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Mercy says ‘capacity’ a moving target; staffing a growing concern

Hospital declines to share detailed data on local level
Some local government officials say they want Mercy Regional Medical Center to be more forthcoming with its COVID-19 information.

After a bit of a scare last week amid a surge of COVID-19 cases in La Plata County, officials at Mercy Regional Medical Center say capacity to care for patients is not an issue, for the time being.

For the past week or so, state data showed Southwest Colorado’s available intensive care unit bed capacity full or nearly full.

Dr. Stephen Cobb, chief medical officer for Centura Health, the company that owns Mercy, said as recently as Friday, hospital officials were concerned about being able to provide care for patients as beds started to fill up.

“It was just busy,” Cobb said. “And you’re worried if there’s an increase, you’ll hit a number eventually when you can’t care for people because you just don’t have the (staff).”

Mercy officials have continually refused to say what is the maximum capacity of ICU beds at the hospital, arguing the number is a constantly moving target that doesn’t accurately reflect the facility’s ability for care.

“We’ve not been given permission to give those numbers, other than to the state,” Cobb said. “(But) a fixed number is not a meaningful number.”

The data provided by the state includes Archuleta, Dolores, La Plata, Montezuma and San Juan counties, and does not break out Mercy individually.

The number of ICU beds fluctuates almost daily. Around Nov. 23, state data showed there were about 25 ICU beds in Southwest Colorado, all of which were occupied. As of Tuesday morning, however, state data showed there were only 14 ICU beds, with 10 of them occupied.

Mercy, by far, is the largest health care center in the region. Southwest Memorial Hospital in Cortez has four ICU beds and Pagosa Springs Medical Center has no ICU beds. Dolores and San Juan (Colo.) counties have no hospitals.

Cobb said Mercy officials have an idea of the threshold at Mercy. But he said it would not serve the community to provide that number.

“If we give you information the public may not perceive in the right way, they may make a bad decision,” he said. “If you need Mercy, we have all the capacity we need to take care of you. And if that changes, we’ll send out an alert.”

Staffing is a concern

Available staff members – not beds – seems to be the main issue, Mercy Interim CEO Michael Murphy said last week, an issue that has been exacerbated as nurses and doctors become ill.

“We have a number of staff obviously that have experienced COVID-like symptoms, so they’re on the watch list,” Murphy said last week. “(That) reduces our staffing level.”

Mercy experienced staffing capacity at its intensive care unit in July. But Mercy is not able to draw from other hospitals as it was in the past because cases are surging nationwide.

“Because the statewide system is stressed, getting more (resources) is challenging at best,” Murphy said. “Given the number of outbreaks ... we’re definitely looking toward much, much more difficult times in front of us.”

Fortunately, it appears hospitalizations have slowed in the past few days, allowing health care workers time to catch up and take a breath, Cobb said.

Again, Mercy declined to provide data about how many people have been or are currently hospitalized for COVID-19, saying it reports those numbers to the state. But state data does not show numbers specifically for Mercy.

When asked for comment about its reporting protocols or if it could provide Mercy-specific data, the Colorado Department of Public Health and Environment responded, “We do not share specific hospital level data publicly due to our privacy policy.”

San Juan Basin Public Health, the local health department, reports there have been 72 hospitalizations in Archuleta and La Plata counties since the pandemic started in March.

But Liane Jollon, executive director of SJBPH, said that’s not accurate data.

SJBPH’s hospitalization count is based on people who tested positive, and then quickly required hospital care, so when contact tracing occurred, the health department could confirm a hospitalization.

“It’s not good data,” said Jollon, who added the health department is considering removing it from the website.

If state modeling rates were applied to La Plata County’s population size of about 56,200 people, an estimated 150 people or so would have been hospitalized since the start of the pandemic, Jollon said.

Regardless, Cobb said the lull in hospitalizations could change at any moment.

“While we stand in good shape Tuesday, we will still need to get through the next several months,” he said.

Indeed, cases of COVID-19 have skyrocketed in the past few weeks. On Nov. 1, La Plata County reported 433 total cases. As of Tuesday, that number stood at 1,740 positive cases.

The rise in cases has also brought an increase in hospitalizations and deaths, which now stands at eight in La Plata County. (The Centers for Disease Control and Prevention does not distinguish between those who died because of COVID-19 and those who had COVID-19 at the time of their death until a county reaches 10 deaths, citing privacy issues.)

If Mercy does reach capacity, there are protocols in place to transfer patients, preferably to other Centura hospitals along the Front Range as well as St. Mary’s Hospital in Grand Junction, part of the SCL Health organization.

To date, Cobb said he was not aware of any COVID-19 patients who required transfer because of capacity issues. Mercy did not provide the number of COVID-19 patients who required transfer in need of a higher level of care.

Wanting to know more

Kim Baxter, a Durango city councilor, said she has heard a recurring sentiment in the community that Mercy is not being forthright with COVID-19 information.

“People are concerned about the fact we don’t have the kind of information they’d like to have, absolutely,” she said. “(And) Mercy is not answering the questions in a straightforward manner as they could, absolutely.”

For instance, Southwest Memorial Hospital in Cortez, Pagosa Springs Medical Center and San Juan Regional Medical Center in Farmington all regularly post updates about COVID-19 information to Facebook.

Baxter said that because Mercy is owned by Centura, a massive health care network, it is likely that corporate policy restricts information local health care workers are able to provide.

The best and likely only way to change that, Baxter said, is to push Gov. Jared Polis and the state Legislature to require local hospitals to raise reporting efforts.

La Plata County officials have asked representatives with Mercy to participate in a public meeting Dec. 17 to openly discuss the hospital’s COVID-19 response, said Commissioner Julie Westendorff.

“I’m hoping Mercy is going to really be able to help answer some of those questions we’re hearing from the public,” she said.

County spokeswoman Megan Graham said Mercy representatives have confirmed they will attend.

Cobb was adamant that anyone who requires care, not just for COVID-19, can get it at Mercy. He said the hospital tries its best to isolate COVID-19 patients.

Because of the recent rise in cases, Cobb said health care workers are stressed and fatigued, and the best thing the community can do is follow public health orders.

He stressed that health care workers are frustrated by people not taking the pandemic seriously or who don’t believe the science, “then make choices that could increase the volume at hospitals.”

“Please do the right thing,” Cobb said.


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