Almost two years after the pandemic began in the U.S., hospitals are grappling with some of their most dire staffing shortages yet.
Among hospitals reporting staffing data to the federal government, 31% said they were anticipating a critical staffing shortage this past week, and 12 states had 40% or more of their hospitals reporting critical staffing shortages, according to the HHS.
Widespread stress and burnout are helping to drive the labor shortage, spurring nurses in particular to quit their roles. In addition, higher wages from travel-staffing agencies are enticing nurses to leave permanent roles for temporary positions.
With hospitals facing persistent, heightened labor expenses while tackling the omicron variant, they're asking for more federal help, including more funding in the Provider Relief Fund and for remaining funds to be distributed as Congress looks to pass the fiscal year 2022 appropriations bill before funding runs out Feb. 18, hospital leaders said during an American Hospital Association call with reporters Tuesday.
The hospital lobby also is renewing its push in requesting the Federal Trade Commission to investigate travel-nurse staffing firms for anticompetitive behavior as dwindling supplies of available nurses have led to elevated pay rates throughout the pandemic.
"These companies have exploited the severe shortage of healthcare personnel during the pandemic by charging exorbitant rates, often times two to three times pre-pandemic amounts," AHA CEO Rick Pollack said on the call.
From January 2020 to this month, advertised pay rates for travel nurses have jumped 67%, with hospitals billed an additional 28% to 32% over those pay rates by staffing firms, according to Proculent Health, a workforce data and technology company. In some areas, travel-nurse pay rates have been as high as $240 an hour or more.
In turn, hospital labor expenses are above pre-pandemic levels, up 12% on an absolute basis and 19.5% on a per adjusted discharge basis compared with 2019, according to a report from Kaufman Hall.
Shortages particularly are acute in rural areas, especially for certain workers such as respiratory therapists.
West Tennessee Healthcare's Bolivar and Camden Hospitals lost more than half of their respiratory therapists throughout the pandemic with many leaving to work for traveling staffing agencies, Ruby Kirby, the CEO of the facilities, said on Tuesday's AHA call.
"We cannot compete with the salaries that they're offering," Kirby said.
Some states have enlisted National Guard members to assist understaffed healthcare facilities amid surges, though smaller, rural systems like Kirby's often don't meet the volume threshold to apply for those resources, she said.
Kirby estimated most rural hospitals likely are experiencing a 30% to 50% vacancy rate across all roles.
Hospitals are busier than ever, unlike the first days of the pandemic when stay-at-home measures and restrictions on elective care to free up hospital resources were in place.
Other care has since returned and higher-acuity patients are staying longer in the hospital. Average length of stay has risen 8.8% compared with pre-pandemic levels, and climbed 9.5% from October to November of 2021 alone, according to data from Kaufman Hall.
Henry Ford Health System in Detroit had about 75 beds closed due to staffing concerns across its nine-hospital system Tuesday, CEO Wright Lassiter said, though that's an improvement from 30 days ago when it had 150 beds closed.
Staffing shortages also caused the system to delay about 400 procedures over the past month, Lassiter said.
In a Thursday letter, AHA asked Congress to include in legislation measures to quickly disperse remaining money from the Provider Relief Fund while adding $25 billion to help hospitals deal with staffing shortages and heightened labor expenses.
The HHS most recently funneled $9 billion from the Provider Relief fund in December to more than 69,000 providers in all 50 states, with average payments ranging from $58,000 for small providers to $1.7 million for large providers, according to the agency.
AHA also is asking for a Medicare sequester relief extension, more time for hospitals to repay accelerated and advance Medicare payments and greater relief for some 340B hospitals so they can stay eligible for the program, according to the letter.
In addition, the lobby asked the FTC to investigate nurse-staffing agencies for anticompetitive pricing in February, though it hasn't yet gotten a response, Pollack said.
"That's why we're asking the administration to help us ensure this matter gets the attention it needs to protect these agencies from exploiting hospitals and health systems' financial viability at a time when they can least afford it," he said.