In the eighth podcast in this series with general counsel on the front lines of the coronavirus pandemic, Sarah Swank, Counsel, Nixon Peabody LLP, speaks with Hal McCard, Senior Vice President, General Counsel and Secretary, Quorum Health, and Peter Leibold, Executive Vice President and Chief Advocacy Officer, Ascension, about how their jobs have changed during the pandemic. The podcast discusses remote workforce issues, how to manage ongoing regulatory changes, supply chain issues, and handling scarce resources. From AHLA's In-House Counsel Practice Group.
To learn more about AHLA and the educational resources available to the health law community, visit americanhealthlaw.org.
In the eighth podcast in this series with general counsel on the front lines of the coronavirus pandemic, Sarah Swank, Counsel, Nixon Peabody LLP, speaks with Hal McCard, Senior Vice President, General Counsel and Secretary, Quorum Health, and Peter Leibold, Executive Vice President and Chief Advocacy Officer, Ascension, about how their jobs have changed during the pandemic. The podcast discusses remote workforce issues, how to manage ongoing regulatory changes, supply chain issues, and handling scarce resources. From AHLA's In-House Counsel Practice Group.
To learn more about AHLA and the educational resources available to the health law community, visit americanhealthlaw.org.
Welcome everyone to today's, uh, GC Round Table podcast. Uh, today is July 28th, 2020. I'm Sarah Swink from the Law firm of Nixon Peabody, and today I have two amazing guests with us. Um, Peter, do you wanna introduce yourself? Although, you know, you almost don't even need to introduce yourself, but why don't you introduce yourself to the audience?
Speaker 2:You bet. This is Peter Lial and my claim to fame is I am the former CEO of the American Health Lawyers Association. Uh, and I currently serve as the Chief Advocacy Officer for Ascension, um, which is a, a health system, uh, here in the United States. Uh, and we have, uh, providers in roughly 20 states, uh, and about 150,000 employees spread throughout those 20 states.
Speaker 1:Great. Thank you. And Hal?
Speaker 3:Sure. Uh, this is Hal Ard. I am, uh, senior Vice President and General Counsel of Quorum Health Corporation. Uh, quorum operates, uh, 22 hospitals, um, and some, uh, associated clinics and physician practices in 13 states. Um, and, uh, just delighted to be here and delighted to, to hear from Peter Lial again, this is just, it's too much, too much to, uh, to really take. Almost. It's fantastic.
Speaker 2:I know. It's like my, this is like, this is old home reunion. This is
Speaker 1:Exactly, well, I'm so excited to have you both here. It is like old. Well, it's like, it is like a reunion and I'm really excited to have both of you. I'm also excited cuz I think you, um, have a really interesting perspective on what's been happening, you know, in the United States right now, given that you are both in national systems with this vantage point. But I'd love to start first with like, um, what it's been like for, for you to do your job, um, virtually, um, what, let's, or in, or going into office and what's that? What's that like? Um, I'll start with you. How have you been going into work and what, what has it, what has it been like during these, this time? Um, when a lot of the states had shut down,
Speaker 3:I actually have been Sarah. We, um, I, I've been, I've been coming in continuously. Our, our offices are located in Brentwood, um, Tennessee. And for the first part of it, I'd say March through, um, maybe May. Um, the, we were in compliance with, uh, the state, um, requirements on, uh, on sort of sheltering at home and things like it was optional, uh, whether to go into work or not. And I had really about four or five o other people, um, had been coming into the office. But I tell people it's, I really see, I saw less people here during that time than I would've shopping at a, you know, Publix or grocery store. It was really only four or five of us. So it was, it was pretty quiet out of a workforce of in excess of a hundred. Um, but slowly as, as, as time has gone on, the workforce has returned, uh, to the office and we're actually just waiting to see, um, uh, what direction it goes in. I think a lot of it's dictated by sort of the day-to-day, uh, reporting. Uh, Tennessee unfortunately, has, has recently bubbled up as, as, uh, having a, uh, a bit more exposure and, and a few and some more reported cases than to cause concern. So, um, I, I've been coming in, coming in regularly though. I'm just not, I'm not a home worker. So I hope, uh, hope, uh, maybe, maybe Peter is, uh, but I, I have a hard time. I have a hard time doing it from the house.
Speaker 1:Yeah's interesting cuz I was trying to think what would change, going back to if I ever had to go back into an office. And yes, we're more casual, but I do have to dress up for my laptop some days. But it's really shoes. Like, I feel like putting shoes on will be an interesting thing if I have to go back into an office ever again because I, I sometimes am dressed up and then don't have shoes on. Um, how about you, Peter? Are you going into the office? I know you used to travel a lot back and forth, um, between d c and St. Louis and other places. Um, how has it changed your, your job?
Speaker 2:It, it, it's been amazing. I have had the opposite experience, so I have not gotten on a plane since the first week of March. It's just, it's just earth shattered. I mean, it's great. Like I, I I can't believe how much that's changed. And we, I have not stepped in, put in my office since the first week of March. So I have worked out of my home here in Falls Church and we have a place up in the Shenandoah and I've spent a lot of time there with my wife's parents, um, you know, there in their eighties. So we're trying to keep them in the protected bubble and, uh, trying to make sure they don't get into contact with those, with Covid. So, um, it's been quite an experience and uh, you know, it is, it is Zoom calls basically from, you know, or Google meets calls from morning to night. Uh, and you know, I'll say we have found ways to get our work done. Uh, you know, and I, it's had some, I think it's had some positive impacts kind of in the ways that we work and it's accelerated some things which I think needed to happen, um, internally. So in that way it's been good. But, but it is weird. I mean, it's weird not going into an office, uh, not having that kind of personal connection that we all had. Um, and seeing others struggle, like, you know, my kids are grown up like they're, they're out of college. Um, but I have colleagues who have young kids, you know, that are, that are in the background and you know, like you Sarah, like that, that that blends your family life and your work life in ways. I mean, I, I'd be more interested to hear what you have to say about it than what I have to say cause I'm just basically working from home now. Um, but I don't have that kind of stress on me.
