In Mid-December, the New York Times published an article entitled “How a Sprawling Hospital Chain Ignited Its Own Staffing Crisis”. This piece  discusses the last few years in healthcare as more hospitals became driven by business. Instead of striving to become successful to extend better healthcare to their patients, these hospitals are operating with the intent to drive up executive bonuses and/or their stock price with a better profit margin. 

The article tells all and is a prime example of what is wrong in healthcare. If you ever questioned how our non-profit hospitals can afford salaries of multimillions for executives but never enough monies to hire and pay the healthcare staff—it’s all described in this article.  

“More than half the roughly 5,000 hospitals in the United States are nonprofits. In exchange for avoiding taxes, the Internal Revenue Service requires them to offer services, such as free health care for low-income patients, that help their communities.” 

The NY Times article documents how large chains of nonprofit hospitals have moved away from their charitable missions.  Indigent care has been diminished and many poor patients have been saddled with unsurmountable debt. 

The hospital industry leaders have been placing the blame for the exodus of healthcare workers on the pandemic, staff burnout, and tight labor markets. There are many factors for the shortage of healthcare personnel, and it is true that healthcare professionals have been leaving the hospitals in droves.  

However, the NY Times article found that hospitals helped to lay the groundwork for the labor crisis long before the arrival of the pandemic. “Looking to bolster their bottom lines, hospitals sought to wring more work out of fewer employees. When the pandemic swamped hospitals with critically ill patients, their lean staffing went from a financial strength to a glaring weakness.” 

The article showcases Ascension as an example of what went wrong in the staffing cuts. Ascension operates 139 hospitals in 19 states and is considered rich. “In addition to its billions in cash, it runs an investment company that manages more than $41 billion. Last year it paid its chief executive, $13 million.’ 

Ascension has boasted about its success at decreasing its number of employees, and before the pandemic, they refused requests to hire more workers to fill open jobs. Executives once bragged about how they slashed $500 million from labor costs.

This downsizing had stark consequences when the pandemic hit. Emergency rooms could not handle the patient load, and some had to close their doors and turn patients away. Surgeries were delayed, and patients lingered for hours on stretchers where no beds were available because there were no staff to treat them.  Medications were late and not on schedule, and no one had time to listen to their patients. All these factors led to mistakes and a genuine decrease in patient safety.  

“Because of its nonprofit status Ascension avoids more than $1 billion a year in federal, state, and local taxes.” 

In Michigan and Illinois, Ascension lobbied against legislation to establish minimum nurse to patient ratios which the hospital would be forced to improve staffing conditions at the point of care. After Medicare began reducing its payments to hospitals for care and the Affordable Care Act became law, Ascension executives feared that the cost of care would outpace the ability to collect payment. These fears never came to pass and the period of time that was forecasted to have an amazing loss, the hospital chain was profitable. Nevertheless, it continued to cut the clinical staff. 

There are many documented clinical examples of poor clinical staffing in the article.  

I am sure you have your own stories to add to the ones cited by the NY Times. 

The NY Times is a subscription service on the internet, and you cannot read without paying. However, a friendly coworker has opened the window to the article and hopefully, you can access it here.  

If this does not work, you can go to LinkedIn and access an article by Rebecca Love, RN, MSN and find a link through her article.