BayCare CEO: Health system is prepared for a Covid-19 surge

Hurricane preparedness and snowbirds have positioned BayCare Health System to handle the Covid-19 coronavirus pandemic.

The system is accustomed to increasing the number of intensive care beds during the winter, when there is in an increase in temporary residents in the Tampa-St. Petersburg area, said BayCare CEO Tommy Inzina. Annual hurricane threats have gotten the health system accustomed to dealing with crisis, he said.

Inzina and Janice Polo, BayCare’s chief financial officer, took questions from investment bankers and credit analysts during a virtual roadshow for the health system’s $600 million bond issue. The bonds — or debt financing — will be used to build a new hospital in Wesley Chapel and to finance improvements at seven other hospitals.

Related story: BayCare prepares huge bond sale as Covid-19 bites into operations, investment portfolio

BayCare, based in Clearwater and the largest health system in the Tampa-St. Petersburg area with 15 hospitals, hundreds of other facilities and $4.4 billion in annual revenue, warned in the bond documents that the pandemic will cut operating revenue and increase costs, but it’s too early to be specific about the financial impact, Inzina said.

“We have faced challenges before. We have faced hurricanes. We faced the recession from 2008 to 2010. We faced the Medicaid program in the state that made reductions. But throughout all of that BayCare has been able to be resilient and produced strong results,” Inzina said.

BayCare’s geography — on the hurricane-prone west coast of Florida —  has given it a leg up on disaster preparation.

“We have a command structure and processes around how we make decisions and communicate that isn’t just simulation-tested from time to time. We typically have to activate our disaster plans as a result of hurricanes at least once a year,” Inzina said.

With elective procedures and surgeries on hold, BayCare employees have been cross-trained to prepare for a surge in Covid-19 cases. The health system does not currently have a severe shortage of any personal protective equipment, but has expanded its sourcing for PPE to make sure it has enough.

Because Florida has a number of seasonal residents, the system typically experiences much higher staffing levels and census levels in the winter than in the summer, so it is used to expanding its intensive care capacity.

“It’s pretty common for a typical hospital to have only about 15 percent of its beds be intensive care beds. But in this disease, at any point in time, you could have 30 to as much as 50 percent of the people hospitalized with the disease needing ICU capabilities. So we have developed a surge plan. We operate currently about 350 intensive care beds and we have a surge plan that would allow us to convert private rooms and other post-operative rooms to ICU capability. So we can expand the ICU capabilities by at least another 200, maybe 300 beds. Based on the current model, we think our ICU capacity is adequate,” he said.

One of the projects the bonds will pay for is a new 90-bed patient tower and other renovations and updates at St. Anthony’s Hospital in St. Petersburg. That project, including refinancing of existing debt, totals $215.9 million, according to an agreement the Pinellas County Board of County Commissioners approved Tuesday.

The new bonds will finance and refinance two other Pinellas projects:

• Mease Countryside Hospital in Safety Harbor master facility plan, $156 million

• Morton Plant Hospital in Clearwater master site plan, Barnard 5 renovation and IR expansion and renovation, $26.2 million

Inzina was asked if BayCare had considered delaying any projects because of the pandemic.

“To the extent there are projects that haven’t begun yet we may delay some of those given the uncertainty and the bandwidth. But for construction projects that are already underway, the cost of trying to shut them down and restart them at a later date can be pretty intense, so our current plan is to proceed with most of the projects that are underway,” he said.

“The exception to that is that we do have a few projects that would involve a lot of construction workers having to get in the hospital, and for safety reasons we don’t want that, or if a project were going to temporarily take beds out of use, we wouldn’t want to — in advance of a potential surge — take beds out of play. Our construction team and chief operating officer have gone through every single project one by one, asking the questions around does it make sense to stop it from a safety perspective. and is there are a cost associated with it, but I’m trying to keep as much as we can going.”

All the major hospital projects are on track at this time, including the patient tower at St. Anthony’s, a spokeswoman for the health system told the St. Pete Catalyst Wednesday. Projects that would impact the use of existing rooms are delayed, such as hurricane hardening efforts that call for some window replacements, the spokeswoman said.