Staffing shortages closing hospital beds: What ASCs need to know

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Staffing shortages have reached a peak at many hospitals and health systems nationwide amid the latest COVID-19 surge, with some closing beds and fearing shutdown. 

Two Michigan healthy systems have closed beds because of staffing shortages. Detroit-based Henry Ford Health System closed 120 beds and Southfield-based Beaumont Health closed around 180 beds, both citing staffing challenges. 

Some hospitals and health systems have said already acute staffing shortages have been exacerbated by COVID-19 vaccine requirements. There's a growing number of health systems and states mandating vaccines for healthcare workers, and President Joe Biden's administration recently announced a vaccine requirement to combat the delta variant for millions of American workers, including healthcare workers.

Rural hospital Brownfield (Texas) Regional Medical Center said it expects to lose up to 25 percent of its employees if the vaccine mandate is enforced, and CEO Jerry Jasper said this loss would lead to shutting down the hospital.

The CEOs of Cleveland Clinic, Cleveland-based University Hospitals and Johnson City, Tenn.-based Ballad Health have expressed concern around an employee exodus due to vaccine requirements that they said would be riskier than unvaccinated workers. 

Healthcare organizations already have seen staff resign because of vaccine mandates. 153 Houston Methodist employees either resigned during a two-week suspension period or were terminated for not complying with the health system's vaccine mandate, and Lewis County Health System, a single-hospital system in Lowville, N.Y., closed its maternity unit after staff resigned over the state's vaccine mandate.

For ASCs, CMS plans to mandate COVID-19 vaccines for all staff at ASCs as a condition for participating in Medicare. 

Many ASC leaders also are worried this requirement will place an extra strain on their staff. Staff recruitment and retention already are burdening many ASCs — fueled by competition with high-paying hospital contracts and sign-on bonuses, as well as a nationwide nursing shortage.

"CMS announcing the COVID-19 vaccine mandate to include ASCs impacts us significantly," said Brock Kreienbrink, RN, MSN, administrator and director of nursing at Outpatient Surgery Center of Central Florida in Ocala. "We are in a market with an extreme labor shortage, and this will just add even more stress to our labor shortage."

For some hospitals, ASCs have been used as a backup for strained capacity throughout the pandemic, all while the ASC industry is facing debilitating shortages. 

Recent staffing shortages already have forced some hospitals and health systems to move staff from ASCs to accomodate for patient influx. ASCs have been accommodating hospital overcapacity through CMS' Hospitals Without Walls initiative, enacted in March 2020, which allows hospitals to provide inpatient care in enrolled ASCs for the duration of the COVID-19 public health crisis. 

Shortages are further strained by how the pandemic has spurred early retirement for many physicians. About 25 percent of physicians said they made plans for early retirement during the pandemic, according to a Medscape survey, and several others said they have considered leaving medicine.

"Physicians already suffered high levels of job-related burnout and depression before COVID-19 arrived," said Gregg Florentin, CEO of Michigan Orthopaedic Surgeons in Southfield. "The exacerbation of those feelings caused by the pandemic could sway older doctors to accelerate their plans to retire."

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