Speaker 1:It's interesting. I would say, um, if I could only get them to review contracts or do like legislative analysis, they'd be really helpful to me.<laugh>. Um, I think my favorite, um, time, cuz I think I always say it's the over under on how many times they walk into my office and it's not been that many, um, given like how long we've been at home with them. But I think my favorite was they were out playing in the sprinklers and came in and stripped down and like walked, just walked into my office during like a pretty important call about, um,<laugh> looking at<laugh>, looking at legislation, um, what, you know, basically legislative oversight during first future natural disasters and pandemics<laugh>. And it's a pretty serious crowd. But I was able to turn the camera off in time.<laugh>, maybe we have That's a good button to learn the mute button and the off camera button. Um, uh, so, um, so Peter, you know, you so DC shut down, which I, I was interesting cuz when I was in house in DC and we were doing like this pandemic preparedness, it was always like shutting down parts of DC Like it was never in my mind. I could never have fathom. And I, I've heard this actually from working on some of these committees and, and talking to the leaders that do this kind of prepared work. They never anticipated for sure all this, like, all this shut down. But in the, even in the DC area, the idea that the government wouldn't be able to be in session together or these things would ha happen like that. Um, how has that changed your, your job and advocacy? Because we've never seen more legal changes. We know that there's even enough, there's more legislation coming. Um, we've never, hospitals probably have never needed, you know, help more, um, given you know, what was happening and what will happen, you know, how do you stay in touch and how do you do your job, um, virtually
Speaker 2:Yeah, it, it, it it has had an impact on that. So you're right, there are no visits up to the center of the house. There are no personal visits. But, but I, I I, I want to commend, uh, the government. I wanna commend, um, CMS and hhs. They've been doing great work from their homes or from wherever they're working from and, and really a H l a and, and my time there has been incredibly helpful cuz I, you know, I know, um, Kim brand, I know Vicki Robinson, I know others who, uh, have been instrumental in, in, you know, helping the government respond to the crisis. So the way we do it is, you know, we communicate with, uh, people in the government, people in congressional offices, um, either on Zoom calls, I mean, we've had Zoom calls with, um, Senator from Kansas, uh, with a number of members of Congress, uh, Senator Cornin from Texas, been on Zoom calls with him, just making our case about the kind of relief that we need, uh, during the crisis. And, uh, so it, it has morphed the same way that our work has morphed. Uh, and they, I would say, you know, for a politician not to be able to press the flesh, that that must feel very kind of alarming for them. So they've been, they've been very willing and, uh, and able to do, uh, this new form of communication so that we can get our, our ideas in front of them.
Speaker 1:That's, I mean, that's great feedback to hear cuz it's, I know we've had a lot of discussions about this idea of we all kind of need to be collaborative, whether that's across in-house or, or even with the government, like having, you know, we had a question and I was like calling around to people and trying to get, um, people bec to, to hear it in the government too, like, who's the right person? Because you'll see FAQs come up or change about the distributions, and we all can, you know, we're getting the questions as they're coming and they're, and then I am seeing the government respond, or they recently was helping a, a couple clients with, uh, app, uh, they were applying into the Medicaid distribution. And then in the morning the deadline was one thing. And by the time I talked to a different client in the afternoon, it was like the deadline had changed. Um, and I was joking that that happens to me sometimes. Um, that's a positive change of giving people more time to pull the applications together. Um, how, how do you, Peter, how do you keep up with how or how did you keep up and how are you preparing to, to keep up if there's additional changes, you know, coming into the fall and winter
Speaker 2:To, to keep up with kind of legislative and regulatory changes and, and those things like that? Yeah. Um, yes. Yeah, we are, we're keeping up and, and it's really, I think it's been a real benefit. Uh, you know, if you can talk about a benefit of Covid, uh, it, we are working incredibly closely with our legal team, with our compliance team, all of whom I really like and, you know, knew some of them from hla. And, uh, it has brought us together. So we, you know, just as you're working, kind of as outside council, we work with in inside and, and outside council, um, to make sure that we're updated, uh, and to craft our responses. Um, so yeah, we've been working on FAQs, uh, out of, out of hhs. Uh, we've been working on a white paper on virtual care, uh, all together, together to try to, uh, make progress on virtual care. So I'd say the way we do it is we just stay in really close contact with, um, our legal and compliance expertise and with members of government and, and with consultants, uh, that we have on retainer that, you know, continually feed us information about developments as they occur.
Speaker 1:Great. And Hal, so why don't you tell the audience a little bit about your legal department and then, um, we'll talk to a little bit about what's happening, what, what you were managing during this time on top of Covid 19. So why don't you first start with a little bit about your legal department?
