June 26 Employee Huddle

June 26, 2020

Please Note: Time did not allow us to answer every submitted question, so we will get to unanswered questions at next week's KD Huddle. Submit a question now for next week by e-mailing dvolosin@kaweahhealth.org.

1. As our numbers continue to rise, are we prepared for a surge? We are. We started preparing before March. Now with the State and County reopening, we are seeing more cases, about 40 COVID patients consistently. If there is a surge, we will use all patient beds that are available and prepare to open all available areas.
2. We are experiencing a shortage of clinical staff, so, does it matter if we have beds if they are not staffed? It is a concern. Everyone has limits, and we cannot ask our current clinical staff to take on any more than they have. We have hired travel nurses and are continuing to hire new employees. We have just started hiring nursing students as Patient Sitters, who will sit with those patients who need more one-on-one care. This in turn will free up CNA’s to return to the floor. If there is a surge and more help is needed, we will start using non-clinical staff and train them in patient bedside care. We are hoping the State/County will pull back on reopening, but if not and a surge is approaching, then we will use all available resources we have in the district. Our surge plan includes trainings, team assigning, and skill mix (non-clinical and clinical working together). We also have introduced extra shift bonuses for RN’s and are hiring more CNA’s with the anticipation for turnover.

• Exposure is when you have prolonged contact with someone who is COVID positive without a mask on. Wearing a mask significantly reduces risk of COVID exposure. If you have been exposed, watch for symptoms for 2-4 days, however it could take up to 14 days to start showing symptoms.

3. Now that staff members and residents at our subacute facility are mandated by the State to undergo COVID testing every 30 days, will Kaweah Health ever offer an alternative to the nasal swab test, such as saliva testing? The Lab Team is working on accessing more platforms for COVID testing. Unfortunately, nasal swabbing is the most accurate way to test as of now. The team is actively searching, but they will not compromise accuracy for comfort.

4. If an employee believes they’ve been exposed to COVID-19, and their doctor wishes them to be tested, what is the cost of the test to the employee? This is going to last for a long time and some of us may need to be tested multiple times so I’m trying to plan for that eventuality. We have talked with the revenue team and there are safe guards in place. There is a cost billed to the insurance, however there is no share of cost, which includes no deductibles or copays. Depending on the insurance provider, they will have different processes in place. Insurance companies have to have a “clinical need” in order to test someone, so they will be watching closely.

5. Patients ambulated outside the room are not required to wear masks unless Covid-19 positive and may pass other patients not wearing masks. Should patients be provided a mask, or required to wear one for ambulation outside their rooms? In clinical areas, all patients should have masks on if they can tolerate them. Non – COVID patients who cannot tolerate wearing masks should maintain 6 feet away from others and we need to ensure that everyone else around them is wearing one. The visitor policy has not changed, so all visitors should be wearing a mask.
6. If an employee travels to another state, namely Arizona or Texas, will they need to quarantine before they return to work? (both of those states are experiencing surges) They should self-monitor for fever, cough, shortness of breath, loss of smell/taste, etc. Although many states are requiring quarantine when entering, California is not. If there is a surge, things might change, especially with summer travel approaching.
7. If an employee travels outside the country, ie. South America, will that employee need to quarantine before returning to work? Same, they should self-monitor for fever, cough, shortness of breath, loss of smell/taste, etc.

8. Do we know if more layoffs will be required? We have laid off 53 employees. We are continuing to watch monthly finances. It honestly depends on COVID. There is no way to predict what is to come. A surge could shut down services again, which would force us to rethink our plans. It is very challenging to lose any individual, which makes our goal to save jobs, not lose them.

9. Has KD considered a work sharing program? Currently we are looking into the possibility.

10. Do we know if we’ll be returning to work the first week of July? We are still planning for the July 6^th date, if there is space available for employees to return to work. If there is no space and we cannot accommodate the employee safely, they might need to continue to work from home. With the increase of numbers, it is changing all the time. The VP’s and Directors have been working together to make sure they are continuing to do the right thing for their employees. For the past 6 weeks, employees have slowly started coming back to work. If you have any questions, feel free to reach out to the H.R. department or Diane Cox.

11. I’m getting mixed messages about working from home. I thought I heard in a huddle that directors would be allowed to decide what was best for their departments and individual employees but I know directors who are stating their VP is refusing to allow employees to work from home after a certain date. If the employee can show their productivity remains the same or even increases when working from home, why wouldn’t we allow them to work from home when that is clearly the safest option?
12. Besides layoffs, what other cuts will impact employees going forward? We will know more about this after the KD Board meeting on Monday.
13. There is a definite cloud of gloom hanging over the District as we watch our co-workers clean out our desks. We also are aware that our hospital is in a precarious position financially even after the layoffs. What is your biggest concern as the CEO of this organization?

• We know that we have dark clouds hanging over us right now, but eventually those clouds part and sunshine shines down. That is the hope for Kaweah Health. Health Care is in a constant state of change and right now we are in a time of challenge that we have not seen before. However, it is now time to focus on the future.
• March, April, and May were difficult months. We had to shut down elective services, such as non-emergent surgical procedures, which are the financial lifeline of any hospital. When we shut down those surgical procedures, it wiped out 40% of revenue. In the last fiscal year, we had an operating loss of $29 million. We are currently 37 million under budget, even with the relief with the CARES Act, about 14 million.
• The biggest concern is the 37 million deficit, which is making us take action. Unfortunately, we have had to lay off people. We are working hard and doing everything possible to help preserve jobs. There is no way to recover from a 37 million deficit. We are hoping the Federal government will increase the stimulus funds. For the first time in history, we are planning for a budget that will break even. If needed, we can dip into the reserve.
• After the Board meeting on Monday, we will inform the district about the decisions made. Here are a few things that are necessary in the future;
  • No pay increases, however we will not be cutting any wages
  • Suspending matches for 401K for 2020 and a smaller matching scale for 2021
  • Reduce travel and education
  • Reduce the amount of money spent on supplies
  • Using vendors for more than one service
• It will be a victory if we break even in the wake of the unimaginable pandemic we are having to endure. It is important to stay positive, look to the future, and support one another.