A Billings hospital has turned to a care home group to house patients to cope with an usual number of COVID-19 cases. Billings Clinic is packed, and its CEO on Friday called the surge "a crisis."
"This is unusual. This is a crisis," said Dr. Scott Ellner, Billings Clinic CEO. "This is something that Billings Clinic has not had to deal with. It's so stressful on our caregivers. They’re working to capacity. They’re stretched."
St. John’s United has offered to the hospital use of a building that has been vacant since March. It can house 12 patients.
The rapidly increasing number of new COVID-19 cases in Montana and Wyoming is resulting in more people requiring inpatient hospital care, according to a press release from the hospital.
On Friday, 177 people with COVID-19 were hospitalized in Montana, according to the state's daily case map.
Almost half of those hospitalizations are in Yellowstone County, RiverStone Health Communications Coordinator Pat Zellar said.
Yellowstone County has 81 people in its hospitals for COVID-19 treatment, 35 of them Yellowstone County residents. According to Zellar, they are split nearly even between the Billings Clinic and St. Vincent Healthcare.
Hospital numbers are fluid, Ellner said Friday; the number of patients hospitalized in the county Friday was down from the 90 reported Wednesday, Zellar said.
Billings Clinic will temporarily use rooms at St. John’s United’s Billings West End location to house and care for less-acute hospital patients. Patients transferred to this unit will not be COVID-19 patients, Ellner said.
St. John’s United is a human services organization that includes retirement living and health and human services — including rehabilitation and transitional care, and physical and occupational therapy — for older adults, according to the press release. It is a family of campuses with locations in Red Lodge, Laurel, Hamilton, Billings Heights and Billings West End.
“This is a community problem needing community solutions. Any positive activity that any organization or any individual can do to mitigate spread will reduce the need for unorthodox actions such as this,” said David Trost, President and CEO of St. John’s United, in a press release.
Billings Clinic staff began caring for 10 patients in the unit Friday.
Teams from the clinic side of Billings Clinic operations have committed to help staff this unit so that hospital teams can continue providing care in their units as much as possible, according to the release. In addition, Billings Clinic’s geriatric provider group will assist with coverage and care.
On Friday afternoon, Billings Clinic had 20 open beds, Ellner said. When it comes to critical care, however, the Intensive Care Unit is full, he said. Billings Clinic has 24 ICU beds.
To cope with the surge in cases, the hospital has enhanced another area of their campus and remodeled office space to double that 24-ICU-bed capacity, Ellner said. In terms of other supplies needed to care for COVID-19 patients, Ellner said Billings Clinic has been able to purchase more ventilators and personal protective equipment.
Still, hospital staff are stretched thin, he said.
"I really am inspired by the hard work, resilience and grit that we’re seeing" from health care providers, Ellner said. But also, "They’re tired. They’re saving lives and doing their absolute best. I’m advocating on their behalf for the community to please do their part."
Montana has broken records when it comes to new active cases several times this week, and Ellner said the hospital isn't bracing for a surge from that — instead, "the uptick is now," he said.
And, it'll only get worse if people continue to gather in large groups and flout the mask mandate, he said.
"If the community really takes personal responsibility today and follows masking guidelines and physical distancing, we’ll see a downward trend," maybe even as soon as in two weeks, he said. "If not, we’re going to have to find other places to manage our patients safely."
Ellner was unaware of a time when Billings Clinic has had to rely on an outside facility to house patients.
COVID-19 patients are spending weeks at a time in the ICU, and caregivers need to pay greater attention to those patients because their condition can decline rapidly, he said. The hospital has also hired more nurses and staff to help handle the surge.
Another way Billings Clinic copes with a surge in patients is by sending them to its facilities in other towns, usually to recover closer to home, Ellner said. Those facilities in Livingston, Red Lodge and Columbus are stretched, too, he said, because Billings Clinic has sent patients to them whenever it can to help offset the number of patients in Billings.
Thus, the Clinic turned to St. John's.
“We are incredibly grateful to St. John’s United for their support and partnership,” Ellner said. “This helps our amazing, dedicated staff serve our patients and communities.”
If St. Vincent Healthcare needs more beds, it plans to continue to make room within the hospital, its CEO, Michael Skehan said in an email Friday evening. The hospital's incident command team meets several times a day to determine what the needs are to care for patients, he wrote.
Skehan also stressed the importance of personnel to capacity. St. Vincent's health system, SCL Health, has recently sent dozens of nurses, technicians and respiratory therapists to Billings from its Colorado hospitals to help care for the growing number of COVID-19 patients. That affiliation has also helped St. Vincent maintain equipment needs during the pandemic, he said.
Both hospitals stressed that they are still open and accepting patients without COVID-19 symptoms and encouraged people who need health care to get it.
The Billings Gazette's Paul Hamby contributed to this story.