and state governments that patients are still going to require surgery, but
physicians need to use their clinical judgment to determine whether
those surgeries can be delayed."
'A big hit financially'
Monticello Community Surgery Center in Crozet, Va., is essentially
shuttered. The multispecialty facility went from performing 115 cases
in one week in March to five the next week, says CEO Andy Poole,
FACHE. The facility's physicians are performing only emergent proce-
dures such as repairing detached retinas, fixing fractures and remov-
ing cancerous lesions. Staff members are working on securing an
emergency loan needed to ensure the center's 30 full- and part-time
employees keep getting paid.
"It's been a big hit financially," says Mr. Poole. "We know the case
volume will eventually return, but we need a way to take care of our
employees, so they'll survive in the meantime."
To that end, Mr. Poole and other surgery centers around the county
turned to the emergency Coronavirus Aid, Relief, and Economic
Security (CARES) Act, which appropriated $350 billion for small busi-
nesses to keep employees on the payroll. Under the CARES Paycheck
Protection Program, the U.S. government will guarantee the loans to
small businesses who maintain their payroll during the COVID-19
emergency and will eventually forgive 100% of the principal amount
borrowed.
Mr. Poole hopes the CARES loan will last until Monticello can
reopen. When that happens, he plans to take advantage of the CMS
Accelerated Payment Program, which Congress expanded for the
duration of the current public health emergency. Facilities such as
Monticello can apply for up to 100% of the Medicare and Medicaid
reimbursements they would have normally received for three months,
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