As the pandemic dragged on, many health care workers chose to retire or even switch careers. Now medical facilities, including hospitals and nursing homes, are coping with a shortage that’s reached crisis levels.
“They don’t have the staff. They just don’t have the staff,” says Dr. Vicenta Gaspar-Yoo, president of AHN Allegheny Valley Hospital. She says it’s a domino effect. When hospitals can’t discharge patients to nursing homes or rehabilitation facilities, because there aren’t any available beds, they have no choice but to keep them…
“So what happens is the patient tends to have a longer stay in the hospital, which is actually not favorable.”
Not only is their recovery delayed, but it ultimately creates a backlog of patients, putting a strain on Emergency Room staff who can’t admit new patients.
“Many times that’s because they don’t have a bed because they don’t have a nurse,” explains Susan Hoolahan, president of UPMC Passavant. She says the nursing home shortage is a problem for her network as well.
“Every hospital in the Pittsburgh area on any given day has some number of skilled nursing patients that are staying with them.”
So how long are patients waiting to be discharged?
“In many cases, it’s days, but it can weeks and it can be months,” says Hoolahan. She adds that it largely depends on the patient’s care needs and whether they need special life-saving devices, such as a respirator.
Making matters worse is that staffing agencies who place temporary travel nurses are charging hospitals a hefty premium – as high as $200 an hour.
“Sadly the staffing agencies, there’s no regulations over them and so they’re, for lack of a better word, price-gouging and that’s really not sustainable for healthcare organizations over time.”
The nursing staff shortage isn’t new. Elder law attorney Julian Gray says there were warning signs for years. “The pandemic was the straw that broke the camel’s back as we saw many skilled nursing facilities fold up and my prediction is we’re going to see many more and so we have a crisis that’s been brewing for 20 years.”
In Mount Lebanon, Baptist Senior Family has announced its closing its skilled nursing and personal care home by the end of the year. Some 90 residents are impacted.
Gray says the real issue here is funding. Nursing homes can’t attract new hires because they can’t afford to pay competitive wages. At least 70% of patients are supported by Medicaid or Medicaid, but the government has only increased reimbursement rates by 5% over the past 20 years. As a result, 75% of Pennsylvania’s nursing homes are operating in the red.
“And unfortunately, we as a society have just not made it a priority to fund these institutions,” says Gray.
But there may be hope on the horizon. Reimbursement rates will increase 17% in January, but it’ll take time for get new staff recruited, hired, and trained. Enrollments at most nursing schools were down during the pandemic, but slowly rebounding.
So how long will it take for beds to open? Hospital administrators can’t really predict.
“I don’t have a crystal ball. Nobody knows. I don’t think anyone knows,” says Dr. Gaspar-Yoo.