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Summary of HHS COVID-19 Hospital Impact Report
Published date: April 13, 2021
Summary of HHS COVID-19 Hospital Impact Report
A recent report from the HHS’ Office of Inspector General described difficulty balancing the complex and resource-intensive care needed for COVID-19 patients with efforts to resume routine hospital care. https://oig.hhs.gov/oei/reports/OEI-09-21-00140.pdf
The report highlights hospital perspectives on their capacity to care for patients, staff and communities and is based on a survey conducted with 320 U.S. hospitals in February, 2021.
Key findings include:
Care delivery
- Hospitals reported that patients have delayed or forgone routine health care as a result of the COVID-19 pandemic, which has led to worsening of patient conditions.
- The pandemic has led to greater mental and behavioral health needs among patients and the needs for mental and behavioral health services will continue to grow
- Rural hospitals reported particular difficulty responding to the COVID-19 pandemic and that the pandemic had worsened longstanding challenges in staffing, limited capacity, and finances.
- The pandemic has exacerbated existing disparities in access to care and health outcomes.
Staffing
- Many hospitals reported that they were experiencing concerning staff shortages, particularly among nurses, raising concerns for hospitals about patient safety and quality of care. Hospitals also expressed concerns about the future of the health care workforce as the recruitment pool for nurses and other health care workers has continued to shrink.
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- Hospitals have been seeing higher-than-normal staff turnover, with 38 hospitals reporting to HHS Protect that they faced a critical staffing shortage during the week before the survey.
- Turnover was especially high among nurses. One Texas hospital in a high-poverty and socially vulnerable community reported its annual average for nurse turnover increased from 2 percent before the pandemic to 20 percent in 2020.
- A hospital CEO responding to the survey said their cost for agency nurses has risen from between $60 and $70 an hour to $200 per hour.
- The administrator from a teaching hospital that typically recruits nurses after their training at the hospital said it had 200 open nursing positions; however, only 100 nurses are set to graduate this year.
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Vaccinations
- Hospitals viewed their vaccination efforts as a positive step toward pandemic recovery but also noted that these efforts come at a cost—further stretching limited clinical staff and straining hospital finances.
- Hospitals reported that some staff and members of the community were hesitant to take the COVID-19 vaccine or declined to get vaccinated due in part to safety concerns.
- Hospitals reported that vaccinating rural communities presented unique challenges that made it difficult to ensure vaccination access for residents.
Finances
- Many hospitals reported concerns about their financial stability as the COVID-19 pandemic had increased costs and decreased revenues. They explained that their higher costs were associated with patient care, staffing, PPE, and COVID-19 testing and vaccinations; lower revenues stemmed from fewer routine and elective services and reimbursement rates that, according to the hospitals, did not keep up with increasing costs of care for some COVID-19 patients.
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- One administrator said their hospital was operating at a 25 percent reduction in revenue.
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