By QUINTON SMITH/YachatsNews.com
The two hospitals in Lincoln County have resumed some elective medical procedures that were ordered stopped by Gov. Kate Brown at the start of Oregon’s response to the coronavirus pandemic six weeks ago.
Brown and the Oregon Health Authority partially lifted restrictions on non-emergency care on Friday.
That’s when Samaritan Pacific Communities Hospital in Newport and North Lincoln Hospital in Lincoln City resumed in- and out-patient care such as elective surgeries, physical therapy and mammograms.
But the number of patients is very limited for at least two weeks and the hospitals have to closely monitor and twice daily report their number of open beds and amount of personal protective equipment.
For now, the hospitals can only do elective care at 50 percent of their former, average volume of patients, said Dr. Lesley Ogden, chief executive officer for the two local hospitals.
“And that’s very wise. That allows us to bring in people slower and more safely,” she told YachatsNews.com. “And, we have to make people comfortable to come in.”
The hospitals are still requiring patients to enter through a single door near their emergency rooms, be checked by an employee and they must wear a mask at all times. Companions and visitors are also still limited. 
The loosening of restrictions on hospitals reflects some of the soon-to-come relaxation of travel and business guidelines put in place by the governor March 23 in an effort to slow the coronavirus spread, preserve medical equipment and keep hospital beds available.
That crush of cases and run on care has not been widespread across Oregon or Lincoln County. As of Sunday, there have been 2,680 reported cases of COVID-19 in Oregon and 109 deaths, most concentrated in Multnomah, Washington and Marion counties. The majority of deaths have been of nursing home patients.
Just five Lincoln County residents have tested positive for the coronavirus. In a county of 50,000 people, that’s one of the lowest rates in the state.
Hospitals lost significant money
Because of the few cases in Lincoln County, Odgen admits it was “weird” to talk the empty halls of Samaritan Pacific and North Lincoln hospitals.
But those empty halls also meant the two hospitals – part of the five-hospital Samaritan Health Services group in Benton, Linn and Lincoln counties – lost 60 percent of their revenue when those patients were prevented from coming in for anything but emergencies.
“When we stopped elective procedures we effectively stopped our business,” Ogden said.
Lincoln County’s two hospitals are among 25 rural Oregon hospitals designated by the federal government as “critical access” facilities enabling them to get 100 percent Medicare reimbursement to cover cost of care. The average Medicare reimbursement is about 85 percent of cost, according to the Oregon Health Authority.
The designation is designed to reduce the financial vulnerability of rural hospitals. Oregon hospital groups have asked the governor for $200 million in financial aid, especially for rural hospitals. Last month, however, the Legislative Emergency Board declined to approve $50 million for hospitals because of disagreements over its terms.
Despite the cut in care, Ogden said the Newport and Lincoln City hospitals have been able to avoid layoffs a variety of ways. Staff have accepted offers to work elsewhere in the hospital, or take paid or unpaid time off. Just 100 in the 6,000-employee Samaritan system took voluntary furloughs, allowing them to be eligible for unemployment.
How elective care is restarting
Now, in order to slowly open the two hospitals to elective care, there is a hospital committee screening requests from doctors.
The committee determines “Who goes first; who makes up that 50 percent of volume,” Ogden said, “We have six weeks of pent-up demand. We’re trying to get the people who need care now back into the hospital.”
For example, she said, a patient with gall bladder issues may have been able to manage the problem with medicine, diet and other preventative care. But now surgery is once again an option. The same holds true for some cancer treatments, colonoscopies, mammograms and physical therapy.
“Yes, we can put these off for a month or so, but now these are the people with treatments we’re trying to get in,” Ogden said.
The limit to 50 percent of previous volume means just 24 elective surgical procedures a week in Newport and 10 in Lincoln City for at least the next two weeks.
The two Lincoln County hospitals are part of a regional care and resource group consisting of facilities in Benton, Linn and Marion counties that must meet state guidelines before they can offer more elective care. So the two hospitals in Lincoln County can’t offer more if facilities elsewhere don’t meet guidelines.
“We understand this is going to be a step-up process … and we have to be ready to back off,” Ogden said. “We may go one step forward and two steps back.”
Ogden said Samaritan officials thought restrictions on elective care wouldn’t ease until mid-June.
“We never really thought the governor would allow us to come back this fast,” she said. “But it’s a testament to the people of Oregon who helped slow this thing down.
“Hopefully the next two weeks goes well and we can move on to the next step.”