Speaker 3:Yeah, well, it's very, very small<laugh>. It's, It's basic. It's basically me and a paralegal, um, with these, uh, with these these ho far flowing hospitals. Um, so it does present it, it does present a number of challenges and Peter just, uh, uh, points out so well. I think the opportunities for collaboration, um, are numerous and the things that we seek to take advantage of the most. Whereas his, his collaboration tends, uh, because of the size of the system, I would think, uh, tends to be with his internal experts in legal and, and compliance. Um, mine tend to be a little bit more outward facing, uh, simply because we outsource, uh, and, and have to outsource, um, part of the, part of the work that we do for the, uh, for the hospital affiliates. So that's been, uh, that's been similar, but just I think for me as, as to Peter's experience, but just also different, but different in focus or different direction, I guess would, would, would probably be, uh, be a better way to put that. But it, it's a lot to, just on the operational side, it's a lot to keep up with because of the multi-state setting that the hospitals are in. Obviously the states have responded in different, um, different ways, uh, you know, to just to issue such as, uh, uh, what are we gonna do with electives and when, when are they gonna cease and when are they gonna return and are we gonna have to cut them back again? And trying to monitor, uh, volume through the hospitals that are co the volumes that are covid related to avoid surge situations and, and, uh, restraint. Some of the states, for example, I mean Kentucky, you know, strikes me as a, um, as a particularly good example of that can be Kentucky, uh, medical society was very active from the very beginning. Um, because I, I think in a lot of states, they've states we've looked toward the governor for, to be this sort of, uh, oracle or pronouncement in terms of what's happening. And I think that's appropriate. But the Kentucky Medical Society, for example, was very active early on in trying to provide guidelines for its physicians and the Kentucky, the Kentucky State Medical Board through the Kentucky State Medical Board. So keeping up with just the various, um, state responses, uh, a lot of which seem to be driven by the, the incidents of the, of the virus, at least on that level or has, has been a, has been a challenge. But as Peter Peter points out, great opportunities for collaboration with state decision makers, um, as well as federal decision makers who are, um, you know, who are providing advice on those. So that's, that's been just sort of in a nutshell, uh, at least my experience.
Speaker 1:Yeah. And so it's also good for the audience to hear that let legal part departments do come in all shapes and sizes, right? There's some that have hundreds of lawyers and then there's some that have how, who probably count, you probably counted a hundred lawyers cuz you're really good. But, um, if I doesn't feel that way,<laugh>, you don't have enough time in the day.
Speaker 3:So sometimes yeah, sometimes you feel like you, you been, you know, sometimes you, sometimes you feel like different people all at one time. So I'll give you that. Although not, not as bad as, you know, sort of this civil type thing, you know, where I have, you know, 37 different personalities. Um, but yeah, when you have to wear a lot of hats when, uh, when you're in a a, a smaller size department, I think that's absolutely right.
Speaker 1:So why don't you tell the audience about what you've been on, on top of managing all this with Covid and, and the hospitals and the different states. Your, your system. You were working through something with your system. Why don't you tell the audience a little bit about what, what you've been working on? Um, yeah. You mean what transformations happened at your system? Yeah,
Speaker 3:Yeah. The reorganization, the bankruptcy. Yep. Yeah, sure. Glad to. Yeah, I would be glad to touch on that. I, we, um, the, the system, it had had been burdened historically with, um, a, a heavy debt load. Uh, that's, that lasted really from the time that it was spun out, which was about four years ago. It's been about four years ago. And, um, looked at a number of different, uh, alternatives for, for deal making. Uh, were approached by, uh, several different systems, um, with merger concepts and things like that. Uh, none of them came to fruition and it became obvious that it was gonna be difficult to sustain. Uh, most, most of our hospitals, with the exception of probably four or five of the 22 are, uh, sole community provider settings. Um, they are rural settings, um, really only have four or five in the system that would be considered to be an urban, uh, more urban markets. And it became obvious after a while that the performance of the company wasn't gonna be able to sustain the debt commitments that the company had. And so, about six or eight months ago, uh, the debt holders, um, were able to get organized and to present a plan to take the company private, but to take it private through, uh, a chapter 11 bankruptcy process, which is, is for those who, for those who are not bankruptcy lawyers, and I am not a bankruptcy lawyer, although I know a lot more about it than I used to. Um, it was a, a pre-packaged, uh, type of bankruptcy in which we present the bankruptcy judge in the court with a, with a, uh, plan, if you will, uh, for going, entering the process, uh, financing during the process, the bankruptcy process, and then, um, a, a debt structure, uh, post emergence from the bankruptcy process, which the court would then approve. So we were able to do that. Uh, the pre-packaged, uh, type bankruptcies generally move a lot faster. Ours moved in about eight to 10 weeks, more or less. Um, after we, uh, we met some objections, um, from some of the folks who showed up. Uh, but that, that was fascinating process. We think that that was the first, um, fully, uh, video, uh, conducted bankruptcy process in the country. Uh, because we had filed so early right after the court shut down, uh, sometime in the end of, uh, or about the middle of April. Um, and so we think in Delaware it was, it was in the Delaware, uh, Delaware bankruptcy, uh, court. We think, we think it was the first one, uh, at least my counsel tells me that as far as they can determine, it was the first series of hearings held, uh, preliminary hearings, uh, and first day hearings held in a bankruptcy proceeding in the country. So we, we felt pretty, pretty happy about that, uh, in some regards. Uh, but yeah, it, it, we emerged, we're able to emerge on time and with a, a greatly, uh, reorganized death drug. So that made a lot more sense for the type of thing that we're doing. And, and, uh, it, it was able, we were able to resolve some issues. And like I say, emerge is a stronger company with, with, uh, great opportunities for growth and potential for the future.
