Many Michigan hospitals continue to have high in-patient numbers despite a decline in COVID-19 cases because of an increase in patients with other health conditions that were ignored during the pandemic, hospital officials say.
The high patient loads are occurring as health systems in Michigan and nationwide are dealing with lingering staffing shortages — a result of COVID-19-related issues.
Hospitals are using multiple approaches to fill positions. Beaumont Health, Michigan’s largest hospital system, has been working with Michigan Works! Association to provide training at no cost to fill positions in equipment sterilization.
“I wanted to try it, and I like it,” said Rufus Carouthers Jr., 50, of Ferndale, who left a 10-year position in another industry to take a job in equipment sterilization at Beaumont Royal Oak Hospital on May 10.
Beaumont Hospital in Wayne and Mercy Health Mercy Campus hospital in Muskegon were both listed as 100% full on the state’s website Friday. Patient census numbers posted by the Michigan Department of Health and Human Services are updated daily Monday through Friday, and reflect the previous day’s occupancy.
Beaumont Hospital in Royal Oak was 91% full Friday, with Detroit Receiving Hospital, Harper Hospital and Hutzel Women’s Hospital all at 93% of capacity. Hurley Hospital in Flint was listed as 95% full on the state’s website.
“Our hospital census has stayed very, very high — and it is also true that our COVID numbers continue to come down, which is a good thing,” said Carolyn Wilson, executive vice president and chief operating officer with Beaumont Health, adding that about 200 patients were hospitalized with COVID-19 Thursday across the eight-hospital system.
“We’re seeing a mix of diagnoses and we do believe that some of the people that are seeking care now, their conditions are due to deferred care, or their conditions require hospitalization, or a higher level of care, because care for so many was interrupted during COVID.”
Why care was deferred
Health systems across Michigan and the country shut down non-emergency surgeries and services from March 2020 through about June 2020 to preserve resources for COVID-19 patients. When services resumed, much of the public remained reluctant to visit doctors or emergency departments for fear of catching COVID-19. And some people who delayed care are now showing up at hospitals with acute conditions.
“Dating back for at least a couple months, hospitals and health systems statewide have been reporting to us higher levels and higher acuity of non-COVID-19 hospital admissions,” said John Karasinski, spokesman for the Michigan Health and Hospital Association.
Hospitals everywhere suffered severe financial losses due to cancellation of revenue-generating procedures and services early in the pandemic.
They also lost money treating coronavirus patients because insurers often reimburse on a flat per-patient basis, regardless of length of stay, and COVID-19 patients can require weeks or even months of hospitalization, said Dr. Justin Grill, medical officer for Mercy Health Mercy Campus in Muskegon.
“There is no question that the COVID volumes did not translate into increased revenue,” Grill said. “In fact, the reverse is true. Most hospitals were losing money on COVID patients because their length of stay was so long.”
Grill’s hospital is part of the Trinity Health-Michigan system, which includes the Mercy Health hospitals in the west Michigan communities of Grand Rapids, Muskegon, Shelby and the Lakeshore area; and the Saint Joseph Mercy Health System with hospitals in Ann Arbor, Chelsea, Howell, Livonia and Pontiac.
The Muskegon hospital is now seeing the “downstream effects” of people deferring medical care during the pandemic, Grill said. They are currently at about 80-85% of capacity, down from the 100% listed on the state’s website, he noted.
The decrease of coronavirus patients and increase in non-COVID patients is helping to steady the hospital’s finances, Grill added.
“Having a full hospital is good because, right now, today, we’re not losing money,” he said. “We’re generally able to manage and still break even.”
Beaumont, with eight hospitals and 38,000 workers, laid off nearly 2,500 workers in April 2020. CEO John Fox took a temporary 70% pay cut, while other executives’ salaries were slashed 45%.
Those workers were laid off because, with the closure of clinics and operating rooms, the health system didn’t have jobs for them, Wilson said, adding that all of those employees have since been called back to work.
“We don’t want anybody to need to be in the hospital if we can prevent it,” she said when asked about the impact of the returning patients on the health system’s bottom line.
“But if you do need to be hospitalized, we’re thrilled that it’s Beaumont that people trust and use for their care — and obviously a return of in-patient census does help Beaumont’s financial position.”
COVID contributes to worker shortage
There’s no percentage of occupancy at which hospitals should become concerned about reaching capacity, said Karasinski, the hospital association spokesman.
A small rural hospital can reach capacity after filling just a small number of beds, so a statewide standard wouldn’t make sense, he explained.
“Beds can always be added,” Karasinski said. “The key determining factor for a particular hospital is their staffing, and that’s the most difficult variable to try to increase.”
Beaumont’s Wilson said said hospitals are facing staff shortages across the country in the wake of the pandemic, after employees from sanitation workers to nurses decided to leave their hospital jobs.
The health system called all of its laid-off employees back to work a few months ago, but some didn’t want to return to hospital work or had found other jobs, she said.
“Beaumont is actively recruiting for lots of open positions,” Wilson said.
Trinity Health Michigan has clinical and non-clinical job openings and is filling some spots with contract labor, said Ane McNeil, the health system’s chief human resources officer.
It is also offering signing and referral bonuses for certain positions such as nursing, respiratory therapists and lab positions, she said. The health system raised its minimum wage to $15 an hour last fall for transports, environmental services, and food and retail services jobs, McNeil said.
American hospitals were facing a nursing shortage before the pandemic because the average age of nurses across the nation was getting older, and COVID-19 pushed many older nurses into retirement, she said.
“Many people who were contemplating retirement in the next two or three years escalated and are retiring at a very fast pace because of the difficulty that COVID has brought to everybody,” Wilson said.
“COVID has hit nursing hard, but it’s also hit pharmacy hard and other parts of our staff,” she added. “Many of them are working only part-time because their kids are home and they’re having to home school.
“We had a major shift from full-time to part-time, or what we call contingent — which is they work when they can.”
Dasha Williams, 25, of Detroit used a new training opportunity at Beaumont Royal Oak Hospital to advance from her job as a nurse assistant to a higher-paying job cleaning surgical instruments.
“I trained for a good 12 weeks, I got a certificate, and now I’m working for Central Processing,” Williams said. “I really want to be a surgical tech, so this is the best way to start.
“I actually like it. There’s different jobs in here you never knew existed.”
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