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As COVID rises, New Hampshire’s health care system is shaken | News

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Construction has taken longer than expected, but workers are finally finishing the new Maplewood Nursing Home, a facility operated by Westmoreland County.

But rather than accepting patients from a waiting list that has more than two dozen names, the newly renovated Maplewood is doing the opposite: a shortage of workers, from nurses to janitors to food services, has forced Maplewood to close part of its building. Despite the space to treat 150 patients, only 95 currently live there.

“We made the horrible and difficult decision that it was time to shut down an entire floor,” said Kathryn Kindopp, the senior administrator of the retirement home since 2007, said.

New Hampshire health care officials, from critical access hospitals to safety net nursing homes, have long warned of a looming shortage of workers needed to care for an aging population. Now, as COVID-19 cases and hospitalizations reach their highest level ever in the state, the workforce problem is at a tipping point.

This week, the state approved spending millions of federal dollars to bring in temporary medical personnel from out of state. FEMA is sending dozens of emergency response workers to reinforce some facilities, and on Wednesday Governor Chris Sununu announced he would call in members of the New Hampshire National Guard to help health care providers. The governor also said he expects the spike to continue for at least a few more weeks.

The increase in the number of COVID-19 patients in hospitals – more than 460 people on Thursday – combined with the lack of manpower in some nursing homes, is creating a bottleneck. Patients who are ready to be released but cannot yet return home languish inside hospitals as they wait for a room to open in a skilled long-term care facility or rehabilitation center. The delays in processing Medicaid applications for some of these patients further compound the problem.

DHHS Commissioner Lori Shibinette told the Executive Council on Wednesday that there are around 30 to 50 hospital patients stuck in this limbo at the moment, during which they occupy the beds needed for the new arrivals of COVID-19 and other critical patients.

“Right now we just need to get people out of the hospital and into long term care facilities or assisted living facilities or wherever they need to go, so that we have beds for our patients. intensive care, ”said Shibinette.

The council voted to spend nearly $ 90 million in federal funds, with some of that money going to long-term care facilities and outpatient surgery centers that have space and manpower for them. new patients. An additional $ 6 million will be spent on the temporary hiring of 32 to 35 itinerant nurses from out of state, who will be assigned to long-term care facilities.

“They did the same in the southern states when they had the surge there,” said Dr. Jonathan Ballard, chief medical officer of the state’s health department, before the vote. “And many of the staff who may be coming to the north of the country have just completed their 13-week assignments in the south of the country.”

But a few dozen temporary nurses, at a cost of $ 200 to $ 300 an hour, won’t fill the gaping holes in the state’s health workforce. Dartmouth-Hitchcock, the state’s largest health care system, currently advertises 1,129 jobs, including 500 nursing and nursing assistants and over 100 physician positions.

“It has a huge physical and emotional impact on our staff. From our on-call staff to our nurses, to our surgeons and to our leaders, ”said Dr. Edward J. Merrens, Clinical Director of Dartmouth-Hitchcock Health this week. “This is a preventable crisis. “

Regulators are working to speed up licensing applications for nurses looking for credentials. In response to an executive decree recently signed by Sununu, the Bureau of Professional Licensing and Certification has contacted more than 750 people who have submitted applications in the past six months, but for various reasons failed to complete all the necessary documents. .

In addition, the Board of Nursing recently passed an emergency rule that will allow applicants to begin work once they have a scheduled FBI fingerprint appointment, rather than wait until the end of the background check.

Lindsey Courtney, executive director of the Office of Professional Licensure and Certification, said her office was able to process a completed application within 24 hours.

“We’re going to do what we can to speed up the process, get people through the door, make sure they’re qualified,” Courtney said. “But I don’t think licensing is going to solve the workforce problem. “

The manpower problem does not seem to be due to a lack of interest in health fields. The University of New Hampshire has seen its enrollment in nursing programs double over the past decade, with 540 students currently enrolled.

The challenge, according to Dr Gene Harkless, the department’s director of nursing and family nurse practitioner, is that after nearly two years of a pandemic, seasoned healthcare workers are running out.

“I am very grateful to every nurse who is always online and working hard,” Harkless said. “But I really want them to take care of themselves and make sure that they can continue to take care of others.”

Early retirements, medical professionals leaving the field, or others forced to stop work due to a lack of on-call services have left the vacancy rate for the night shift at Maplewood Nursing Home at around 70%. Kindopp, the administrator of the facility, said she is now scrambling to hire the same limited group of mobile nurses that all other hospitals and long-term care centers are looking for as well.

Kindopp said the Biden administration’s vaccination mandate, which was temporarily suspended in a federal court, also prompted several employees at his facility to resign.

The result of this staff shortage is more than 50 beds opened in Maplewood, and managers, including Chief Administrator Kindopp, are taking shifts in other departments. At 5 p.m. Kindopp said she was heading to the facility’s kitchen.

“I’ll either scrub the pots and pans or sanitize the surfaces we prepare food on. And mop up, yes. All that.”

This article is shared by a partner of The Granite State News Collaborative. For more information, visit collaborativenh.org.