Speaker 1:Yeah, there's a, you know, it's interesting cuz one, we were talking a lot about distress hospitals or, or on the office side, um, systems that were buying up distressed hospitals either at a mission or market or, you know, whatever the rationale was. Um, and it was funny cuz I, I'm, I'm not a bankruptcy lawyer at all either, and I met some of our distressed hospital team, which just, I was like, we have infrastructure. Like that's a thing. And now, like in the pandemic there, it's, there's law firms that are moving people around over into bankruptcy because not just in healthcare, but across industries, but all that to be said, right? All that to be said, it doesn't always have to be a bad thing. I mean, it can, a lot of times it would be, but there are, I mean, it's nice to hear your story because, um, when we hear the word bankruptcy, we think, oh, oh no, everything's, you know, all, all these companies are going under,
Speaker 3:Right? Well, that most people think liquidation, you know, they, they think mm-hmm.<affirmative> pretty much liquidation selling off of assets. Although I was, you know, and to satisfy the claims, the creditors, although I was, you know, it was a fa it was a great education. I mean, I, I can tell you it was a great education, but our, our pre-packaged proceeding was, was distinguishable from a, what, what I learned that people refer to as a free fall bankruptcy, which is more of a, a liquidation type proceeding. Um, and, and you know, it's, it's been interesting, I mean, with some of the, uh, with some of the, uh, the properties, what has happened to them. I mean, we had, we, we actually, we had to close a hospital, um, in, in Blue Island, uh, Illinois. Uh, which was a process that took, uh, about six to eight months as we were working with the IDPH in the, the various, you know, state officials and the local, uh, the local political interest to try and come to a satisfactory solution on that. But we<laugh> we found out not too long ago that the, uh, the state, and so the campus was essentially closed and it was, the property was eventually bought by nu by a buyer, uh, who wanted to develop it, um, for some healthcare purpose. It was not acute care hospital related, but we found out recently that the state had filed, um, a petition for imminent domain on the property to reopen it and to re try and respond to the covid crisis. So we were, we were well past ownership by that point, and had, and had, um, and had disposed of the hospital to the buyer. But we were fascinated, uh, that that, uh, sort of thing was, was happening and, and Blue Islands on the south side of Chicago. Uh, but we were fascinated that that had sort of been the ultimate fate that it would now the hospital, which was in, you know, still in working order when it was shut, uh, there was nothing wrong with it as fully licensed and accredited, um, we're fascinated to see that it was now the subjects of an imminent domain proceeding under the state's emergency powers due to the covid crisis. So you just never know how those things will turn out.
Speaker 1:No, I guess you, I guess you don't, cuz I know there were other hospitals in other states where they, some of'em were left abandoned, uh, like basically, I mean, someone owned the property in the building, but they weren't used at all. Um, yeah. Here
Speaker 3:In, yeah, here in Tennessee, they were looking at reopening a couple se several of the, of the more rural hospitals that had closed during the past, not hours, but during the past year or two years or so, that could still be used, um, could still be used in a, in a hospital, in a hospital way, you know, that hadn't deteriorated to the point that they were unusable anymore.
Speaker 1:Yeah. So, so Peter, you're, um, in a, in a different type of system cuz you're in a state based, um, nonprofit system. How do you, how do, and I'd like the contrast how is saying he's in the for-profit system in, out of Nashville, you know, but in, in both cases it's about, you know, serving the communities and, um, interacting with the state and in some cases survival or interact or partnering with physicians, you know, what are some of the strategies and, and advocacy that are happening around that? Or I mean, what happened and, and what do you, what do you think might happen in the future?
Speaker 2:Well, it, uh, it, there's been a lot of financial stress. I mean, you can't overemphasize that, uh, once electives, uh, were, uh, prevented in many instances, uh, by state executive orders. Um, you know, that, that, that dries up your revenue. Uh, and so, you know, I think, I think all health systems, whether for-profit or nonprofit, um, have had to deal with, you know, a, a depletion in their revenue stream. Um, so advocacy became all the more important. I mean, you know, the, the, the revenue that we have gotten, uh, and the loans that we have gotten, um, from the federal government, uh, and I and I, and we're hoping that in this next bill, uh, they will amend the terms, uh, of the loans that were provided to healthcare, uh, so that they can be paid back over a longer term, uh, and they can be paid back, uh, without doing a hundred percent of the payment, uh, when they come due. Um, but that said, they've been incredibly beneficial. Uh, and we, you know, we are in indebted to, uh, Congress and to the administration and to others foreseeing the need to provide those resources to hospitals and health systems throughout the country. Cause you know, as you implied, I mean, it, it has been very, very difficult for, uh, many hospitals. Um, some in areas of the country where Covid was not as, uh, alarming in the spring, just laid fallow and lost revenue. Others became overwhelmed. And, you know, we, we have, uh, hospitals in Detroit, uh, in Michigan, in Illinois, in Chicago. Uh, they were overrun. Uh, and, you know, the state and our, uh, Michigan, uh, hospitals collaborated on, uh, setting up, uh, you know, alternative hospitals, uh, alternative places where people could go. So that, that's been one issue with this, uh, uh, pandemic, is that it, it surges in some areas and it doesn't serve in others, um, which does argue for state, uh, you know, that there can be differences in state policy with respect to them. Uh, but obviously there are, you know, there, there are some things that everyone should do throughout the country to try to reduce the spread of the pandemic. But it, it, you know, it, it has been difficult for us financially. Um, but I think that our, our clinicians, and you know, it, it, it's said all the time, but it deserves to be said, they, they have been heroes in this, uh, they have risked their lives going into hospitals throughout the country in order to care for, um, covid positive patients. You know, putting themselves at risk, uh, trying not to put their families at risk, but by doing so, segregating themselves from their families. Um, so, you know, I just, uh, kudos to doctors, nurses, those people that do, uh, supply work, those who are cleaning in our hospitals that are nursing homes. I mean, the list is endless of people that have sacrificed themselves to, um, to serve the communities. But, uh, it, it, it, it's been, it's been difficult. Uh, you know, it's been a challenge. Um, but, but I feel like Ascension in many respects has risen that challenge. And, and, and our board has been understanding of the fact that, that we're facing these financial challenges and we're trying to innovate to deliver care as best we can.
