“And recognizing the percentage to total of our mix compared with the other health systems in Virginia, that is, our Medicaid and self-pay, we started pulling back on non-urgent care to free up capacity and to conserve PPE before the governor required the state to do so.”
Fortunately for VCU Health System’s workforce, this move didn’t lead to layoffs or furloughs.
“We immediately declared every employee in VCU Health System as being essential, because we also didn’t know if we might not need everybody,” Hancock said.
So in addition to creating a command center, the health system also created a staffing center, with team members reviewing the health systems’ workforce to determine which employees had no assignment and redeploying them after ensuring they received appropriate training.
“For example, when we stopped doing valet services for safety concerns, we redeployed some valet staff members to our decks to help with way-finding to ensure that patients got in safely,” Hancock said. “We also redeployed people to the front lines to help with screening, and to the floors, to provide additional hands, since COVID-19 patients are very resource intensive.”
VCU Health System also found other ways to redeploy staff. Following the example of other states, Hancock said, the health system converted a dorm on its campus, which previously was a hospital, into a surge capacity center.
“We converted it in two weeks back to a hospital, and we got temporary licensure for that hospital,” Hancock said. “And today it stands fully equipped and ready to go at a moment’s notice. That’s another reason we didn’t furlough and lay off anybody, because we were going to need to staff that hospital’s nearly 180 licensed beds. The licensure has now been extended through the pandemic, not knowing what a future surge would look like.”
VCU Health System also made a commitment to childcare for its employees.
“We partnered with the area agencies, the local YMCA and others to open up additional childcare centers to help our employees,” Hancock said. “Then, when the Families First Coronavirus Response Act was passed, VCU Health System opted into it. Prior to that, we had covered one week of quarantine, and now, under the legislation, we cover both weeks of any required quarantine for a staff member.”
All that is not to say VCU Health System didn’t make difficult decisions, or that it did not experience a negative impact from COVID-19. Hancock noted that, as of early June, the health system overall had lost $150 million in net revenue.
“Just like everybody, we’ve reviewed every project, and we’ve had to curtail things,” Hancock said. “But we’ve also been very honest with our employees. The only reason we could do what we’ve done is that the employees helped us get in a really good financial position before the pandemic, which is now carrying us through the crisis. So we are giving back to them.”
VCU Health System’s actions and unique circumstances enabled it to quickly project a positive financial outlook. “Because we have been able to reactivate quickly, with a return to non-urgent procedures, we have a chance to end our fiscal year in June with a positive bottom line. As of May, many of our services were scheduling close to, and even above, 100% pre-COVID-19 volumes. And I think a key factor was that we didn’t lay off anyone.”
But she also acknowledged that the prospect of a positive bottom line may be out of reach for many other hospitals and health systems.
“I am not recommending to anybody that they should have followed our example,” Hancock said. “I want to be super clear about that. You cannot compare one health system to another.”
Each hospital and each health system has to make its own decisions according to the demands of its situation and its market, Hancock said.
“And we’re in totally different markets.”
Hancock pointed out, for instance, that VCU Health System is an urban academic medical center with other community hospital sites, with a payer and patient mix that differs from that of other health systems. She also noted that the acuity of patient conditions at VCU Health System has gone up during this time.
“Part of what I learned as chair of HFMA is that healthcare is indeed local, and you cannot compare it. So don’t judge.”
Laying a groundwork to weather a crisis
Intermountain Health in Salt Lake City has been able to weather the COVID-19 crisis because of its efforts prior to the pandemic, and the commitment of its workforce, said Kerry Gillespie, CPA, the health system’s CFO for specialty-based care. And as with VCU Health System, redeployment was a centerpiece of Intermountain’s response.