Rural hospitals' broad experience can help in covid-19 fight

As the saying goes, necessity is the mother of invention. For many rural hospitals trying to cope with the influx of covid-19 patients, years of having to be flexible and make do with limited budgets and supplies could give them a leg up in fighting the pandemic, Ginger Christ reports for Modern Healthcare.

Tim Putnam, president and CEO of Margaret Mary Health, said the 25-bed hospital in Batesville, Indiana, has been struggling with the extra load since mid-March. "The hospital that normally has 15 patients at a time had as many as 28 patients at one point and went from being 80% outpatient to 80% inpatient, Putnam said. They had to purchase seven more ventilators to double their capacity to intubate patients," Christ reports.

But Putnam said rural hospitals' flexibility can help with the pandemic. "In rural hospitals, staff often have a broad scope of responsibilities and deal with a lot of different illnesses, Putnam said. Caregivers aren't separated by departments in the same way that they are in urban settings. That experience helped prepare them to respond to covid-19," Christ reports. One University of Minnesota study found that rural nurse practitioners at primary care clinics have more autonomy in every measurable way than their urban peers.

Rural hospitals are applying that flexibility not only internally, but externally. Some community hospitals, including Putnam's, have banded together to share staff as needed when local outbreaks sap their staff, Christ reports.

Such partnerships may prove critical to rural hospitals' ability to weather the pandemic, though the CARES Act provided some relief. "About 80 percent of the income for rural hospitals comes from outpatient services, which have not yet recovered," Christ reports. "Through April 15, 14 rural hospitals in the U.S. permanently shut their doors, which is on pace to the be the largest number of closures yet."