Speaker 1:So would you, I feel so the same way about all the people on the front line, that, you know, it's what's hard to see where the pictures of people in trash bags trying to care for patients because they didn't have the proper p p e, and you know, we're hearing less and less about that. But I know we're going in, um, for those of you who do spend a lot of time in healthcare, we know the flu season can be different each year. But we have that potentially overlying covid 19. I, I was reading that there was some cities in other parts of the world that were showing that because we're, if you're socially distancing with masks and washing your hands more, there may be less transmission. But, you know, we don't know how that may impact us here. But, but ultimately we may be back to thinking about, um, ppp. Is that on your radar at all? Um, I think I've been thinking about are ppe obviously vaccines and innovation, um, are, you know, are those things that, that you think about in advocating in going into the fall and winter?
Speaker 2:Absolutely. Oh my gosh, they're, they're very high on the agenda. We, we are lucky enough to have kind of internal purchasing group called the Resource Group. Uh, and they deserve commendation, uh, for the efforts they put in to try to get us ppe. I mean, the efforts, and this is where, you know, I'm sure Hal has similar stories where everyone had to do everything. Um, you know, I was on calls with people that were offering, you know, different ways to try to get PPE from different countries. And I would put them in touch with the resource group so that they could reach out to people to, to they, they really tried everything they could to make sure that the clinicians had the supplies that they needed. Um, and so, uh, we, we, we, they have been heroic, uh, at the resource group and it, and it, it could still very well be an issue as could testing. And we have a national testing lab that, um, has, uh, been, you know, making every effort to try to keep us, uh, with a, with a decent testing supply, uh, in Florida. We started running drive-through testing, um, and we've been trying to innovate in that area as well. And I think doing it fairly successfully, but that remains an issue. Um, I think we're collaborating with almost all of the pharmaceutical companies that are trying to develop a vaccine. Uh, we want to be, um, you know, involved in those. Uh, but you're right to point to that. I think everybody, you know, everybody wants to see, uh, you know, an accelerated development of vaccine that will give people confidence that, um, they can, you know, reenter public life and the economy in a way where that will help the economy grow. So all three of those issues that you mentioned are of enormous import to us. Uh, we have people working around the clock on them and doing a great job from, uh, from our perspective. Um, but it's not easy. Uh, and they run into challenges every single day. And so, you know, as I said before, we in advocacy have been collaborating with so many people now in the system that, that we otherwise probably wouldn't have had as much contact with. And, uh, those who do testing and those who try and get ppe, uh, and uh, those who are interested in vaccines, we are, uh, we are very much in contact with them and trying to be a resource for them in any way that they think helps them do their job more effectively.
Speaker 1:Yeah. So Hal, that Peter just said it, like, did you have some of those experiences? Cuz I know I did. I was like, I would get, I guess it was interesting to be in a position where you're a law firm where you were getting things and I would like someone say, oh, I know someone that has like maps and I'd like send it to like a bunch of lawyers who would then forward it off to their supply chain. Um, folks. Um, did you have those, any of those experiences where you were working some of those issues?
Speaker 3:Yeah, I had a number of'em. I got more interesting emails, uh, during the, during the first iteration, during, you know, sort of the end of February, 1st of March when the, when the thing really gained some, I think gained some traction when the virus really gained a lot more traction, became more of a national, you know, national story. And then the, the stories about the strain on the healthcare system. But I was amazed at the resourcefulness of some of my local council, um, at, at coming up with, um, sources, uh, for, uh, for various of the PPE and the, the masks. Um, and, and just various and sundry other supplies. So yeah, I, I did, I got some interesting, like, so I got some interesting email from, from some interesting places as well. Uh, but we're fortunate we have a, a gpo, a group purchasing organization that we have access to that that was also, I think took a lot of the, um, uh, took a lot of the, the sort of ups and downs out of it, made it a little bit more, um, uh, evened out the rough edges, I guess it might be a better way to put it. Uh, and so even though supplies may have been lower, there was, uh, there wasn't quite this, um, fear of running out, you know, running out of equipment to zero, um, as, as opposed to, to knowing and being able to predict what the supply chain was gonna look like to the extent that we could. And so we could plan, you know, trying to plan accordingly. Um, but yeah, had<laugh>, that was the supply, the sort of underground, the underground supply, uh, market was, uh, was hopping there for, for some period of time. And I see where I see where a lot of it's been in the subject of federal enforcement<laugh> now in terms of, uh, some criminal enforcement and some, uh, and some other, uh, and, and some other things. So I, I, I, I, I commend the, the efforts to get it, but also the efforts to, to try and control it and maintain some quality over it.
Speaker 1:Right. So how about, um, how about testing and, and, and other innovations? I know you're going through a reorganization, um, but those things, those two items are also really important. What, how are those, um, how, I mean, obviously testing has been, we we're seeing the evolution of those and we're hopefully there's more innovation going. Um, but how do you see that playing into, um, the rest of the summer and, and fall and winter?
