but we're struggling to keep staff pay and keep the doors open,

Covid-19 has completely ravaged hospitals across the country.

All across the state, rural hospitals are on the brink of collapse.

Two hospitals closing for good, leaving patients and doctors to fend for themselves.

Hospital administrators are fearing shortages in staffing and supplies and in cash.

The Boston Consulting Group said in a recent report report that during this pandemic, about one out of every five U.S. hospital systems is on the brink of insolvency.

The longer this goes on, and when I say that, I'm not talking about months or quarters on the calendar.

It's literally weeks because every week that goes by that many more hospitals that are going to be closing.

And so it really is that urgent.

It's brought to the fore the fragile nature of health care, and rural health care in particular.

If you can't keep hospitals, especially in rural West Virginia, rural America,

then we've got no money to take care of our citizens.

This is Scott Graham.

I am the CEO of two hospitals, two small rural hospitals

and both of those hospitals have been hit especially hard by Covid-19.

This moves so quickly that one day we we're talking about our plans to grow and develop our service lines.

And literally the next day we were talking about are we gonna be able to stay in business?

Both Three Rivers and North Valley Hospital have been struggling to be profitable long before the Corona virus.

Prior to all of this, Three Rivers Hospital, the one located in Brewster, Washington,

was really struggling financially and has been for many years, probably two decades.

Some of that has to do with the fact that it's located in a very sparsely populated area.

So patient volumes are pretty low and we rely on patient volumes for the revenue that we get

to cover the cost of the care that we provide.

A lot of hospitals in the US have been in dire financial straits for a while now.

We know that at least 30 hospitals entered bankruptcy last year alone,

and that's just a continuation of a trend that's been going on for several years.

About 120 or so rural critical access hospitals have closed since 2010.

To understand why hospitals are in so much trouble, you have to understand how they make their money.

Hospitals and physicians are paid really by three primary payers.

Medicaid, Medicare and then commercial insurance.

There's obviously patients who pay for their own services, but that's a very small portion of how hospitals and physicians are paid.

Nearly 80 percent of hospitals revenue is generated by high margin specialized surgical procedures.

The best example would be orthopedic knee, knee elbows, shoulders, a total joints.

Those are typically called elective procedures because they can actually wait.

They don't need to be done emergently.

We have general surgeons who do a variety of different types of surgical procedures from colonoscopies to endoscopies

to appendectomies and those sorts of things.

And usually those do well enough that they can make up the difference for what our other services don't.

Once Covid-19 hit, those moneymaking elective surgeries vanished.

The surge of Covid-19 in southeast Michigan is having a chilling effect on the health systems non corona virus services.

The impact is leading to some hospital staff members losing their jobs.

Both speaking for hospitals and also for physicians, it's obviously chaos.

There have been rapid changes in the law in the last four to five weeks since the pandemic was declared.

They have not been allowed to do what they call elective procedures.

So anything that can wait has to wait.

Compounding the problem of no more elective procedures are patients without Covid-19 avoiding hospitals altogether.

What I hear across the board from my hospital clients around the country,

because we have a national practice,

is that the number of patients that are in their hospital is at least one half,

if not greater than what it normally is at this time of the year.

And if a hospital closes in an urban area, it might be difficult for the community but not a catastrophe.

The same can't be said for hospitals in rural areas.

The hospital has a symbiotic relationship with the community.

We not only provide care and very much needed care.

We not only save lives every day, but we provide a livelihood for many of the folks who live and work in these communities.

We employ nurses and doctors and surgery, tax and housekeepers and dietary folks,

and they all live in these communities and contribute to the economy.

And we're we to no longer be able to exist.

There would be a large gaping hole in the economy here in Okanogan County.

Hospitals are not just one of the most important health care providers in America

They're also one of the largest employers in America.

So with all these hospitals on the brink of insolvency, the government had to step in.

We haven't seen that flood of bankruptcy filings that may come yet.

And in part, that's because the government recently passed this multi-trillion dollar stimulus bill.

The 2.2 trillion dollar CARES Act is comprehensive and absolutely needed.

A significant amount of this money will go to the hospitals and hot spots.

While a portion of it will reimburse hospitals for the cost of treating uninsured patients and for the Corona virus.

There was about a hundred billion dollars allotted to hospitals across the country.

We're very grateful that the CARES Act was passed.

And it has provided some initial help, though, it is not sufficient to get us through this.

Three Rivers Hospital got about 307,000 dollars from the CARES money

and that will give us nearly a month's worth of cash on hand.

It really is just a Band-Aid right now for the greater financial crisis to do the healthcare industry.

So while the first round of federal aid has helped. The problem is far from being solved.

Hospitals are getting an additional $75 billion as part of the latest

bailout package approved by Congress on April 23,

But it still may be be enough. More government aid could be needed as the pandemic continues.

This really affects every physician, every dentist, every health care professional in the country.

I think what this is helped people realize is even hospitals may not be there if we don't take care to help them be there.

Obviously, we're going to need more and we hope that that support continues.

But actually, it's it's given me a lot of hope.