from GVH,” said VanderVeer.

“We are trying to understand the accounting methods on how they are applied. Quite frankly, they keep changing the rules for what does and doesn’t apply,” said Santilli. “In a way we have a buffer here—those funds give us a longer leg of support. The ability for the health system to be strong is what’s important to us.”

 

Testing changes

Santilli said one major issue was that last week the state department of health announced it would not continue to provide its free service of analyzing COVID-19 specimens for symptomatic people, as it pivots to focus only on those involved in outbreaks and at nursing homes.

“So that created an immediate concern for the health department,” Santilli said. “And what we came up with was something relatively unique for the hospital. We will continue to screen them here and now we will send tests to the Mayo Clinic at our own cost.”

Tests take a plane ride to the clinic in Rochester, Minn., and results come back within about 48 hours. Santilli said the hospital system uses the Mayo Clinic as a reference lab for complex testing anyway, so it was a natural choice. And GVH is hoping for reimbursement through CARES funding.

 

Looking ahead: cold weather

Santilli said there are a few unknowns surrounding the quickly changing temperatures. The Senior Center has been able to accommodate visitors by holding all visitations outdoors this summer and fall, but with the cold weather transition, the center is concerned about keeping people warm and is trying to get creative.

One issue is that the state requires indoor visitors to provide a negative COVID test result from within the 48 hours prior to their visit at the Senior Center, while outdoor visits do not require testing. Current testing turnaround times would make the indoor requirement challenging, and Santilli said he has a call with Governor Jared Polis on November 13 to troubleshoot the issue. “We are hoping at that point in time to have an idea… Plan A is inside visitation in a conference room in the new facility,” he said. In between visits the facility can use its UV light bot and sterilize the room in about 60 seconds.

Plan B is to construct an outdoor facility, but that can present health code hazards when using heat, Santilli pointed out. But the hospital submitted a plan to the state to build an outdoor facility in case it comes to that.
In general, Santilli added that regular communication with the Colorado Hospital Association and its network of healthcare partnerships have helped tremendously.

“We have a level of confidence that even the care the hospitals are able to provide are more intuitive—it includes earlier and preventive care, and it seems like we are ahead versus being behind,” he said.

“I have confidence that we are going to be able to continue to address this pandemic with all the medical care and support from the largest health systems giving us continual guidance… that makes a real big difference. You don’t feel you are a small hospital in Gunnison, Colorado trying to make big decisions all alone. You are really collaborating with some of the largest hospitals in the state.”