Speaker 3:Yeah, I mean, you, you'd hope to see a, a continuous increase in it. I mean, we, we enter that question, I think more from the standpoint of safeguarding the, um, wellbeing of our, of, of our workforce and our employees and the folks that Peter, um, so eloquently talked about who, who were out there caring for folks. I mean, they're, they're really our first, um, first concern, uh, as far as testing, community testing and, you know, uh, matters like that. I mean, we've seen, you know, speaking just from, from personal experience here in Tennessee, we've seen a great, um, increase, uh, in, in the availability, um, of, of covid testing. I would, I would hope that that would continue, uh, you know, as we go into the, as as we go on into the fall. Um, and it, it impacts a lot of, you know, it's a lot of, uh, different aspects of it. You know, whether the kids can return to school or not. That's a very hot issue here in Nashville right now. Uh, what's the school you're gonna look like? Um, how's that gonna, you know, how's that gonna work? What sort of testing will there be, uh, on a regular basis? And, uh, how, how will they control that? So it's gonna continue to be a, you know, a huge, uh, uh, I think a huge issue as far as the vaccine goes. I think that's the sort of holy grail. That's what everybody seems to be waiting for it. Um, and with good reason. Uh, but, you know, I kind of, it, it's almost, I I kind of liken it to being stalked by a turtle almost, because there's this, this seems to be this psychological slow process where, you know, we think we beat it back a little bit and then it flares up, uh, in various hotspots again, uh, whether by city or by state, um, or by region in some cases. And it's just this inexorable, um, spread. It seems that sometimes that, uh, that hopefully the, the vaccin we see promising things, this other are gonna enter a phase three on one of'em. Um, I don't know if it's the Oxford and then if it's the Oxford group or not. I forget, uh, just right off hand. But there does seem to be a number of, and I saw Pfizer recently the other day, saw Pfizer had been, had received a contract to produce, uh, multiple million doses along with one or two of the other. So that was all, you know, all very promising news. But I think the, the vaccine is, is what everybody seems to be waiting for.
Speaker 1:And the other thing I've been thinking about, um, is nursing homes, uh, because right, I mean, when you look at like, the statistics, even you look at over 60 and then you really look at that population of over 60, and you look at the over 80, and then you, um, years old and you look at, um, you know, and you, and, and they seem that, that over ADC most vulnerable. And if you look at where that population sit, it's often in a nursing home. Yeah. So I'll start with, start with you. How, like, what have you been thinking about that and how do you, how, how do hospitals partner with that, with nursing homes? And how do we like, cuz we're, we're serving our communities. How do we do that? We don't have,
Speaker 3:Yeah, we don't have a lot. We've got, um, we've got, uh, two or three skilled nursing facilities that we, um, that we operate. And obviously they're, they're in full life now. I'll tell you just a personal story. My mom's in a skilled nursing facility in Georgia and I haven't seen her since, um, probably January Bec well, February, yeah, because the thing's been just on absolute. And my, uh, my father, they live in a sort of multi-level, um, uh, community where they're all different levels of healthcare available as people progress through life. Um, so it's, and that thing's been on, uh, uh, lockdown since March. Uh, so, you know, just even, even from a, a personal standpoint, I haven't been able to see my parents since then because access to the, to their community has been restricted, uh, with good reason. I think it's Prudential. Um, you know, it's, it's been clear that once the virus gets in amongst that population, it, it wreaks havoc and results in a lot of death. So, uh, so sort of, you know, on the one hand you understand why it is, but on the other hand, you know, you can see, um, you can see what it, what it would do. And we've, we've obviously the, where our, where our nursing facilities were involved, we've, we've taken, uh, sort of draconian, uh, for most protective measures, uh, you know, to try and protect that, that particular population.
Speaker 1:Yeah. And I'm sorry to hear about your parents. I think it's a pretty, it's a fairly, it's fairly common. I know some visitation in a loud and certain certain, um, nursing homes. But, you know, think about some of the studies that were done around, uh, uh, you know, just that population, but just, I mean, it'd be interested people being around people and how as, as humans, that's something that we crave and, and need. Um, and so Peter, how about you? Have you been thinking about nursing homes and the interaction with nursing homes and in the communities that you serve?
Speaker 2:A Absolutely, um, Ascension has over 50 senior living communities in 12 states and in Washington DC And, um, you know, for a while there in the spring, there were daily calls from our command center. Uh, and thankfully, you know, cuz you, you read about stories where, uh, if, if nursing homes were not doing covid protection the right way, it just spread like wildfire through their senior living communities. Uh, and we definitely, uh, had some instances of covid. Uh, we had some death, uh, in, you know, in, in our facilities. But to the best of my knowledge, I don't think we had one of those situations where it just started spreading like wildfire through the community. So that, that's kudos to Ascension living and their leadership and the people on the ground. Um, they, you know, I I they, they, they would be humble enough to say that they were lucky enough to learn, uh, uh, from the cdc, from others, from best practices put out by their associations. That's the value of association. I'm sure that the senior living associations were offering educational opportunities, uh, they put those into practice. And, um, you know, while there were absolutely challenges, uh, there was a woman dead Falkenberg that was on our calls, uh, every day. Um, they, they, they seem to have done the work necessary to avoid, you know, cataclysmic events, but they, they were on our mind every day. Uh, you know, I know, um, Danny Stricker, who heads up Ascension Living was on some of those association calls and was talking about, you know, the need for ppe, the need for resources, uh, you know, that, uh, the provider relief fund, um, it, it was always misnomer to a hospital fund, uh, and only probably half of the resources, but the hospitals. Um, but I think senior living, uh, and nursing homes had, uh, you know, a recognizable claim that not enough resources were being put to them when, as you said, Sarah, their communities were the vulnerable community. They were the ones that if they got covid, you know, it would have really bad ramifications. So, you know, it, it was definitely on our mind all the time. Uh, and I think that, you know, they needed, uh, they probably needed more resources than they got, um, for, uh, the kind of issues that they had during this crisis and will continue to have. So, you know, it is, it's, it's constantly on my mind. Um, and, uh, hopefully, you know, we'll just continue to advocate so that they get the resources they need.
