A troubling new paradox is emerging in local health care as hospitals and clinics try to stay staffed up and ready for an expected surge in COVID-19 cases at a time when they are bleeding red ink because of a sharp drop in normal business.
The balancing act in medical staffing highlights financial vulnerabilities facing medical institutions on the front line of Kern County's response to the coronavirus pandemic.
Hospitals and other medical care providers said Monday they continue to see patients for everyday events unrelated to the new coronavirus, such as births and broken arms. But they emphasized volume is well below normal levels and financially unsustainable depending how long the crisis continues.
Inpatient volume is down 30 percent at Ridgecrest Regional Hospital, CEO Jim Suver said, and outpatient care was off 60 percent before the medical center halted all such services to non-acute patients.
He said the resulting hit to revenues will be "very challenging for us," though he does not anticipate the need for layoffs.
"We certainly have some concerns about the financial effect that we’re going to be having probably for the next month and a half or so, depending when the peak happens,” Suver said. He added that the hospital has redeployed staff who would have covered outpatient services to help with tasks related to the pandemic.
In some cases, the pandemic has created additional work requiring substantial expenditure of resources — but which comes with no compensation.
Dr. Dan Erickson, emergency physician and co-owner of Accelerated Urgent Care, said his staff is working long hours to meet paperwork requirements associated with the processing of patients' COVID-19 tests that his company does not perform and is unable to bill for.
At the same time, he said fewer outpatients than normal are coming in for services.
"It feels like we’re a lot more busy now but we’re not," he said.
Kern Medical Center CEO Russell Judd said several days ago he is not looking for additional workers and that, in fact, he had more staff on duty than patients in need of service.
"Right now, volumes in the hospital are very low," Judd said.
Other local hospitals were highly guarded in their comments.
San Francisco-based Dignity Health, which represents Mercy Hospital Downtown, Mercy Southwest and Bakersfield Memorial, said it would offer no comment Monday for this story.
Roseville-based Adventist Health, which owns hospitals in downtown Bakersfield, Delano and Tehachapi, said it was adjusting its staffing levels to meet demand. But it would not say whether that meant adding staff or sending employees home.
The company emphasized it is still hiring for essential positions that are currently open.
A spokeswoman for Bakersfield Heart Hospital said the medical center is "fully staffed for the patient census at our hospital." She would not say, however, whether the patient population is up or down as compared with normal occupancy levels.
Spokeswoman Laura Sabedra explained by email Bakersfield Heart continues to treat and admit patients who come to the hospital's emergency department. If additional personnel are needed to address a COVID-19 surge, she said, outpatient staff will be called to do so at the center's existing outpatient facilities.
Medical centers up-and-down the state are canceling most elective procedures as long as they're not emergencies, said Jan Emerson-Shea, vice president of external affairs at the California Hospital Association trade group. They're also discharging patients who don't require the level of care provided by acute-care facilities, she added.
The idea is to preserve the availability of beds, equipment and supplies for a surge in COVID-19 cases observers say is coming in the next several weeks.
Individual hospitals are deciding for themselves how to make the best use of staff who are not on the front lines, Emerson-Shea said by email.
That may mean creating "labor pools" of workers who can be reassigned to other parts of the hospital, she noted.
"Others are encouraging some staff to take vacation time now — knowing that these individuals may be called back when the surge hits," she wrote.