At a special meeting Thursday, the Powell Valley Healthcare Board of Directors discussed how the hospital is weathering the pandemic — and how the health care organization will move forward as it becomes safe to do so. PVHC recently got a boost from the federal CARES Act, receiving a $5 million loan to help meet payroll and other obligations.

The Powell hospital has stopped performing elective surgeries and a number of other procedures, such as mammograms, but officials are hoping to resume them as the state opens back up.

Despite the name, “electivae” surgeries are not optional or unnecessary procedures. Rather, they are procedures planned in advance, as opposed to those done in an emergency.

Amid the COVID-19 pandemic, the U.S. Centers for Disease Control and Prevention has encouraged medical providers to reschedule elective and non-urgent admissions and procedures, among other guidelines. That’s in part to preserve supplies of personal protective equipment.

No federal, state, or county directive has forbidden health care providers from doing elective surgeries, Dr. Nathaniel Rieb said.

“The reason we stopped doing elective surgery is outside forces that weren’t mandating it but pressuring us to stop doing elective surgery,” Rieb explained. “My position is when we’re ready to bear the heat from outside forces, we can start doing elective surgery.”

Powell Valley Healthcare CEO Terry Odom said she concurred with the surgeon’s position.

Based on University of Washington modeling, PVHC is estimated to hit its peak around April 30. Odom explained to the board that the hospital was trying to balance safety with its needs to be financially viable.

“We’re starting to plan how to get back in business,” she said. “We’re trying to use our common sense and look at all the data, but remain sustainable as an organization.”

She said the model suggests that Billings Clinic is in the middle of its peak demands on hospital resources from the coronavirus.

“It’s not as critical as they thought it would be,” Odom said.

No layoffs

Although there was concern among the roughly 420 PVHC staffers over the possibility of layoffs or furloughs — as many hospitals across the country are experiencing — “there will not be that here,” Odom said confidently.

PVHC does have employees who won’t be needed, as some health care services are being postponed during the pandemic. These employees, Odom said, can either use sick leave, paid time off, or time off without pay — or a combination of those options. Once those options are exhausted, the employees can file for unemployment, and the hospital will cover the cost of the employee’s benefits.

“So they are still our employees — and we don’t have anyone in that circumstance yet,” Odom said.

Employees at PVHC’s internal meetings also had a lot of questions about travel. The hospital has one employee who commutes from Montana. As a health care employee, this person is classified as essential and doesn’t have to quarantine for 14 days, as the state is requiring for those traveling to Wyoming from other states.

One employee was traveling to Idaho through Montana when Gov. Mark Gordon enacted the quarantine rules. The respiratory therapist was put on quarantine and was due to come back to work on Monday.

$5 million in PPP funding

Joy Coulston, PVHC CFO, was commended for her work to secure funding through the federal Payment Protection Plan. Multiple application changes, website crashes and closed bank lobbies made the process challenging, but she managed to get PVHC a loan for $5 million. The funding will pay for PVHC employees’ salaries and benefits, with the amount matching what the organization spends in eight weeks on wages and benefits, Coulston said.

She also gave a shout out to the bank: “First Bank went above and beyond,” she said.

The program requires the health care organization to keep 75 percent of its full-time employees working, and it must spend the entire amount within eight weeks. If the organization does that, the loan will be forgiven; if not, then some or all of the funding could become a loan that PVHC would have to pay back. 

Coulston is also pursuing funding through the U.S. Department of Health and Human Services. The agency received $100 billion in funding through the Coronavirus Aid, Relief, and Economic Security (CARES) Act, of which $30 billion is currently being distributed. Coulston said PVHC would receive approximately $772,000 from that source.

The funding can be used to cover expenses and losses of revenue due to the pandemic.

The hospital also received a $90,000 grant from the state through a Medicaid program, and it is filing an insurance claim for the business disruptions it’s faced due to the pandemic. Coulston said that might bring PVHC about $100,000.

The state will receive $1.25 billion from the CARES Act. Sen. R.J. Kost, R-Powell, who is a member of the PVHC board, said that based on what he’s hearing in legislative discussions, hospitals are high on the list of priorities being considered for state funding, but exactly how much would go to PVHC is still uncertain.

Supplies

The Powell Valley Care Center and The Heartland have both mandated that all employees wear masks throughout their shifts, in order to protect the high-risk patients and residents they care for throughout the day. These masks can be particularly uncomfortable, especially when they are worn for long hours.

PVHC is seeking cloth masks — and many are being produced in the community by volunteers. Coulston is also looking into some programs through FEMA that might provide the hospital with needed supplies.

The board will meet again on Monday, April 27, for its regular monthly meeting.