When the COVID-19 pandemic struck in 2020 rural hospitals around the world, many of whom were already struggling to survive, found themselves caught between an influx of critically ill patients they were not fully equipped to care for and a significant decline in patients seeking what had always been the routine procedures that helped these businesses make ends meet. The fear of contamination made many people put off coming to local clinics for their checkups and postpone minor elective day surgeries. 

Foreseeing the critical threat this could be on these health centers which were needed more than ever as patients were being turned away from metropolitan hospitals for lack of space the state and federal government began passing legislation to offer some support.    

Since 2020 Jefferson Hospital has received around $4.5 million in grants and funding through the Coronavirus Aid, Relief and Economic Security (CARES) Act, the American Rescue Plan Act (ARPA) and the COVID-19 Prevention and Mitigation Hospital Grant.    

Wendy Martin, the hospital’s CEO, said that her team has worked hard to make the best use of these funds to not only provide the best care possible for the current patients, but to also prepare for the future, all while meeting the requirements of each individual grant. 

“I want the community to understand that a lot of what we are doing, we are doing with grant funds,” Martin said. “There are very specific things you can use these grants for and if you don’t spend it, you lose it. I don’t want to lose a penny of what they are willing to give us.” 

Primarily, she said, the funds are being used to replace aging equipment and infrastructure needs.  

“We try to identify projects that will help us in the long term or help us improve patient care that fit within their parameters,” she said. “We really have to spend a lot of time brainstorming. Patient care is the number one priority, but I feel the facility and the experience of the patient is also extremely important. People are more confident in your services if you have an up-to-date facility.”  

The first funding from the CARES Act hit the hospital’s bank account when it was still learning new strategies for how to care for the patients who were sick with COVID but could not be transferred to a larger facility because there were no beds available there. 

“We didn’t know what we were getting or when we were getting it,” Martin said. “They just sent it out. They knew then that they had to get these hospitals some assistance. With the volumes dropping at the smaller hospitals our cash was getting really tight. They had to make sure we were all ready to take care of patients. Thankfully they realized that need quickly.” 

The funding came in several phases and different rounds. Some was clinic specific. Some were hospital specific. Some were organization wide.  

Some of those first funds were used to set up negative pressure rooms and purchase ventilators at Jefferson Hospital.  

“We only had two (ventilators), one we hardly ever used and they were both older,” Martin said. “We purchased four new ventilators as well as equipment to provide high-flow oxygen. We replaced our patient beds with new safety features like bed alarms.” 

The hospital also purchased new stretchers for the emergency department and a new telemetry monitoring system that allowed them to more than double the number of patients simultaneously monitored. And where the previous system only monitored patients’ heart rates, the new one also monitors their oxygen levels. It also added a video monitoring system for all patients’ rooms, which Martin said was particularly helpful on the COVID unit. 

Funding was also spent on personal protective equipment (PPE) and COVID testing supplies, the cost of which steadily increased as supplies were exhausted. 

“We weren’t really sure in the beginning what else we could spend it on,” Martin said. “They kept coming out with guidance that gave us a better understanding of how we could spend the money. After the crisis part of it (the pandemic) was over, we had a better idea how we could utilize those funds.” 

The hospital spent $900,000 replacing its entire roof, which had been patched and repaired over the years.  

“We had leaks everywhere, in the ER, in the lab, there were leaks all over the building,” Martin said.  

New digital signs were added at the hospital and each of the community clinics throughout the county. The funds for those came from a grant that offered help with community education. The signs have been used to share messages regarding the hospital’s COVID hotline as well as on such important issues as vaccine availability.  

“We would never have been able to buy those without these grants to cover it,” Martin said.   

In 2001 inpatient numbers were way up compared to previous years because of the coronavirus, but outpatient procedures and other ancillary services that are such a huge part of keeping small hospitals like Jefferson operational were all way down. Funds that came in that year were also used to help support operations.  

“There have been major staffing challenges everywhere,” Martin said. “We still have some contract staff in positions that we haven’t been able to fill full time. Without that money it would have been very difficult for us to remain open.” 

Under grants that provide assistance with infection prevention and control they are working to replace furnishings in the hospital and clinic waiting rooms, lobbies, and patient rooms, trading out fabric furniture for vinyl that can be much more easily disinfected.  

“We have also purchased a lot of patient care equipment,” Martin said. “We have a new point-of-care ultrasound that they can use in the emergency department and in surgery. There’s lots of new equipment. We’re trying to replace anything that is aging or older or adding multiples of some equipment, like our ventilators. We are trying to pick appropriate projects that will prepare us for the future." 

Projects like the new roof Martin said should reduce costs and maintenance for the next 20 years. 

Most recently, Gov. Brian Kemp has earmarked $217 million for healthcare facilities across Georgia through the COVID 19 Prevention and Mitigation Hospital Grant.  

Martin said that the governor has set aside $950,000 per Georgia hospital and Jefferson Hospital has already completed its application process and been approved. 

Around $700,000 of that will go towards replacing the hospital’s emergency generator, which was installed in 1971.  

"It’s extremely old and it’s not large enough to support all the functions of the hospital. So if we do have to go on generator power there are some things we can’t do,” Martin said. “We aren’t going to be able to support the entire hospital quite yet because the cost of the electrical wiring is more than we wanted to spend, but we did purchase a larger generator. We’ll be able to support more of the building and this new one allows us to be able to add different things to it over time.”  

The remainder of the funds will be used to replace HVAC units on the main hospital. Most of its current units are over 20 years old and there are areas like the lab and emergency room that contain equipment and supplies that must remain temperature controlled.  

“We are thinking long term,” Martin said. “The units should save on efficiency as well. I believe that we need to invest these funds in the facility and things we know are going to carry us for a long time. The generator, the roof, HVAC, once updated, these things we will not have to worry about for 10 or 20 years.”