Cleveland hospitals delay surgeries due to COVID-19 spike

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The Cleveland Clinic, including MetroHealth and Unversity Hospitals in Cleveland, Ohio, will be postponing some surgeries due to a spike of COVID-19 cases in the area, turning the clock back to the height of the pandemic when many facilities placed a freeze on elective procedures.

In a joint announcement, the organizations said they're experiencing "unprecedented demand" for inpatient care, leading many facilities to deal with near-full capacity. 

Unvaccinated patients comprise the bulk of the new hospitalizations. Statistics released by the three systems reveal that more than 90% of COVID-19 patients in intensive care units are unvaccinated. Most of the vaccinated patients who are hospitalized have underlying health conditions that place them at greater risk.

While Cleveland Clinic and the MetroHealth system have seen a significant increase in hospitalized COVID-19 patients, University Hospitals have been slammed particularly hard, reportedly seeing a "record-high census" of such patients.

The surge has prompted the organizations to adjust the scheduling of non-urgent surgeries at certain locations, with an eye toward freeing up resources for patients "with immediate and life-threatening needs."

The move also manages the demands of frontline caregivers, the systems said.

WHAT'S THE IMPACT

Delaying non-urgent and elective surgeries was a common tactic hospitals used at the height of the initial wave of the pandemic in 2020. Then, as now, surges of COVID-19 patients strained hospital staffs and forced many to reprioritize their resources.

Cleveland Clinic will temporarily halt the scheduling of additional non-urgent surgeries in all Ohio locations, save for Euclid and Lutheran Hospitals, beginning today and lasting through January 3, 2022. Essential and urgent surgeries, as well as heart, cancer, pediatric and transplantation surgeries, and outpatient surgeries not requiring a hospital bed will continue to be scheduled.

University Hospitals is currently rescheduling certain non-urgent surgeries at UH Cleveland Medical Center that require an inpatient stay for a short duration. For the time being, the hospital continues to perform urgent surgeries and outpatient surgeries and procedures that do not involve an overnight stay. 

University Hospitals continues to perform all types of surgeries and procedures at its community hospitals although the situation is fluid and subject to change, the system said. University Hospitals' physicians are seeing patients as they always have, and UH labs and testing centers are open.

MetroHealth, meanwhile, is postponing some elective surgeries to free up space and is also exercising other options such as encouraging more use of its Hospital in the Home program to meet the latest patient surge.

THE LARGER TREND

If the move to delay some procedures is a foreshadowing of things to come nationally, hospital finances could be affected significantly. In July 2020, American Hospital Association President and CEO Rick Pollack, pulling from Kaufman Hall data, said the cancellation of elective surgeries was among the factors contributing to an industry-wide loss of $120 billion from July to December 2020 alone. When including data from earlier in the pandemic, the losses were expected to be approximately $323 billion.

Most hospitals adjusted their costs to mitigate some of the financial hit. Even some larger systems such as the 92-hospital nonprofit Trinity Health in Michigan took measures such as laying off and furloughing workers and scaling back working hours for some of its staff.

A Kaufman Hall analysis released last week found that labor expenses are stubbornly high. Total labor expense rose 2.7% from September to October, 12.6% compared to October 2020 and 14.8% compared to October 2019. At the same time, full-time equivalents per adjusted occupied bed decreased 4.5% year-over-year from 2020 and 4.1% from 2019 – suggesting higher salaries prompted by nationwide labor shortages that are driving up labor expenses, rather than increased staffing levels.

That data, which is from October, is consistent with a recent report released by Fitch Ratings that found labor shortages and supply chain challenges to be a rising threat to profit margins for healthcare and pharmaceutical companies. The scarcity of workers is likely to increase pressure on some issuers' margins in the near term but is unlikely to trigger any credit downgrades, the report said.

Multiple factors are contributing to labor pressures, including staff burnout caused by the pandemic and an overall shortage of qualified help, which has resulted in higher costs to hire temporary staff, as well as wage inflation.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com