Becker's Hospital Review

59 PRACTICE MANAGEMENT THOUGHT LEADERSHIP The Impact of Hurricanes, the Resilience to Build Back: 5 Questions With Schneider Regional Medical Center CEO Dr. Bernard Wheatley By Alia Paavola and Julie Spitzer T wo Category 5 hurricanes slammed into the U.S. Virgin Islands in Septem- ber, stripping off roofs, knocking out power lines and flooding streets. About four months after the storm, many of those who once called those islands home still had yet to return and most places on the islands lacked power. Schneider Regional Medical Center, the only hospital on the island of St. omas, which is part of the U.S. Virgin Islands, hardly made it through the storms. It lost a section of its roof, its entire cancer center and suffered a drastic decrease in patient volume affecting staffing, revenue and the range of services available. "Every area of the U.S. has different disasters. In the Caribbean, our biggest threat is hur- ricanes, and it's unprecedented to go though not just one but two Category 5 hurricanes ... but we have to rebuild," says Schneider Re- gional Medical Center CEO Bernard Wheat- ley, DBA. "It's completely wreaked havoc on the island and our health system." e 159-bed facility offers a range of services spanning from behavioral health to med-surge capabilities. It has eight operating rooms, an eight-bed intensive care unit and an emergen- cy room. Before the storms, the hospital would see about 80 to 90 patients each day, or close to 20,000 emergency room patients per year. "We are a typical hospital with ambulatory sup- port, labs, radiology, physical therapy, dietary, wound care," Dr. Wheatley says of Schneider. Aer the storms, Dr. Wheatley says visits have dwindled to 40 to 50 patients per day. e hospital's chemotherapy unit, which once saw 75 patients each day, now sees only seven. Only two of its operating rooms are function- al and its monthly revenue dropped from $5.2 million to $1.6 million. Becker's Hospital Review spoke with Dr. Wheatley in December about the hospital's post-storm challenges and recovery efforts. Note: is interview was edited for length and clarity. Question: What protections were tak- en as the hurricane approached? Dr. Bernard Wheatley: We began to down- size inpatients and move them … We dis- charged those we could. Once the hurricane came upon us, the U.S. Department of De- fense, National Guard and the U.S. Public Health Service helped facilitate the transfer of patients off the island. … Patients were moved out to protect them. Q: Can you describe how the hurri- cane impacted your organization be- yond damage to the building itself? BW: I would say beyond infrastructure dam- age, our patient volume has dramatically de- creased since the storm. Prior to the storm, we saw an average of 80 to 90 patients per day, but that has dropped by roughly 50 percent. e average length of stay has also dropped from 6.1 days to 2.9 days. We no longer have the bandwidth, structures or staff levels to provide the same number of treatments and procedures as before. I would estimate that was cut by 50 percent, too. Outpatient ser- vices have also decreased by an average of 50 percent. In essence, there's been a significant loss to our revenue stream due to a decrease in patient volume. ... We've gone from $5.2 million in revenue per month down to $1.6 million per month. at will come back slow- ly, but that is what is happening right now. e storm has been detrimental [to staffing levels]. We have had 58 separations since the storm, 46 were layoffs [and] another 12 po- sitions were simply eliminated. Additionally, we lost 30 contracted nurses and employees. And, there are another 37 employees cur- rently on extended leave and extended family medical leave due to the storm. Additionally, a considerable portion of our staff has simply vacated the island because of damages to their houses — the complete loss of their roofs, no electricity and other major devastations. [In regards to power,] we were very lucky on this end, I think because we are the only hospital on the island. … We were on a gen- erator for only one week. Shortly after, we were able to connect back to power through an agency in the Virgin Islands called the Water and Power Authority. Q: What has been the biggest chal- lenge since the storm? BW: e sheer loss of revenue, the financial impact, has been detrimental. e structural damage is something we are getting help with and something we will be able to deal with as [the federal government] helps. But it's truly been the financial impact, which has caused us to reduce our force and lay off many em- ployees in an effort to decrease the losses to our organization. ere's only so much an or- ganization can absorb. Q: Can you describe the fiscal ef- forts your health system is taking to bounce back? BW: We have been working with a number of entities [including, teams, associations, the U.S. government and the U.S. Treasury] to obtain disaster relief funds, which has come with some success in regards to supplies and equipment. We obtained a hurricane relief fund for employees, which we have been able to distribute to help them rebuild their lives … If we get this working capital it would help us improve and rebuild. Q: Do you have any additional thoughts? BW: It will take years to get this island back to where it was before the storms. ... Even the infrastructure of the island, the power. I still don't have electricity in my own home, and it has been three months, and I have no fore- cast of when I will once again have power. And now, trying to rebuild a hospital, without knowing what the settlement, relief fund will be from the government, is a hurdle and we will have to wait and see, but we have to re- build. We have to rebuild because we are the only hospital on the island. n "We no longer have the bandwidth, structures or staff levels to provide the same number of treatments and procedures as before."

• Cover