LEWISBURG — “I don’t think anybody would have imagined that we would all be sitting in a room wearing masks to do many things,” Congressman Fred Keller, R-Kreamer, said in a roundtable discussion with Evangelical Community Hospital administration this week.

Keller, alongside President and CEO Kendra Aucker, James Stopper, CPA, vice president of finance and CFO, William Anderson, executive vice president and COO, and Angela Lahr, MHA and vice president of clinical operations, discussed the “tremendous” set-backs that COVID-19 has caused on their rural operations.

Many of the set-backs are indeed financial and related to equipment.

“Evangelical is very fortunate,” Aucker said. “We came into the pandemic in a fairly strong position, but obviously ramping up with closing, elective procedures, sky-rocketing prices of PPE, having to test staff and patients…it’s been a challenge.”

She added that the system has received $13.8 million in grants, which has helped off-set some costs, but not nearly enough.

“We had to take drastic steps to cut costs,” Aucker said. “We ended up furloughing nearly 200 people. I feel blessed compared to most rural hospitals…but the dollars that we did receive did not even touch what we were required to do (to cover those costs).”

“That is something we are still discussing,” Keller added. “We are advocating for us to be able to incorporate that (funding and how money is distributed). I think there needs to be more dollars for reimbursement.”

Anderson explained to Keller that though Evangelical has been fortunate in terms of personal protective equipment, there are ongoing struggles about affording equipment for rapid testing, testing outside of COVID-19 and more.

“We have definitely seen some constraints,” he said.

The pricing of such equipment has also severely increased with much longer delivery periods, he added.

“We would love to see more of that (equipment, swabs, etc.) so that we can move patients through the system,” Anderson said.

Insurance companies are also not paying for tests for individuals who happen to be asymptomatic, Aucker added. This causes another financial strain on the hospital system.

So far, Evangelical has tested over 6,000 patients either in-house with rapid testing with turn around time of one hour, or their outpatient or drive-through testing, which comes back in three to four days.

“The rapid testing supplies (reagents, swabs and more) are severely limited,” Lahr said.

They have recently seen an uptick in patients over the last two weeks with eight patients currently hospitalized and 80 to 90 tests a day — this increases the concern about having enough testing supplies during the upcoming flu season.

“We can’t make a request anymore to the state level for increased allocation,” Lahr said.

Keller said there is ongoing discussion about where to allocate resources and funds, and that this issue would be looked into, including looking into the issues with the supply chain, the national stockpile and more.

Anderson asked Keller to investigate maintaining regulations such as telehealth as something of more permanent usage in hospital systems.

“Looking at broadband as a utility,” Keller said, “I look at broadband as infrastructure. That leads into telemedicine and how we provide that service and reimburse for that. That is a thing that we have looked at. In rural Pennsylvania and rural America, it is difficult for some people to get out there, so they stay at home and their situations become worse.”

On a more positive note, Evangelical staff also discussed their PRIME expansion project and said that they have adapted their plan to include more private rooms, a new ICU and more negative pressure rooms to adapt to the pandemic.

In another matter, Lahr discussed concerns regarding the ongoing national opioid crisis and how healthcare systems can move away from opioid drugs after surgery and onto injectable Tylenol, which has the same effect as an opioid drug, can be easily monitored and administered, and is not addictive, she said.

“We as a hospital want to reduce the prescription of opioids,” she said. “We found that injectable Tylenol is just as effective…so we transitioned a lot of our preoperative and postoperative pain management to injectable Tylenol.”

She also added that the pricing on this drug however, has increased by 100 percent whereas opioid drug prices have stayed the same.

Evangelical has also experienced a shortage of this drug as they were having trouble getting it.

“If you can manage the pain the same way, just as effectively, it shouldn’t cost you more money,” Aucker added. “We get paid the same amount of money no matter which drug we choose to use. We don’t have the buying power, it is a challenge for us.”

“The time that you (Evangelical administration) have taken to meet with us is invested well,” Keller said. “As much of what we can get in the final product will be there. I want to let you know that what we are discussing will get to work in legislation.”

“You are a friend to Evangelical and we appreciate that,” Aucker said.