CHARLESTON, S.C. (WCSC) - Hospitals across the country are facing a more than $200-billion financial hit right now, according to the American Hospital Association. And that’s just from the last four months during the pandemic.
The South Carolina Office of Rural Health tells us 80% of our state - by landmass - is rural. More than a quarter (27%) of South Carolinians live in rural communities.
In some counties, one hospital and a handful of clinics make up the entire healthcare safety net.
“These facilities are vitally important. When they’re not available, folks in local communities suffer,” said Graham Adams, CEO for the Office of Rural Health.
Four South Carolina hospitals have closed since 2011, he pointed out, and 130 closed nationwide. Many were in underserved rural areas.
Adams says the pandemic has only put more stress on cash-strapped rural providers.
"Volume is down, income's down. Because they've had to buy a lot of different supplies for trying to treat COVID, their expenses are up. We're concerned about their viability," he said, pointing out that financial concerns are not new for the facilities.
Christian Soura with the SC Hospital Association says the lifeline for many clinics and hospitals right now is emergency federal funding through the CARES Act.
"We had one hospital that had a single day of cash on hand at one point," said Soura. "We've had others that were putting together closure plans, and then one of these grants came in from the federal government."
"Many of these support payments sound like pretty big dollar figures - one million dollars - five million- ten million dollars. But often these forms of assistance have been enough to keep people going for maybe two more weeks," Soura added.
We looked at some of the data showing some of the federal funding released to healthcare providers so far.
For example, 21 hospitals that are all part of the Rural Health Coalition in our state received a total of almost $53 million from this particular round of federal funding.
But it's not an even split. Four of the 21 rural hospitals got more than half that money, $27 million.
One in Easley received about $53,000.
The amounts are significantly less than bigger metropolitan hospitals like MUSC, which has received $54 million.
We asked Soura to help explain the funding formulas that HHS is using to decide which facilities get how much.
“The answer is nobody really knows yet,” he said. “They’re releasing this money in tiny little pieces. So you almost have to look at your email every day, check federal websites every day to see has there been another distribution? Who did they extend money to? What rules did they apply?”
Adams said, “I think Washington has been effective in trying to get money out to rural providers and healthcare practitioners quickly which is very, very helpful. But there is still a lack of clarity.”
For example, Adams says, the money appears with little explanation about what the hospitals and clinics can spend it on.
Does it have to be COVID-related or can it be used to offset lost revenue?
"The math is still fuzzy," he added.
An SCHA survey of hospitals in South Carolina projects nearly a billion dollars of unexpected costs tallying up by the end of 2020.
Soura said, "We will probably see more money come from federal government, but it wont be anywhere close to an amount that covers all those losses."
So, where does that leave us? Soura said they are working to help providers to figure out other efficiencies and other sources of funding.
"Congress gave $125 billion to the Coronavirus Relief Fund," he said. "South Carolina received $1.9 billion out of that."
The governor and General Assembly is involved in determining the best use of that money.
“Hospitals are hoping to be on the list of priorities once that money is distributed,” he said.