Speaker 1:Great. No, that's, I, I've been thinking a lot about it and having talked to senior living communities and others that before there was any funding, they were, um, they were loo they were losing population both by, um, not being able to take new, um, new members, but also because people were, like, in some, in some cases people were, were dying of covid cuz they were in a surge area, for example. And, um, and they were trying to do their best and do all the things that they needed to, but they were, uh, didn't always have the resources that they needed to do that. And I think there's a common theme of like, we need to make sure the people that have the resources, um, have them, right? I mean, it seems to be what we, what what's so important, um, right now to think about. And that's what I've been thinking a lot about. Um, so, you know, let's, it's so, it's summer<laugh>. I know we're gonna, like, we have different seasons, right? And we're, I, it's hard to imagine that we were in fe march, you know, February, march, and now we're in, we're in the summer. Um, what have you both like, I'll start with you Peter. What have you been doing to like, you know, take a deep breath knowing that we're going into fall? Like how so, you know, our communities are thinking about schooling and whether to go back testing all the things we're talking about, PPE e um, our work, our workforce and healthcare have had gone through a lot while they had a lot of cases or were just preparing for the cases that didn't come, um, or are getting cases now. I mean, how are you, how, how are you personally, you know, taking a deep breath and, and getting ready for the fall and winter and what's to maybe potentially to come?
Speaker 2:No, it's, it's important for all of us to do. I, you know, I was on calls the last couple of days and, you know, people kept using the expression that, um, employees been muscling through. They've been, you know, using momentum to continue to be as productive as possible. You know, kind of riding the emergency high of the spring, but it's gonna give out. Um, it it, you can't keep going at a relentless, relentless pace without trying to find times to recover. Um, so one thing, and, and it is great, the, there's been this kind of cultural recognition, um, that one employees, if they possibly can, should take their pto, their paid time off. Uh, and if they do, and this was, there was a great example on a call today. It was a leadership call and we were discussing an important topic, uh, actually, you know, about the fall in the winter and said there was a guy that got on, a good friend of mine, um, cuz he thought the topic was really important, but he was on pto. Um, and the CEO who was leading the discussion, um, had called on everyone to talk about this particular issue and had not called on him. So I, I texted the CEO and said, Hey, you know, this guy's on the phone. And he, and he called on and he said, you know, I thought you were on pto. And the guy said, yeah, but this is a really important topic and I wanted to phone in. And he is like, you gotta take your ptl. Um, I didn't know you were on the phone. Uh, you know, I think if you are taking pto, you gotta take time for yourself and for your family. And to set the example, the CEO was on PTO last week and he totally, he totally disengaged to the degree that he could. I mean, I'm sure, I probably don't even know of the circumstances where he had to be brought back in to make decisions. But he is trying to set the example of taking PTO and really taking time off with his family to recharge, to recharge his batteries. And he's telling all of us do the same. Don't, and not only because you're doing it for yourself, but to set the example for everyone else that when you take pto, you disengage. And that is kind of a cultural change. And one of the guys on the phone this morning said that like, you know, he, he took PTO in the past, but he did calls, he was checking his email, he was making sure he wasn't missing anything because he kind of thought that was the expectation. So by the CEO making this like a serious issue. And by actually upgrading the guy on the phone from being even on the phone because he was on pto, it just sets a really good example. And I, and I, I commend him for it. I think we all need it. We're gonna burn out. He can't go at this pace forever. Um, and so, you know what I, what I do, cause I can't, you know, Hal and I are talking about the beginning. I can't play soccer. You know, we're not, I I I'm not in the Premier league, so I can't be tested and go out with my buddies and play soccer every weekend. So I've become a big Peloton guy. I got a Peloton, I get on there, I'll, I'm gonna get on there after my calls today. Um, it's important for me to exercise kind of hard on a regular basis. All my old colleagues at a HLA will remember that that is kind of important to my mental health. So I'm just finding ways to do that even in an era where you can't play socially like I used to. Um, I'm still getting out on a bike, you know, working hard, trying to get out some, you know, steam, sweat, um, just, you know, stay as fit as I can in this time. But it's a really important issue. I'm glad you raised it, Sarah. All of us need to take that time off if we can.
Speaker 1:Yeah, I was talking to a CEO today and she was saying, cause I tried to take Tim off and I'm awful about it. And, um, because I don't, I I wanna make sure I'm responding to people, but um, and she was saying the same thing. She's like, I think I took a week off, but it didn't count<laugh>. I think I did. You know, if you're, especially if you're working at home most days and you end up working the same hours that you didn't take those days off, that doesn't count. Right. Um, um, how, how about you, what are some of the things that you've done to kind of regroup, um, before we get into fall and winter?
