As COVID-19 cases continue to surge in Minnesota, hospitals and long-term care facilities are dealing with prolonged staffing shortages, resulting in less care for patients and financial problems for medical systems.
Gov. Tim Walz has taken some steps to alleviate the issues, like activating National Guard members to help at long-term care facilities, calling in federal medical teams for hospitals, and approving $50 million for things like hiring and retention bonuses in the health care sector.
Health officials and legislators are also debating other potential steps. The Minnesota Senate GOP has proposed a new $150 million plan for nursing home relief, and hospital representatives have argued for short-term help with things like background check requirements while also advocating for longer-term assistance such as loan relief for workers.
On Wednesday, state Sen. Jim Abeler, R-Anoka, convened the Senate’s Human Services Reform Finance and Policy Committee to hear from long-term care facilities and hospitals about how they’re dealing with staff problems and to ask more about the impact of current vaccine mandates and a potential requirement from the federal government.
Here’s what we learned:
Long-term care staff shortages are ‘huge’ and limiting admissions
The number of open jobs in long-term care continues to grow in Minnesota, said Nicole Mattson, vice president of strategic initiatives for Care Providers of Minnesota, a long-term care trade group.
[image_caption]State Sen. Jim Abeler[/image_caption]
A new survey of long-term care providers found more than 76 percent are limiting admission to their facilities, up from 70 percent in the earlier fall survey, Mattson said. In rural parts of the state, the problem is even worse. Mattson said more than 90 percent of providers there are limiting admissions.
“This is extremely unusual,” Mattson said in an interview Wednesday. “70 percent is a huge number … What’s typical? I mean less than 10 percent at any given time would be limiting admissions. We’ve had workforce issues in the past but nothing, nothing has ever compared to this.”
Cami Peterson-DeVries, a adult-geriatric nurse practitioner for St. Francis Health Services of Morris, which operates mostly in rural areas and has 13 nursing homes, 10 assisted living facilities and more than 70 group homes, told the Senate committee that some of their care centers are at 60 to 70 percent occupancy. And despite efforts to recruit and retain workers — made more difficult by nearby high-paying Mayo Clinic facilities — they’re paying out huge amounts in bonuses and overtime to cover shifts.
Mike Deuth, regional executive director for the Good Samaritan Society for Minnesota, Wisconsin and Ohio, said the group has 28 nursing homes, 31 assisted living facilities and a variety of home health and hospice homes in Minnesota. The organization has resorted to hiring outside agencies to bring in staff, something it budgeted $690,000 for in Minnesota but has ended up spending $6.73 million on so far in 2021.
“For the month of November, we spent just shy of $1.5 million,” Deuth said. “It’s simply not sustainable.”
Diane Rydrych, assistant acting commissioner for the Minnesota Department of Health’s Health Systems Bureau noted staff shortages have been a problem before the pandemic, but said there are new challenges. Typically about five nursing homes close in any given year, and Rydrych said at least four have closed or will close by the end of the year, not specifically for pandemic-driven staffing issues. But she said “I do think that there are some that are at risk” of closure, despite state efforts to help with staffing shortages.
What a staffing shortage means for hospitals
The long-term care industry is not the only one facing workforce shortages. Mary Krinkie, vice president of government relations for the Minnesota Hospital Association, said at the start of the pandemic, when hospitals talked about capacity, they had beds and space, staffing and equipment in mind.
“It was all about the number of ventilators we had, and all about our personal protective equipment and could we get enough PPE for our employees,” she told the Senate panel. “As we fast forward now 20 months later it’s all about staffing, or more particularly the lack of staffing.”
[image_caption]Mary Krinkie[/image_caption]
Krinkie said one major hospital system in the state told her their overall job applications had fallen by 50 percent compared to a year ago. And “critical access hospitals” in rural areas said on average they have job vacancy rates of over 11 percent.
As a result, hospitals have canceled all procedures “except for basically those that are life saving” or would prevent “extreme harm” to a patient, and are dealing with skyrocketing costs to hiring nurses through outside agencies or “temporary float pools.”
“Hospitals are under enormous financial pressure, canceling surgeries and increased volumes of Medicare and Medicaid patients and we’re paying a lot more for staff,” Krinkie said.
Vaccine mandates are only a small portion of staffing issues
Abeler probed the health officials about vaccine mandates — including those created by a private employer or the one President Joe Biden’s administration has proposed but is on hold in the courts — and asked some whether they have hurt staffing levels significantly. The answer from those testifying was largely no.
[image_caption]Dr. James Watson[/image_caption]
Allina Health has fired 53 employees out of more than 27,000 workers and has a 99.8 percent compliance rate with its vaccine mandate — including medical and religious exemptions, said Kristen McHenry, director of government relations for the medical system.
When it comes to nursing homes and long-term care facilities, the answer was somewhat more complicated. Rydrych said the vaccine mandate “is one factor that I think has made things more challenging for some facilities in areas of the state, especially where vaccine rates for health care workers are low.”
The injunction pausing the mandate “may have given some facilities a little bit of time to take a breath and plan for what’s going to happen if it does get reinstated,” Rydrych said. “But it is a serious issue, mandate or no.”
Peterson-DeVries, from St. Francis Health Services, said she didn’t have exact numbers of how many people have left in anticipation of vaccine mandates, but said some people did. There are also some places where employees are waiting to make a last-minute vaccine decision, she said. And Peterson-DeVries predicted a mandate would lead to fewer workers, particularly in northern Minnesota.
