The pandemic has dealt Kent Hospital a financial and staffing blow that only an injection of funding and a reduction in Covid patients can remedy.
Dr. James Fanale, Care New England President and CEO gave the Warwick Rotary Club an unvarnished appraisal of what CNE and Kent, the state’s second largest hospital, face at the club’s weekly luncheon meeting at Chelo’s Restaurant.
Fanale opened with the promising observation that while Covid patients fill the hospital, the surge of the last month has leveled and he expects that it has peaked. He said the Omicron variant has a lot of people sick, but not a lot of people very sick. He said that generally those who are very sick have not been vaccinated.
“The good news is that the number of cases is declining every day,” he said.
What hasn’t stopped is the financial bleed and the impact the pandemic has had on the nursing staff. Fanale said he doesn’t expect Kent to turn around monthly losses of $2 million until the number of Covid patients drop dramatically and the hospital can return to elective procedures that not only need to be addressed but generate revenues. Many of those procedures could be performed now if it wasn’t for a lack of nurses. Last week Kent stopped all non-emergency services because it needed all its staff to care for Covid patients. He thought that would change by this week, but “the impact of that financially is enormous,” he said.
Fanale said several factors have played into a shortage of nurses starting with Covid and including retirements, changes in careers, burn out because of Covid and departures to take higher paying jobs with an agency or what are termed as “traveling nurses.”
He said Kent nurses are paid about $45 an hour, but when the hospital has to rely on traveling nurses to fill gaps in staffing, those nurses can get paid as much as two and three times that wage an hour, and the cost to CNE is $190 an hour. Some of those traveling nurses, who aren’t paid benefits and aren’t guaranteed work are the nurses who left their jobs at Kent.
Fanale doesn’t blame them for leaving to get paid more, but he noted it has had a demoralizing effect on the staff that has stood by the hospital and patients through the pandemic. He applauded the resilience of the Kent staff more than once during his talk.
Fanale also spoke about Women and Infants Hospital and Butler Hospital.
He said “behavioral health needs are incredible” and that at Butler an auditorium has been converted into a ward with 25 beds to meet the need and provide beds for patients who would otherwise be in waiting rooms in hospitals across the state.
Fanale called the pandemic “an economic disaster that has cost us tens of millions of dollars.”
He asked rhetorically how CNE could stop the financial drain.
“You can close Kent and you don’t lose $2 million a month. We can’t do that,” Fanale said. Putting the financial impact of the pandemic aside, Fanale said the reimbursement provided by Medicaid falls short of the cost of the services provided. On the one hand, he said, it is a positive than virtually everyone has healthcare coverage and that healthcare systems are getting paid. On the other hand, he said that 35 percent of CNE patients are on Medicaid and that with each case CNE is losing money. He called on the state to increase Medicaid reimbursements to hospitals.
Fanale also touched on the plan to merge CNE and Lifespan, which is under review by the Rhode Island Attorney General and the Federal Trade Commission. The plan was the subject of a public meeting Thursday night, and was endorsed by Fanale and his counterpart Dr. Timothy Babineau at Lifespan.
At the Rotary Club meeting, Fanale was critical of an op-ed published in last Thursday’s Beacon written by Dr. Michael Dacey, the former president and COO at Kent who reasoned the merger would be bad for Kent and the state. Fanale didn’t get into specifics, but said some of the data Dacey used to support his argument was not factual and what Dacey suggests “are not solutions.”
What bothers him most, he said, is that Dacey’s comments implied “we don’t know what we’re doing.”
Fanlae said CNE and Lifespan have spent $14.1 million each to advance the merger through the regulatory process to date. He said if the merger gains approval there would “be oversight to ensure there is not a monopoly.”