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PA Hospitals Out $5 Billion From COVID-19

Pennsylvania hospitals reported a combined $5 billion in additional expenses and lost revenue associated with the COVID-19 public health emergency during the nine-month period from January through September, according to a new report from the Pennsylvania Health Care Cost Containment Council.

The report breaks down the additional costs and lost revenue as follows:

staffing expenses – $379 million
testing expenses – $81 million
supplies and equipment: $258 million
construction – $21 million
housing care – $500,000
other expenses – $88 million
lost revenue – $4.1 billion

These figures, the report notes, do not reflect emergency funds hospitals received through the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), or the Paycheck Protection Program and Health Care Enhancement Act.

Learn more about how COVID-19 has affected the financial performance of Pennsylvania’s hospitals in the PHC4 analysis “COVID-19 Disaster Emergency Report.”

PA Safety Net Admin2021-01-18T06:00:13+00:00January 18th, 2021|Coronavirus, COVID-19|Comments Off

COVID-19 Update: Wednesday, January 13

The following is the latest COVID-19 information from the state and federal governments as of 4:30 p.m. on Wednesday, January 13.

Pennsylvania Update

The Wolf Administration

The Wolf administration has announced that the state is transitioning from the Regional Response Health Care Collaboration program (RRHC) created last year to a Long-Term Care Task Force that includes Regional Congregate Care Assistance Teams (RCATs) to continue supporting those facilities. The ten health systems that participated in the RRHC will continue to work with the RCATs, with some previous RRHC functions to be performed by separate contractors. The program has been allocated $12 million for January and February. Learn more about the transition, the new program, and the contractors in this Wolf administration news release.

Governor Wolf and Secretary Levine

On Monday, January 11 Department of Health Secretary Rachel Levine held a news briefing and the following day she participated in a separate briefing led by Governor Wolf. Highlights from the January 11 briefing:

As of January 11, when this briefing was held, the state has received 827,000 doses of vaccine and 285,000 of them have been administered. This latter total may not include some administered by CVS and Walgreens, which are serving long-term-care facilities. They take as long as 72 hours to report on how many vaccines have administered.
Operation Warp Speed says Pennsylvania will receive 138,000 new doses this week.
It will take several months before there is enough vaccine for everyone, Secretary Levine said.
Doses are going directly from federal sources to hospitals and other providers and those providers are often receiving them with very little advance notice. Notification comes from Operation Warp Speed, not the state.
The state expects more than $100 million to help administer vaccines; this money comes from the end-of-the-year COVID-19 relief/stimulus bill.
The perception that the state has been slow to administer vaccines is largely a function of unrealistic projections from the federal government, especially during the holiday season, Secretary Levine said.
Pennsylvania is considering expanding access to vaccines to Phase 1-B individuals (seniors).
In response to concerns about people choosing not to be vaccinated, Secretary Levine said that the federal government needs a better plan for communicating the importance and effectiveness of the vaccines and the state will be doing the same.
Pennsylvanians should not expect to see the impact of vaccinations on new COVID-19 case levels for several months.
Secretary Levine said she has received no reports of hospitals discarding unused vaccines.
In response to questions about new guidance from Washington about vaccination priorities, Secretary Levine said that she and the Department of Health have not yet seen that guidance and will review it before making any changes in the state’s current approach, although she supports vaccinating additional elderly individuals when programs are in progress and there is serum available.

Highlights of the joint January 12 news briefing:

311,000 vaccines have now been administered, including to more than 52,000 skilled nursing facility residents and staff.
Special testing is needed for the new (UK) strain of COVID-19. Based on the genetic content of current test results, the state is directing that some samples be sent to the CDC or CDC-designated labs for further analysis to ascertain whether they are the UK strain. The state hopes to develop the capacity to do these tests itself at its Exton lab sometime next month.
About two percent of Pennsylvanians have received the vaccine, Secretary Levine said. That roughly tracks the current vaccination rate nation-wide, she said.
There have been no reports of people trying to jump the line to get vaccines, Secretary Levine said.
In response to a question, Secretary Levine said that while rural areas did not receive doses of the Pfizer vaccine because they lack facilities to store it, those areas have received, and will continue to receive, the Moderna vaccine and others as they become available.
The state’s partnership with rural pharmacies to administer vaccines should begin the next few weeks.