Deuth said the Good Samaritan Society is a division of Sanford Health, which has a vaccine mandate. Of Sanford’s 48,000 workers, more than 300 people have not been vaccinated or received an exemption, he said.
Abeler asked repeatedly for health care systems to not quickly dismiss people seeking vaccine exemptions, particularly for religious reasons, even if he said the employers had a right to seek the mandates. He also said describing vaccines as safe and effective “is a little simplistic” in part because of self-reported adverse reactions in a government database. More than 3.67 million Minnesotans have received at least one dose of a COVID-19 vaccine. State and federal health officials say the vaccines are incredibly safe and the benefit of strong protection against severe coronavirus cases far outweighs the small risks of complications from vaccination.
Describing Mayo’s rationale for a vaccine mandate, Watson said: “Our highest obligation is to do everything in our power to keep our patients safe. We’re a destination practice. We care for those patients who are acutely ill with complex medical needs. Those patients have the highest risk from COVID.”
What we know about national guard deployment
Gov. Tim Walz announced Monday that three National Guard teams were deployed to long-term care facilities in New Hope, Onamia and Fergus Falls to help with severe staffing shortages.
[image_credit]REUTERS/Brian Snyder[/image_credit][image_caption]Gov. Tim Walz[/image_caption]
There are some limitations for the teams. They won’t be sent to areas with active COVID-19 outbreaks, and Rydrych said each team will help a facility for two weeks at a minimum but only three weeks at a maximum. After that, Rydrych said the state will help facilities determine what other help they may be eligible for and talk them through what additional steps they’ll take to fix their shortages.
“I think for some of them this creates a softer landing,” Rydrych said. “They may be pretty far down a path and they may be already considering closure.”
Yeah, typical republican tone deaf anti vaccine nonsense: “Abeler probed the health officials about vaccine mandates — including those created by a private employer or the one President Joe Biden’s administration has proposed but is on hold in the courts — and asked some whether they have hurt staffing levels significantly. The answer from those testifying was largely no.”
Its pretty clear to anyone looking its the anti-vaxers are causing all the trouble! “burnout and exhaustion experienced by current staff” Religious or not, the anti-vaxers spread the Covid! But evidently providing vapor thin political cover is far more important than actually solving the problem.
“Largely no”
Well, that is definitive. Every single person leaving results in less care. 53 workers, 300 workers, it adds up fast.
Wages didn’t seem to be an issue prior to vaccine mandates. It is probably just a coincidence. And I believe that the State sets the rate for caregivers at nursing homes and similar facilities.
Here’s hoping that Abler is an outlier as a chiropractor with regard to his disregard for science and other facts. He describes himself as a friend of Health Commissioner Jan Malcolm yet he intends to lead the charge of denying her confirmation in the upcoming legislative session for competently doing her job.
With friends like that, who needs enemies? With legislators like that, who needs professional clowns?
Can’t say that many of the Senator’s comments about vaccines and health care appear to be false although there are certainly people who disagree with his opinions. People who enter the arena deserve more respect even if we disagree with them.
Please follow up and see if MN nursing schools are even producing enough nurses to replace the number that are retiring.
Use that covid $ to provide scholarships ( free rides like the athlete gets).
I don’t think it is the cost of the degree that is the main issue. Nursing schools have wait lists.
Thankfully many, if not most nursing homes and extended care facilities now allow family to visit in-person instead of outside windows of buildings. Of course, many require no proof of vaccination for the visitors. Vaccinated workers are a must but unvaccinated relatives roaming about is not a problem. Sounds like the government has things well in hand.
This really isn’t an issue because it is not being covered by Fox news. If it was covered by Fox news and its cousins, then it would be an issue. That is the Fox News Fallacy. They react, the other side counteract. It is baked into the algorithm….And then the right’s justices who are somehow above the law due to unrepresentative maneuvers decide. And they usually fall on the side of individual liberty over the rights of the greater good…. What would it take for the medical community to overthrow poor legal decisions? As it is now individually they are being singled out and withdrawing from public life. Couldn’t the AMA and or the nurses unions pledge to fight as a group and challenge the court’s decisions? ….Certainly the oilmen and the food and beverage groups are winning the war. As it stands now this latest culture war is one of attrition as the virus burns through the “dry tinder” and somehow we are bandaging it by putting male soldiers primarily into roles they are less suited for. Are we going to have to melt down our arms for caskets?
Well, if nobody has noticed, the vaccine mandates are disappearing fast. The legal challenges are winning. I am not saying I don’t think that vaccines aren’t good, or don’t work. I am saying the legality of the mandates have failed. The PR message around vaccines has been atrocious. So, other than complaining people not getting vaccines, what is the solution?
Perhaps time travel where those who show up with severe Covid can go back and get immunized.
Simple solution: Exempt insurance companies from paying for Covid related bills of non-vaccinated patients.
I don’t think there is one. We’ve lost. The people dying from Covid and filling up Hospitals are mostly the unvaccinated, but they are preventing other people from getting care.
I listened to the hearing as an AARP Advocate for our seniors. I compliment Mr. Orenstein for his excellent description of comments made by MDH’s Ass’t Acting Comm’r Diane Rydrich and other professionals, and his explanation of Sen. Abeler’s consistent suggestions that requiring vaccination hurts staffing. Reality is the opposite: the commenters stated clearly that the pandemic itself and staff burnout are the biggest cause of staff shortages!