Now we are at the part where states are running out beds such a goddamn mess
www.nola.com
BOGALUSA - In a second-floor hallway at Our Lady of the Angels Hospital, Dr. Garland Anderson and CEO Rene Ragas stared at a printout filled with patient names, deciding who might be able to go home to free up desperately needed beds.
Staffed for 34 regular beds, the hospital had a backlog of patients building up in the emergency department. Nine people who needed to be admitted were waiting in bays usually used for quick assessments before admission or transfer. Under normal procedures, some would go to bigger hospitals in New Orleans, Baton Rouge or elsewhere to receive specialized care.
But the big hospitals, struggling to treat record numbers of COVID-19 patients, weren't accepting transfers. The only way Anderson could find a bed for emergency patients struggling with heart attacks, brain injuries, COVID and other serious health issues was to figure out how to discharge admitted patients early - or for someone to die.
"The system is so packed that people who come in with a stroke, with a heart attack, with life-threatening conditions, we are unable to deal with it," Anderson said. "We are unable to transfer patients to any hospital in Mississippi, Alabama, Florida, Missouri. There are no beds anywhere."
Across Louisiana, hospitals are full. Large ones, such as the Ochsner Medical Centers in the New Orleans area and Our Lady of the Lake Regional Medical Center in Baton Rouge, won't accept most transfers from the 100-plus small Louisiana hospitals that rely on them. About 50 of those hospitals are in rural areas.
Ochsner Health, Louisiana's largest system, declined 175 transfers in a week, according to reports from hospital officials. Normally it accepts about 50 transfers every day.
Ochsner Lafayette General has declined 70% of transfer requests from smaller hospitals since July, said Dr. Amanda Logue, its chief medical officer, on Friday. Our Lady of the Lake hasn't been able to accept most transfers for about a month; at one point, it had 23 patients sitting in an emergency room waiting for admission to the intensive care unit, said Dr. Katherine O'Neal, chief medical officer.
"Hospitals are stretched to the point that they are not able to provide the quality of care they normally would under regular circumstances," said Dr. Joe Kanter, the state health officer. He said an emergency room where he worked last weekend accepted a heart attack patient who traveled more than two hours in an ambulance before finding an open space.
Small, rural hospitals such as Our Lady of the Angels in Bogalusa rely on transfers as part of their care model. Some smaller hospitals can treat many conditions, depending on the equipment and experts on staff, but they rely on larger hospitals with specialized services to treat many patients. Some rural hospitals don't have ICUs or doctors with critical respiratory care experience. Some don't even have maternity care.
It's the same story at every small hospital across Louisiana.
"If our little place is busting at the seams, it's a tough situation," said Kevin Guidry, administrator of the 15-bed Assumption Community Hospital in Napoleonville. All five of its emergency room bays were occupied.
"We've called as far as hospitals in Oklahoma and Texas to try to find placement," said Peter Sullivan, CEO of Riverside Medical Center in Franklinton. His 25-bed critical access hospital was full, with patients waiting in emergency bays for rooms.
'No beds anywhere': As COVID wards expand, Louisiana's small hospitals have nowhere to turn
Big hospitals won't take transfers, so small ones discharge early or wait for someone to die
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