As health care workers treat a growing number of coronavirus patients in hospitals across Tampa Bay, many are facing pay cuts, reduced hours and temporary assignments to other jobs.
The moves come as hospital systems in Florida and around the nation struggle to balance their financial health with the need to prepare for the coming surge of virus cases. Their bottom lines have suffered significantly as revenue-producing surgeries and other non-essential services have been halted to conserve supplies and free up resources.
“I don’t think people appreciate what’s happening inside hospitals right now. If you’re a critical care doctor, or you’re in the E.R., you’re busy,” said Dr. Charles Lockwood, dean of the USF Health Morsani College of Medicine at the University of South Florida. “But if you’re a urologist or an OB-GYN or a general surgeon, you’ve got nothing to do.”
As a sprawling medical enterprise impacted by these forces, USF Health has been “clobbered” financially, Lockwood said. “We’re looking at a $43 million loss.”
With more than 17,000 positive cases and the death toll nearing 400 as of Friday afternoon, Florida has yet to reach the peak of the outbreak.
“We’re in this tricky time where some hospitals are overloaded and others may be overloaded soon, but right now they’re not seeing the patients they typically would have seen, and the funding they’re getting isn’t sufficient to keep everyone on staff,” said Karyn Schwartz, a senior fellow with the Kaiser Family Foundation.
“It’s creating a challenge,” she said.
The impact on employees has prompted National Nurses United to file grievances against HCA Healthcare, one of the largest hospital operators in the country with 15 facilities along Florida’s Gulf Coast.
The grievances say nurses are being forced to use their paid time off if they must be quarantined. They are meant to “hold HCA accountable for its promises,”said union representative Erica Askin.
Nurses in the area also are concerned about reductions in pay, she said.
Some workers will be paid 70 percent of their base pay for up to seven weeks "until HCA Healthcare better understands the long-term implications of this pandemic on the organization,” according to an April 2 company announcement. Those affected include workers whose hours have been reduced at hospitals like the Medical Center of Trinity in Pasco County and St. Petersburg General.
HCA said it will also work to “redeploy” health care workers with reduced hours to clinical facilities or support areas in need. Some nurses reported that these temporary positions were too far out of the region to be a feasible employment option. The company said those who cannot be redeployed will receive the 30 percent pay reduction.
“This pandemic is unique, and our caregivers’ concerns are real,” Dr. Ravi Chari, president of HCA Healthcare West Florida, said in a statement. “We want them to know that we care like family, and we stand with them.”
Health care workers who must be quarantined under federal guidelines will receive 100 percent of their base pay for scheduled hours “regardless of where the exposure took place,” the HCA announcement said. However, staff who do not work in a patient-care facility and are quarantined will be eligible only for short-term disability while they are ill.
HCA said it is working with hotel chains to provide free housing for COVID-19 caregivers, and will offer child and elder care services and free telemedicine appointments.
The company’s senior leadership team said it will take a 30 percent cut in pay until the pandemic passes, the announcement said. HCA Healthcare CEO Sam Hazen is donating his full pay check for eight weeks to the HCA Hope Fund, a financial aid resource for employees.
Tampa General Hospital has not furloughed any employees, and officials are trying to develop new programs to help with pay and benefits for those whose work has been affected during the pandemic, said spokesman Curtis Krueger.
Health care workers who get sick on the job will be compensated through worker’s compensation. Those who become ill due to factors outside of work must use their accrued time off normally set aside for holidays, vacations and sick time. If those workers run out of that paid time off, “they will be paid a partial amount of their salary,” Krueger said.
“It’s a tough time across the country and we understand the high levels of anxiety that can come along with this pandemic,” he added.
BayCare Health System has not furloughed any of its workers at this time and does not plan to do so, said CEO Tommy Inzina.
The not-for-profit organization, which operates 15 hospitals in Tampa Bay and around Florida, is continuing to recruit and hire and has more than 2,000 open positions. However, hiring in some areas has slowed “as a result of providing only essential services” during the pandemic, according to spokeswoman Lisa Razler.
In departments where some services have been suspended, such as elective surgeries, BayCare is retraining and temporarily redeploying health care workers in other areas of the hospital at the same rate of pay, Razler said.
“For example, some of our clinical team members working at our outpatient surgery centers have been at Hillsborough County’s testing site at Raymond James Stadium,” she said.
If a reassignment is not available, team members are being paid and won’t have to use their paid time off, Razler said. That includes health care workers who have been exposed or contracted COVID-19 and must self-isolate, she said.
“Like almost every industry during this time, the COVID-19 pandemic has disrupted our normal workflows and had financial consequences," Inzina said in an email. He pointed to the postponement of elective surgeries as among the biggest revenue losses, but also cited “a general downturn" in people seeking medical services over fears they will be infected.
"It’s just too early for us to know the full financial impact,” Inzina said.
The AdventHealth system, which operates 10 hospitals in its West Florida division, has closed some of its wellness centers and departments in addition to limiting elective surgeries, said spokeswoman Ashley Jeffery.
Affected workers have been temporarily moved to other departments. Also, the system secured discounted rates on hotel rooms and is offering discounted or free child care. Employees can get “to go" family meals and groceries from hospital cafeterias.
Some relief is coming, as the CARES Act passed by Congress will deliver $30 billion to hospitals across the country this month. This first wave of funding is based on individual hospitals’ Medicare revenue.
USF Health, which employs physicians, nurses and other staff on the university and Tampa General campuses, has seen a tremendous drop in appointments. At one point business was down 90 percent, said Lockwood, the medical school dean.
He said the USF Health system was able to recover some of those initial losses by taking in patients through telehealth apps. But hospitals won’t be able to fully recover until it’s safe for patients to come back in, he said.
“Look at Tampa General. As the Level 1 trauma center, they had to clear out the most patients for a surge that hasn’t happened,” Lockwood said. “The economic consequences are extraordinary.”
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