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Mt. Ascutney, Gifford say they’re ready for influx of coronavirus patients

Valley News Staff Writer
Published: 3/24/2020 9:18:45 PM
Modified: 3/24/2020 9:18:42 PM

WINDSOR — Leaders of two of the Upper Valley’s critical access hospitals say they’re ready to weather an anticipated surge of COVID-19 patients.

Both Mt. Ascutney Hospital and Health Center in Windsor and Gifford Medical Center in Randolph have in recent weeks restricted visitors; begun screening patients and providers for symptoms of COVID-19 and testing for it as merited; and canceled elective procedures, freeing up space and staff to prepare for a wave of patients.

“We’re in a good position right now,” Mt. Ascutney CEO Joseph Perras said in a phone interview Tuesday.

Both Perras and Gifford CEO Dan Bennett said they aren’t certain exactly what the surge will look like or how long it will last, but they said they are confident in the steps they’ve taken to prevent transmission of the respiratory disease first identified late last year in Wuhan, China, and to prepare for inpatient cases, which neither hospital had yet seen as of Tuesday.

There were 95 cases identified in Vermont, including 15 in Windsor County and three in Orange County, as of Tuesday afternoon. At least one of the state’s seven deaths was a Windsor County resident.

In New Hampshire, health officials had reported 108 cases of COVID-19, including 21 in Grafton County and one in Sullivan County, as of Tuesday. So far, 13 of New Hampshire’s identified cases have required hospitalization.

In response to COVID-19 in recent weeks, Mt. Ascutney, which is part of the Dartmouth-Hitchcock Health system, has created two separate clinic spaces — one for patients who come in with respiratory complaints and another for those with other health issues. Perras said that has helped keep the five or six patients who have so far tested positive after samples were collected at Mt. Ascutney from transmitting the disease to others.

The 25-bed hospital has an adjacent 10-bed rehabilitation center that could be converted to a dedicated COVID-19 treatment unit, if need be, he said. In addition, he said Mt. Ascutney has the capacity to add another 10 beds if necessary.

The hospital has five ventilators on hand should patients come to them in need of mechanical assistance to breathe. Mt. Ascutney does not usually see patients who are that ill, so medical staff are updating themselves on how to care for people in such circumstances.

Perras said he hopes that, should patients in need of such treatment come to Mt. Ascutney, they come one or two at a time, not five at once.

“I don’t want to undersell how stressful it would be for a critical access hospital to have five vented patients,” he said. But, he added, “I don’t think we’re going to get to that point.”

Bennett, at Gifford, said he couldn’t say exactly how many more beds could be added to the hospital’s 25 licensed beds because that would depend not only on space, but also on staffing levels.

As he spoke, he said Gifford, which is a federally qualified health center, had three ventilators on-site, with six more on the way.

“That’s great as long as we don’t need more than nine at any given time,” he said.

During the lull while Gifford’s two adult day programs have closed and elective surgeries aren’t happening, Bennett said much of the focus has been on refreshing workers’ skills and cross-training workers so they will be prepared to handle COVID-19 patients.

If the hospital saw a large influx of COVID-19 patients, staff would be redeployed from other areas, including the anesthesiologists who aren’t needed for elective procedures at this time, Bennett said. Bennett also said some recent retirees have stepped up to help out.

Though it’s been challenging and stressful for staff members to prepare for a surge, Perras said they have stepped up.

“We’ve had very few folks say, ‘I just can’t deal with this.’ ” he said.

As of Tuesday morning, Mt. Ascutney had not had any staff members test positive and no inpatient patients had yet tested positive. That could change though, Perras said. And should dozens of providers be forced to stay home due to a positive test or possible exposure, that would affect the hospital’s ability to deliver care, he said.

Gifford, like Mt. Ascutney, has not laid off or furloughed anyone due to the low volumes of surgeries and corresponding lower revenues they have now. A few staff members have been sick due to illnesses other than COVID-19, or had to stay home with children, but staffing levels haven’t been seriously affected, Bennett said.

Both hospitals are working to develop their telemedicine abilities. At Mt. Ascutney, a couple of providers now have the ability to video-chat with patients. Others are checking in with patients via telephone.

The restrictions on in-person visits have helped Perras and his team to see that they need to encourage patients to sign up for their online portal so more can participate in telemedicine via video technology.

Similarly, Gifford providers are checking in with some patients by phone, but reimbursements for outpatient visits can’t make up for the loss of revenue from surgeries, Bennett said.

“We are hoping both on the state and federal level that there will be relief to hospitals,” Bennett said.

Gifford also may put some of its capital projects on hold in order to ensure it has the cash reserves it needs on hand, he said.

Perras also is looking to the future. Given that Mt. Ascutney, like most small hospitals, aims to break even or have a small positive operating margin in a good year, postponing elective procedures and telling people who would otherwise come in for appointments to stay home could seriously affect its finances, he said.

“These are going to be big holes that we’re going to have to climb out of,” he said.

For the moment, Bennett said, Gifford is doing what it can to support workers who like others in the community now have children at home and are worried about family members. One of the hospital’s social workers is running a recurring support group, he said.

In addition, hospital staff have been bolstered by the donations of personal protective equipment such as masks that members of the community have donated in recent days.

“It really means a lot to our employees (to) see the community appreciates what they’re doing,” Bennett said.

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.




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