Speaker 3:Yeah. Well, I, I completely agree with Peter on the importance of, of just regular physical activity. I mean, I, I, I work out with a trainer three days a week and a run on the weekends. Um, it's just part of my personality. It's something I have to do to, to maintain sanity, um, just, uh, with, you know, with, uh, with everything. But I, you know, and I, I completely agree. I haven't really thought about<laugh>. I really, really haven't thought that far ahead to tell you the truth.<laugh>, which is probably to my, to my discre. Um, it's really been more of a one, one day at a time, one week at a time, uh, for, for some time
Speaker 1:How I'm making, I'm making you, I'm making you plan now on podcast.
Speaker 3:No good. Yeah, we would normally, we would normally go, you know, do something in a beach setting around Labor Day. You know, traditionally we would, we would do something like that. And I really haven't thought that far ahead, the beach is d you know, if you're, if you're properly socially distanced, the beach might be an inviting place. Um, but we'll have to, we'll have to see, uh, like I said, we didn't, didn't have any, uh, don't, don't have any plans, uh, yet, but this is probably gonna give me a catalyst to, to try and, and think about it a little bit more. So thanks for that. I appreciate that Sarah.
Speaker 1:See you learn stuff on the podcast and now I'm gonna harass you about bug you constantly like your slow tur like your slow turtle analogy,<laugh>. And I'm gonna make sure that, that is a
Speaker 2:Great analogy. I'm gonna steal that phrase. I love that phrase. I've never heard it before. That is a great phrase.
Speaker 3:Yeah, I have added, I, I just, uh, it just, that's what it seems like. I mean, you, you look over your shoulder, it's still there. Well, yeah, you look over your shoulders still, there're a little bit closer. Uh, look over. Yeah, it's still there, you know,<laugh>. So it just, I dunno, it just kinda seemed the way it was
Speaker 1:<laugh>, I think. That's great. Um, so how, why don't you, um, you know, we're getting to the end here. Um, and I think I could probably talk to you both for hours and hours. Um, but why don't you, why don't you, uh, tell us something you'd like to leave the audience with? What's something that you would like to, a takeaway for the audience today?
Speaker 3:Well, I, I think we've covered, uh, you know, really just, uh, in summary, I think we've covered a, a lot of things that, that I hope folks will, will find useful, you know, and, and personally as well as just sort of in regard to our systems. Um, don't lose hope, you know, don't, uh, try to maintain patience is, you know, patience is a good thing, uh, to, to try to, uh, to maintain as well. So, you know, I think, I think hope in patience, uh, in, in difficult times, uh, obviously it's gonna call for folks. Uh, and, and I'm especially proud of all of our A H L A members, um, who will be asked to demonstrate leadership as well. And, and there's a reason that the association I think is so successful, um, because it's members take, uh, their mission very, very seriously. And so there will be opportunities, I think, in this for folks to demonstrate leadership and to demonstrate, um, what they have and what they can do. And I just kind of ask them to, you know, accompany it with, uh, with that little, little bit of extra patience and hope and, and never lose, never lose sight of that. You know, we're, we're going to, to move to, uh, to better days ahead, I think, um, and a little bit more normalization. So, uh, I think if anything I'd, I'd ask folks to consider that and also to thank'em for, for spending the, the last, uh, 30 or 40 minutes with us. We, we certainly appreciate that as well.
Speaker 1:Great. Thanks Hal. How about you, Peter?
Speaker 2:Boy, Hal, Hal, hit it. Um, um, you know, I I what this in, in the context of hla, what, what this has brought home to me was the importance of the relationships that are created in, uh, the American Health Lawyers Association. And, and the fact really that it's not an advocacy organization. I'm an advocacy now, but these relationships were in many ways built up in the context of an association where people are not advocating with each other. So you just get to strengthen your relationships and, you know, in times of stress, relationships matter, and we're kind of learning how to continue relationships, like we're doing this on the phone or we could be doing it on a zoom call or, you know, so that puts stress on relationships. But the fact that there is an association that believes in studying health law, making health law better doing it together between private sector and government, um, means that when the stress comes, uh, when there's a crisis, um, the strength of those relationships matter. And, uh, you know, there's no one that can probably better talk to that than David Gage who runs it now, and as you know, serve for a long time in government and now runs the association as to how those relationships can really make a difference. So I'd give you the same advice as how, um, be patient, uh, believe in something that's bigger than yourselves. Uh, and, and we all need to do that, um, in order to, uh, have the patience to ride this out. Um, you know, and, and, and as you implied Sarah in your questions, be as innovative and transformative as you can. We're trying to do that with virtual care. Let's, let's to the best of our ability, try and build opportunity out of crisis. Uh, and so I'm just glad that, uh, I've had such great experiences with A H L A and that it's been a large part of the relationship building that that is critical to the job I do now and was central to the job I did then.
Speaker 1:Well, thank you Peter, and thank you Hal, and thanks for leaving with that because, you know, I know you both through h l A and, and, uh, and I feel like I have so closer to people. There's just something about, um, during these times where you know, you, like you said Peter, you could feel more distant, but I feel like because of the strength of the association, I feel closer to people. And so I really appreciate you both joining us today. I appreciate the audience joining us today. And I would direct everyone to go to the, uh, a h l a, uh, coronavirus hub. If you need additional information, if you wanna listen to the other podcast. Um, also if you want to, uh, join the membership, that would be great. Um, I really, really appreciate everyone joining us today. Thank you.
Speaker 2:Thanks so much. All right. Thank you all. Thanks for.