For-profit hospitals reported treating their highest numbers of COVID-19 patients during the third quarter of 2021 as the delta variant surged across the country.
About 10% of Tenet's admissions in the quarter had COVID-19, compared to 4% in the second quarter, executives said on a call with investors. Universal Health Services' acute care admissions with a COVID-19 diagnosis during the period was around 14%, executives said.
But this wave was markedly different from others throughout the pandemic. Hospital volumes didn't plunge or remain depressed. Instead, most systems' numbers improved or nearly mirrored those before the pandemic.
"Unlike previous surges, non-COVID volumes including emergency room visits and elective and scheduled procedures were not crowded out and in fact, generally were running at or near pre-pandemic levels," UHS CFO Steve Filton said on a call with investors.
Emergency room visits in particular rose significantly in Q3. At HCA, same-facility emergency room visits soared 31% compared to the prior-year period, and Tenet's emergency room visits were up 25% year over year.
At the same time, workforce issues and widespread burnout came to a head during the period.
Community Health Systems was the only for-profit operator not highly affected by rising labor expenses, while those costs were up for Tenet, HCA and UHS during the quarter.
HCA used contract labor, overtime, bonuses and "whatever it took to staff to the patient load that we had," resulting in about 10% to 12% of full-time staff being placed in premium pay categories, CFO Bill Rutherford said on a call with investors. The company expects that to trend down as COVID-19 cases decline, in line with past surges, Rutherford said.
Higher revenues helped UHS offset premium labor costs during the quarter, though it still spent more on overtime, temporary travel nurses and sign-on bonuses, CEO Marc Miller said on a call.
Turnover now is a key challenge, driven in part by nurses seeking higher-paying, temporary travel nurse positions elsewhere, though like HCA, UHS expects that should wane as COVID-19 cases and demand for temporary staff decline, Miller said.
Overall, Tenet and HCA posted net incomes and revenues up year over year and both raised their full-year guidance.
UHS' revenue was up compared to the same quarter last year, though its profit was down year over year, and the chain is maintaining its full-year guidance.
Net income and revenue at CHS barely changed from the same period last year, and it raised its full-year guidance.