Editor's note: This story is part of a series on women in the healthcare workforce.
When schools and day cares closed early in the COVID-19 pandemic, Katie Miller, a registered nurse at Wellstar's Kennestone Hospital in Marietta, Georgia, wasn't too concerned about finding child care for her 4-year-old daughter, Kamdyn.
Kamdyn attends Wellstar's learning academy, a child care center located on the hospital campus, and has since she was 3 months old. The center remained open throughout the pandemic, serving as a lifeline for working mothers being asked to pick up extra shifts or work overtime amid surges of COVID-19 patients.
"It is one of the biggest perks that I think any parent could ask for," Miller said.
Child care issues borne by working mothers came to a head during the pandemic, especially among healthcare workers, an overwhelming majority of whom are women and in direct patient care roles, rendering them unable to work from home.
The largest occupation in the healthcare sector by far is registered nurses, followed by aides, with women accounting for more than 85% of those jobs, according to 2019 data from the Census Bureau.
Hospitals that leveraged on-site child care centers throughout the pandemic say they helped ease staffing shortages, a persistent issue across the workforce that's expected to worsen in coming years. Such offerings can also drive better retention amid a "Great Resignation," as burned out employees across all industries reevaluate their roles and workplaces.
While building out child care centers and finding ways to cut enrollment costs for staff isn't cheap or easy, systems that have done so say they are seeing returns on their investments.
"Our talent acquisition team has found several things that are kind of those sweet spots for potential candidates, and child care and child care resources are a huge benefit for folks," Penny Ferrell, executive director of employee wellness and work-life services for Wellstar, said.
Wellstar has 11 hospitals and many other clinics and facilities in Georgia, and has two on-site child care centers at its largest hospitals and one in the center of Atlanta. Among the system's 24,000 employees, 82% are women, Ferrell said.
During the worst of the pandemic, Wellstar rolled out additional child care options for working parents, including staff with older children.
It opened up spaces in existing centers for older kids to get tutoring and do their virtual schoolwork, and leveraged an emergency back-up child care program through Bright Horizons, a company that operates child care services for employers through a network of on-site and in-home providers.
Bright Horizons, a major for-profit operator of child care services for employers, saw an uptick in healthcare providers seeking to build their own centers or offer back-up care during the pandemic, Maribeth Bearfield, chief human resources officer, said.
Healthcare and pharmaceutical employers account for the largest percentage of centers Bright Horizons operates in the U.S. (17.5%), followed by government and education employers (15%), according to its latest annual report.
"I think healthcare has seen it more extreme right now than most other industries because they never stopped, they stayed open while many other industries were able to work remotely or work differently," Bearfield said.
"It is one of the biggest perks that I think any parent could ask for."
Registered nurse at Wellstar's Kennestone Hospital in Marietta, Georgia
Other systems across the country, like Mass General Brigham's hospital system in Boston, also partnered with Bright Horizons during the pandemic to boost its child care offerings for staff.
Mass General Brigham has offered on-site child care for staff for well over a decade, and currently operates four traditional on-site centers for employees with infants, toddlers or preschool-aged children, Matt Badger, senior vice president of total rewards and HR customer experience, said.
It also has two emergency back-up child care centers it used during the pandemic for employees with children up to 12 years old. The centers are all owned by Mass General Brigham, though Bright Horizons now provides day-to-day management for the sites.
"The last couple of years have been quite different and we have dramatically increased our investment in child care services so that we can provide more support for employees," Badger said.
'Very smart business decision'
That includes finding a way to make enrollment costs more affordable.
Child care costs vary widely from state to state. In Georgia, it costs $8,530 on average annually to enroll an infant in child care, according to a report from the Economic Policy Institute. In Massachusetts, the average annual cost for infant child care is $20,913.
That's while the median annual wage for registered nurses was $75,330 in May 2020, according to the Bureau of Labor Statistics.
Mass General Brigham offers child care subsidies for employees, though it's still trying "to figure out how to make sure we provide an appropriate subsidy that is sustainable for the organization but also supports our employees at different levels of income," Badger said.
Wellstar also uses subsidies to make tuition more affordable.
"We looked at market rate for all the areas, and we subsidize that quite heavily for our employees," Ferrell said.
The child care benefits Wellstar has been able to offer not only helped ease shortages during the worst COVID-19 surges, but are also driving better retention and attracting new candidates, she said.
"It's not cheap to either build a facility or pay Bright Horizons to manage it, but it is worth it," Ferrell said.
"What you're doing is you're investing in your team members' ability to come to work and have a kind of peace of mind that their children are taken care of in the best environment possible. It's a business decision but I think it's a very smart business decision to do it."
Miller, whose daughter attends Wellstar's learning academy, has worked as a registered nurse for the system for the past seven years. She recently turned down a job opportunity with higher pay with another provider because her daughter would have to leave Wellstar's child care program.
"I 100% base my job and my career around her learning," Miller said.