Nearly one in four beds is empty at the TaraVista Behavioral Health Center in central Massachusetts, not for lack of patients, but for understaffing.
Even before the pandemic, the lowest-paid nurses and caregivers were still in short supply, but the 116-bed facility could still function at full capacity, said chief executive Michael Krupa. In similar hospitals in Massachusetts, hundreds of beds cannot be filled and “the reason is exclusively the staff,” he said.
What some are calling the worst healthcare job crisis in the United States in memory heightens concerns about the attrition of resistance to vaccination warrants – even in Massachusetts’ medical mecca, where COVID cases – 19 remain well within the capacity of hospitals. According to the US Department of Health and Human Services, about 16% of US hospitals were experiencing a critical staff shortage as of October 1.
The rise initially coincided with an increase in hospitalizations for COVID-19, but shortages have persisted even as the virus recedes, suggesting other factors.
âWe don’t have a single position we can afford to lose right now,â Eric Dickson, president of UMass Memorial Health, told Bloomberg Radio last month. âI have neighborhoods that have a vacancy rate of 50%. And God forbid, we lose more.
In recent weeks, labor shortages have resulted in extreme measures, even in areas that are not COVID-19 hotspots. In Virginia, five state mental hospitals have had to stop accepting patients. A shortage of nurses has forced the Rhode Island hospital to shut down part of its emergency department. And a major Michigan hospital chain says 5% of its beds cannot be filled due to understaffing.
At TaraVista, a modern building with airy hallways and large windows, demand for psychiatric and drug beds is skyrocketing amid the heightened emotional stress and substance use of the pandemic. âParents call me crying, ‘Please take my child,’â said Sheila Crowley, director of admissions. It hurts to refuse them, she said.
All at once
Historically, severe health workforce shortages have occurred in dispersed areas and hard-to-hire sectors like nursing homes, said Karen Donelan, professor of health policy at the ‘Brandeis University. But “at this point we hear about it in most states,” she said, and even in the big, wealthy institutions that have not traditionally struggled.
Factors include retirements and quits motivated by burnout; absences due to illness and quarantine; immigration limits in recent years; and the attractiveness of lucrative âtravelâ contracts from competing employers across the country. Now add vaccine resistance to the mix.
âAll of these challenges at the same time,â Donelan said.
Salaries for nurses have remained relatively stable for many years after adjusting for inflation, she said, and salaries for less skilled jobs have also stagnated. The country has nearly 4 million nurses and the supply has grown steadily over the past decade, she said. Demand, driven by an aging population, has also increased and is expected to accelerate over the next decade.
In some markets, increases and bonuses in response to the pandemic may represent a long-term correction, Donelan said, although it is not yet clear.
Overall, employment in the health care sector remains below pre-pandemic levels. The gaps are greatest in nursing homes and care facilities: Nursing facilities employed about 14% fewer people in August than in January 2020, according to data from the Bureau of Labor Statistics. In residential mental health facilities, the decrease is 8%.
Doctors’ offices employ roughly the same number of workers as before the pandemic, while employment in laboratories and dental offices has increased.
In the hardest-hit settings, hospital and health agency leaders are experiencing the worst staff shortages in four decades. At a Massachusetts law hearing last month, officials said at least one in five jobs caring for people with disabilities and in nursing homes was unfilled.
Other sectors of work, such as tourism and catering, are also experiencing labor shortages, but “the consequences are different,” said Michael Weekes, president of an association of service providers in the city. anybody.
âWhile it can be disappointing for someone to wait for a lobster roll or an ice cream cone, or to wait longer for their hotel room, when essential staff are absent from social services, security and the health of clients and residents is immediately there. risk, âhe said.
In behavioral health – which includes psychiatric care and addictions – at least 400 beds statewide remain empty, while several hundred patients are forced to inappropriately ‘board’ for days in wards. emergency or medical services.
300 more psychiatric beds are expected to come online this year, but âthe big question is where will the staff come from? said David Matteodo of the Massachusetts Association of Behavioral Health Systems.
More than half of the state’s nursing homes have had to stop accepting new residents intermittently, according to Massachusetts Senior Care Association president Tara Gregorio. She called on foreign workers to fill the void.
State officials are allocating $ 31 million to strengthen the behavioral health workforce, along with tens of millions more to deal with the larger crisis.
So far, aside from government financial assistance, employers have been largely left to their own desperate means to retain and hire staff.
At TaraVista in central Massachusetts, CEO Krupa estimates the hospital is investing an additional $ 1 million per year in salaries, improved benefits, bonuses and other sweeteners for 310 employees there and in a hospital. partner. Overtime has doubled from around 3% of pay to 6%.
When asked if he had ever seen such big loyalty bonuses and increases, he replied, âdramatically, emphatically no, no, noâ. Krupa is determined to have enough staff to fill all the beds by the end of the year, he said – even if that means recruiting and housing workers from out of state or even d ‘other countries. He sees the longer term solution in higher payments by insurers and great potential in forgiveness of student loans.
The hospital’s vaccination mandate will begin on November 1, he said, and âI hope we don’t lose a lot of staff. But I know we’re going to lose some.
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