Interview with a Hospital CEO During COVID-19

By Dean Barber

May 7, 2020

Dean interviews his brother Eric Barber, the CEO of Mary Lanning Hospital in Hastings, Nebraska, in this glimpse inside the operations of a rural midwest hospital amidst the COVID-19 outbreak. Listen to the interview from America’s Wealth Management Show below:

Interview on COVID-19 with Eric Barber, CEO of Mary Lanning Hospital

DEAN: We’re talking about the economic impact and the opening of our economy. Just before the break, we talked about how we’re seeing major outbreaks of COVID-19 in rural America. Joining us by telephone for an interview here is my brother Eric Barber, the CEO of a hospital called Mary Lanning Hospital in Hastings, Nebraska. Eric, welcome. Thanks for taking a few minutes with us.

ERIC: You bet guys happy to do it.

DEAN: All right. So we’re getting word and we’ve seen there’s some hotspots around prisons and packing plants and you’ve had that experience there in Hastings, Nebraska. Tell us what you’re seeing there.

ERIC: Yeah, so it’s been a major outbreak, and while we’re facing a huge escalation in the number of cases per capita here, hospitals are no different than every other business that’s been, quote-unquote, shut down.

Because we basically closed the profitable service lines, right? We shut down the elective surgeries, the cardiac cath, and the diagnostic procedures. We basically focused completely on the critical care patients who are in the ICU, which is not really a profitable thing for a hospital. Still, then we have all the same expenses that continue with payroll. And so it’s been an interesting endeavor.

DEAN: So, Eric, how many cases have you guys actually seen there at Mary Lanning, and you have a rough number there?

ERIC: Sure. So we’ve had some success. The story is we were as high as 21 total patients in-house who were COVID-19 positive. And for some perspective, we’re about a 100-bed hospital; we’re licensed for 160 beds. But if we had 100 patients in-house, we’d be crowded. Our ICU can hold 10. So, COVID-19 is a little bit overwhelming for the ICU itself, but not for the rest of the hospital.

We’re down to six or seven this morning. In a two-week timeframe, that’s been a nice downward trend. We’ve gone from as high as 21 or down to having seven positive cases in-house now. We have seen four individuals who were ventilated for multiple days, actually multiple weeks, who recovered and went home. That’s great to see. We’ve also watched three or four people pass away. So a little bit of everything.

DEAN: Eric, is there anything different in general between the persons that were ventilated for an extended period and recovered versus the ones that passed away? Was there anything significantly different in their health prior-to? Like any comorbidities or anything like that?

ERIC: The individuals that passed away were older. And one of them had a lot of comorbid conditions. One of them was a hospice patient who happened to contract COVID-19 at a local nursing home before they came here to die.

So yeah, not being a physician, I think it’s safe to say that with comorbid conditions, COVID-19 is way more deadly than if you’re an otherwise healthy individual.

DEAN: So, what do you see with the outbreaks there? What’s going on? The news is saying, “Hey, it’s because of the meatpacking industries and prisons.” and things like that. What are you seeing?

ERIC: Yeah, at the risk of profiling, I guess. There’s a distinct population impacted in rural Nebraska. Dean, we grew up in Garden City, Kansas, you could like the same thing down there in southwest Kansas or northern Texas, areas where there’s a large Hispanic population where English might be their second language.

So, there’s a communication barrier there. We can look back at the timeline of March and April here in Nebraska when everybody else was getting the word that this was a thing that there was going to be an outbreak. That particular population I don’t think heeded the warning to say, “Hey, we got to stop gathering.” I’m hoping there weren’t any Cinco de Mayo parties because social distancing has flattened the curve. However, I don’t think it’s been significantly, and my personal opinion is it’s time to end to shut down.

But, that particular population didn’t stop, it didn’t change a thing. They didn’t change any way that they operate. So, obviously, this is a very contagious virus; it spread like wildfire through that particular demographic. There has been a noticeable trend that has repeated itself across the state of Nebraska, and I think across the Midwest.

DEAN: Interesting. So what is the what’s the general vibe like in rural Nebraska right now? Are people out and about and doing things and are stores open? Are you guys experiencing the same shut down that the major cities are?

ERIC: Yeah, so I have to give props to Governor Ricketts. He’s hosted a weekly conference call with all the CEOs of every hospital across the state of Nebraska. Governor Ricketts is in constant communication with the local health departments. He’s been in continuous contact with the mayors. And he’s doing it in a pretty methodical way.

At some point in March, I can’t remember the exact date we shut down the entire state. Right? Everybody said, “Okay.” He never said, “Shelter in place” or whatever. But he has a little slogan which is “Stay home, stay connected, stay healthy.” And he had like six guidelines to follow through all the businesses in Hastings.

Well, in Nebraska right now, all the businesses are closed. The restaurants are all doing takeout, which I’ve talked to several restaurant owners, and that has worked out well for them because they got their Payroll Protection Program money. So, they can keep employees on the payroll even though you don’t have as many employees at the restaurant.

I think what’s so cool about rural America, and I know there are cool towns all across this place. Still, this community has rallied around itself where everybody recognizes everybody’s suffering. So as a hospital, we’ve made it a point to order lunch from a different restaurant every single day.

DEAN: That’s cool.

ERIC: People are just like, “Hey, we’re gonna help each other through this!” Also, the government has done a great job. I don’t care if you like Donald Trump or not. The government has done a fantastic job of sending relief funds where there is need, I can’t overstate that. We received just about $9 million in relief funds, grant money, as a hospital from the federal government because they recognized how much our revenue was falling short. They almost matched it to the penny.

So, again, I don’t care where your politics lie, the government’s done a fantastic job. Because I don’t think there’s a playbook for how to manage an outbreak right now.

In Nebraska, to answer your question, there are 19 distinct health districts. Each one of those districts gets a chance to decide in the next three weeks when they think it’s safe to open back up based on the number of cases. I’ll use the local example that I know the most about.

Two weeks ago, we reported 25 new cases in one day; we had six new admissions to the hospital. So, it was like, “Okay, ah, skies falling!” Well, this morning, the same meeting that we host every single day to talk about the same topic, there was one new case in our community, and there was one new addition to our hospital. We have seen a downward trend.

When I’m on the phone with the governor on Thursday, I’m going to say, “Hey, but I think it’s time.” Right? I think Governor Ricketts has been as pragmatic about this as anybody. He’s doing a great job of listening to science and following the facts. I think when he sees a downward trend like that, he’s going to say, “Okay, I think it’s safe to open up in central Nebraska.” Two weeks, I’m going to say two weeks.

DEAN: Do you think that there is an appetite in rural America for opening back up? And do you think people will get out there and do what they were doing before? Or do you think people are going to be a little bit nervous?

ERIC: Yeah, I think it’s a mixed bag. We just decided to start doing elective surgeries again, as a state, with the governor’s help. He lifted that measure on Monday, May 4, 2020, allowing us to go back to doing some elective surgeries. Several surgeons I work with called a lot of patients who had delayed their cases. They had about a 30% response rate to say, “Yes, I’ll be right there to get my case done this week.” And they had about 70% of them say, “I’m gonna wait a couple of weeks.” So, I think people are eager to get back to normal, but they’re also very cautious about what’s normal looks like. So, it’s a mixed bag.

DEAN: Eric, thanks so much for taking the time to spend with us here on America’s Wealth Management Show. That interview was with Eric Barber, CEO of Mary Lanning Hospital in Hastings, Nebraska.

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