Department of Health – by the numbers

After several days of its highest new case counts in several weeks, the number of new COVID-19 cases reported in Pennsylvania has declined significantly in recent days.
The death toll remains high, however, and yesterday the state surpassed 18,000 deaths since the pandemic began.
For the week from January 1 through January 7 the state’s overall COVID-19 test positivity rate fell to 14.4 percent; it was 15 percent the week before that. This marked the third consecutive week the rate fell slightly.
Despite this modest decline, all 67 Pennsylvania counties remain in “substantial level of community transmission,” as has been the case the past several weeks.
Fourteen of those counties have positivity rates greater than 20 percent, down from 27 such counties the previous week.
The numbers of Pennsylvanians hospitalized with COVID-19, in hospital ICUs, and on ventilators remain very high but are at their lowest levels since early December.
Nearly 21,000 health care workers in the state have contracted COVID-19.
More than 68,000 long-term-care facility residents and employees have contracted COVID-19 in 1500 facilities in all 67 Pennsylvania counties.
Currently, 16 percent of adult ICU beds in the state are unoccupied, as are 14 percent of medical/surgical beds, 14 percent of pediatric ICU beds 28 percent of pediatric beds, and 32 percent of airborne isolation units.
In its “Reduction of Elective Procedures” dashboard that tracks the criteria the state is using to determine whether to order hospitals to reduce or eliminate elective procedures to ensure their ability to handle possible influxes of COVID-19 patients, the state continues to flag a growing staffing shortage in hospitals in the state’s Keystone health care coalition region (Adams, Bedford, Blair, Centre, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Juniata, Lancaster, Lebanon, Mifflin, Perry, Snyder, and York counties). In that region, 41 percent of the region’s hospitals anticipate a staffing shortage in the coming week – more than the 33 percent level that the state believes poses a potential problem. The overall situation in the Keystone region, however, has not reached a point where the state would direct hospitals in this region to reduce or eliminate their elective surgeries.
As of January 13 the state’s vaccine dashboard shows that 300,000 COVID-19 vaccines have been administered so far and more than 42,000 Pennsylvanians have received both doses of vaccine.
The vaccine dashboard shows vaccine totals by county both on a map and in lists.
As ordered by the Department of Health in late 2020, health care institutions – hospitals, FQHCs, and others – must reserve 10 percent of the doses of COVID-19 vaccines they received for non-hospital health care providers. Now, the vaccine page on the department’s web site features a map of locations where non-hospital providers can obtain vaccines. The map includes contact information for non-hospital providers identifying whom they can contact to schedule their vaccines. State officials say more sites will be added to this map as more doses of COVID-19 vaccine become available.
Every week the White House Coronavirus Task Force provides a profile to the administration with data and recommendations for each state. Go here to see the latest (January 3) report for Pennsylvania.

Department of Human Services

DHS’s Office of Long-Term Living has issued vaccination information for its home and community-based providers.

General Assembly

House Bill 55 was favorably reported from the State Government Committee earlier today. This legislation would amend Pennsylvania’s constitution to limit gubernatorial emergency declarations to no more than 21 days unless the General Assembly agrees to extend it in whole or part. In addition, once a disaster emergency expires, the governor would not be able to declare a new one based on “the same or substantially similar facts” without approval from the General Assembly. Further, the bill would clarify that the General Assembly, through a concurrent resolution, could vote to terminate a disaster declaration without having to present it to the governor. Similar legislation was passed by both chambers in the previous legislative session. If it is passed by both chambers this session, it could be placed on the ballot as early as this spring for voter approval.

Around the State

Various jurisdictions are beginning to plan, or to establish, mass vaccination sites across the state. The Lehigh Valley Health Network will build a mass vaccine site at Dorney Park; the city of Philadelphia will open one at its convention center; Montgomery County at its Montgomery County Community College’s Blue Bell campus; and Delaware County in Yeadon. Allegheny County is still reviewing potential sites for mass vaccination facilities.
Reading Hospital has opened a tent outside its ER to handle a recent surge of COVID-19 cases, according to WFMZ.
The Lehigh Valley Live web site has posted an interactive map that shows COVID-19 case and death counts for every county in the state.
The mayor of Harrisburg has mandated that all city employees receive COVID-19 vaccines, the Harrisburg Patriot-News reports.

Federal Update

Provider Relief Fund

HHS has updated its Provider Relief Fund FAQ with nine new or modified questions on pages 12-13, 13, 15 (three questions), 40-41, 41, and 56. The new and modified questions address
- how changes of ownership affect providers’ ability to receive Provider Relief Fund grants and nursing home quality incentive payments;
- answer questions about audit deadlines and extensions;
- and describe the methodology for calculating Phase 3 distributions and the timing and size of those distributions.

Providers that have received past distributions and that believe they are eligible for Phase 3 distributions should review the updated FAQ carefully.

Department of Defense

The Department of Defense, which is playing a leading role in the distribution of COVID-19 vaccines, has posted a brief document titled “Officials Discuss COVID-19 Vaccine Deliveries and Prioritization Criteria.” The document outlines the status of vaccine distribution efforts to date, offers data on the number of vaccines that have been distributed and administered, and notes the expansion of vaccine administration to individuals beyond those considered to be the highest priority for receiving vaccines.

Department of Health and Human Services

HHS has updated its guidance for hospitals on the reporting of COVID-19 data. Hospitals now are asked to report data weekly on their administration of COVID-19 vaccines to health care personnel. This request is optional at this time, and the relevant portions of this document begin on page 13.
HHS has launched a web-based locator for sites that provide outpatient monoclonal antibody treatment for COVID-19. Go here to read HHS’s announcement about the new initiative and go here for the locator site itself.
HHS has established a “Vaccine Adverse Event Reporting” web site for individuals to report adverse reactions to COVID-19 vaccines. The site also offers data on adverse events that have been reported.

Centers for Medicare & Medicaid Services

CMS has issued a letter to state Medicaid agencies presenting Clinical Laboratory Improvement Amendments of 1988 (CLIA) Laboratories surveyor guidance for new and modified CLIA requirements related to COVID-19 test result reporting.

CMS COVID-19 Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information about the agency’s response to COVID-19. These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer participants an opportunity to ask questions of CMS and other subject matter experts.

CMS COVID-19 Office Hours Calls

Tuesday, February 2 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 4956655

Audio Webcast link: go here.

Tuesday, February 23 at 5:00 – 6:00 PM (eastern)

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 2528725

Audio Webcast link: go here.

Centers for Disease Control and Prevention

The CDC has updated its FAQs for laboratories about COVID-19.
The CDC has established a web page to track COVID-19 vaccinations. It includes data on vaccine dose distribution and administration, an interactive map for the individual states, and other data.
The CDC has updated its guidance on the importance of COVID-19 vaccinations for residents of long-term-care facilities.
The CDC has published research on the incidence of COVID-19 among people ages 0 to 24 in the U.S. between March 1 and December 12, 2020.

Resources to Consult

Pennsylvania Department of Human Services

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