Pandemic relief funds can mask budget crises in rural hospitals in Western Australia

Disparities in transparency

More than 20 miles down Highway 2 at Central Washington Hospital, nurse Paul Fuller said he saw his fellow healthcare workers leaving ‘en masse’ amid hectic schedules, heavy patient loads and growing burnout. Some took on attractive travel nurse contracts that offered significantly higher pay. Others felt stretched by staff turnover or left in the dark about how hospital administrators planned to deal with the crisis.

“Hospitals as a whole need more transparency, at all levels,” he said. “Because it’s teamwork. …Staff should be able to know what is going on.

If the hospital had told staff where the pandemic relief money was going, all the restrictions on that and why there wasn’t enough to give them hazard pay or retention bonuses early on , said Fuller, it would have made him feel much more respected. He said he thought it would also have stopped some of his colleagues from leaving.

Reporting requirements for federal relief, such as vendor relief funds, may seem solid, despite delays in post-payment review or audit plans. Reports can be time-consuming and detailed, according to administrators such as Blake. But private hospitals are not required to share this with their employees or the wider community.

Washington Central Hospital is owned by a private, nonprofit organization, Confluence Health. A spokesperson declined to confirm how much the hospital has received as part of federal pandemic assistance, how it has used the money or details of its current financial stability. Confluence’s audited financial statements are not public records and its IRS tax return (Form 990) has not been released for 2020.

In its 2021 Community Report, Confluence writes that CARES Act money has helped it “maintain a positive operating margin.” According to federal data, the two Confluence hospitals and possibly other related entities received $34.7 million in provider relief funds.

Multistate systems PeaceHealth and Providence St. Joseph Health have both agreed to share information with Crosscut about pandemic relief awarded specifically to some of their hospitals in Washington state. Otherwise, federal rewards to large hospital systems often mask dollars going to local hospitals.

For example, Crosscut estimated that Providence St. Mary’s Medical Center in Walla Walla received $5.5 million in relief funds from providers listed under two iterations of the Providence Health & Services – Washington name in Walla Walla. But the Providence spokesperson confirmed that they received $15.6 million.

In response to these reporting gaps, health unions and other advocates have pushed hospitals to report not only to the government, but also to their communities for their use of federal relief funds and other activities. during the pandemic.

“More transparency is always better,” said Ruth Schubert, spokesperson for the Washington State Nurses Association, which represents staff at Central Washington Hospital.

In Washington State, a 2021 law (House Bill 1272) will soon require hospitals to report to the state Department of Health further details on hospital expenditures and revenues, grants and loans. emergency (such as during the current pandemic), patient demographics, charitable care and Suite.


Find tools and resources in Crosscut’s Track Money guide to track federal stimulus spending in your community.


Similarly, Community Catalyst, a national nonprofit focused on health equity, sent a letter to U.S. Secretary of Health and Human Services Xavier Becerra in August, calling for greater accountability and transparency of federal funds. pandemic relief.

And, he argued, subsidies to health care providers should be conditional on those providers taking “concrete steps to address health inequities.” These measures could include the suspension of medical debt collection activities during and for at least one year after the end of the public health emergency.

Mark Rukavina, program director at Community Catalyst, said no new restrictions have yet been imposed, but his organization continues to advocate for tougher rules on future relief funds.

“We would like to see clear conditions attached to this funding,” he said, “so that it benefits both those hospitals or healthcare providers, as well as the patients served by those providers. “