Sunday, October 2, 2022

Report shows major workforce shortages in Kentucky hospitals, which they describe as 'the most critical shortage in recent history'

By Melissa Patrick
Kentucky Health News

Results from Kentucky's annual hospital workforce survey show critical labor shortages at hospitals across the state, with the highest vacancy rate among registered nurses and licensed practical nurses.  

The Kentucky Hospital Association's 2022 Workforce Survey Report looks at the non-physician hospital labor force in Kentucky. The report says 110 hospitals responded to the survey, including all 96 acute-care hospitals. 

The report, published in August, found 13,423 total vacancies in Kentucky hospitals, including 5,391 for RNs and LPNs combined, or more than one in five nursing positions. 

LPN positions had the highest vacancy rate, 25.5%, followed by RNs (21.9%) and certified nurse assistants (17.7%). Other top vacancies included respiratory therapists (17.7%), laboratory staff (14.2%), environmental services (13.7%) and social workers (13.7%). 

Urban hospitals were found to have larger vacancy rates than rural hospitals, at 18.3% and 13.8% respectively, but the report says both rates are "unsustainable."  

"The results showed the depth of the crisis in Kentucky. And so we can say that the commonwealth's hospitals are facing the most critical shortage in recent history," KHA President Nancy Galvagni said at a press conference. She added later, "Every region of the state is impacted by this issue."

Galvagni said one of the biggest concerns is that 53% of the nursing vacancies are in medical/surgical units, critical-care units and emergency departments, areas that are essential to providing patient care. 

Also, she said there is a shortage of experienced nurses, and 14% of the nursing workforce is nearing retirement age. 

"The data on the shortage of nurses is of huge concern, because the demand for nurses is steadily increasing," Galvagni said. "Kentuckians suffer from more chronic disease than most of the country. We regularly rank high in rates of cancer, lung disease, heart disease and diabetes. And with an aging population, there's going to be a demand for more hospital nurses to provide the care that is needed." 

Galvagni said costs associated with nursing shortages have been astronomical. The report says spending on short-term "travel nurses" rose from $88 million in 2019 to nearly $1 billion projected this year. And premium pay, which is pay provided above base salary and wages, has increased from $50 million in 2019 to nearly $400 million. 

"The skyrocketing increase in labor costs plus the ever rising inflation that everyone's facing, equals an unsustainable situation," she said. "As one of the biggest employers in the state and the safety net for life saving care, this could be devastating for every Kentuckian." 

Mike Sherrod, chief executive officer of Tristar Greenview Regional Hospital in Bowling Green, said some hospitals across the country have had to limit the services they provide due to the staffing crisis and skyrocketing costs and that Kentucky hospitals are trying to avoid that. 

"The reality is . . . we need more nurses, respiratory therapists, we need more lab techs and other trained individuals dedicated to health," he said. 

Galvagni also spoke to this concern, saying, "Each of us will be a patient at some point. . . . It doesn't matter how many beds a hospital has, if they're not enough professionals to staff them. Our hospitals will have no other choice than to reduce services."  

To address the nursing shortage in the short-term, many hospitals have offered sign-on bonuses, raises, extra overtime, premium bonuses, tuition reimbursement, and scheduling flexibility. 

Galvagni said the hospital association is working on solutions to increase the nurse workforce, including encouraging  middle- and high-school students to enter a health career; talking to higher-education systems about how to increase the number of graduates; and encouraging high schools to offer a LPN program, which would allow students to work immediately after graduation.

To address rising costs, the association also plans to ask lawmakers to increase the rate of payment for outpatient Medicaid patients in the state as it did for Medicaid inpatient services last year. Galvagni said KNA thinks the proposal will pass. 

"There is no one silver bullet to fix this problem," said Galvagni. "But the sooner we start, the better."

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