Lawmakers and health care officials are sounding the alarm about crises facing upstate hospitals.
Upstate New York hospitals face a thorny problem: declining revenue exacerbated by staffing shortages and patient overflow. Lawmakers say New York faces being short 30,000 registered nurses by 2030.
A survey by the non-profit Iroquois Healthcare Alliance, which represents more than 50 hospitals and health systems across 32 upstate counties, revealed 88% of providers in their network are operating in or near red ink territory. Iroquois president Gary Fitzgerald traces the problem to nursing homes.
With lawmakers Wednesday at the state capitol in Albany, Fitzgerald says many have had to reduce the number of available beds because they can't meet staffing requirements.
"It's never been worse than it is today," Fitzgerald said. "And I've been doing this for 30 years. And so we have vacancy rates of RNs across our hospital systems of 19%. We have total staff vacancy rates at 50%. Pre-pandemic and a normal vacancy rate is about 7%. So you can see where the problem is. Those nurses are not in nursing homes. They're not in hospitals. So hospitals, nursing homes are not at capacity. They're usually at 90% capacity. Now they're at about 60%. And most nursing homes across the upstate New York. That means those patients that should be in a nursing home, are now taking up a hospital bed, which means the ER backs up, ambulances can't get into the ER, and the whole system begins to shut down."
108th District Democratic Assemblyman John McDonald, a member of the Health Committee, says the scenario is very concerning.
"You'll see it either at Albany Med or you'll see it over at Samaritan in Troy," said McDonald. "You'll see ambulances waiting in the bays and under decks for hours at a time to discharge patients into an overcrowded emergency room."
Albany Med President and CEO Dr. Dennis McKenna says the COVID-19 pandemic and the workforce upheaval it caused compounded the problem.
"When the great resignation occurred and nurses in large part, mainly retired early hospitals were caught with significant staffing shortages," said McKenna. "So as a result, the staffing agencies stepped in. And they did what I would call poach, and lease."
Syracuse area Assemblyman Al Stirpe is also a Democrat. He echoed McKenna's sentiments, pointing out that temp agencies are taking full advantage of the depleted nursing workforce.
"We're looking at some of these temporary staffing agencies getting 40% of whatever they charge hospitals," Stirpe said. "And that isn't helping at all. In March of 2022, the average traveling nurse earned approximately $3,334 a week. Prior to the pandemic, traveling nurse salaries were around $1800 a week. "
Dr. McKenna said the rate increase for nurses under the traveling nurses program is unaffordable.
"What is happening is, a staffing agency will contract with a nurse from St. Peter's hospital, and they will in turn, place them at Albany Medical Center. And in return, a nurse from Albany Medical Center will go down the street to St. Peter's," said McKenna. "And both hospitals are paying three to four times the rate for the same nurse. And that's happening with one mile of each other."
Assemblyman McDonald says if the situation isn't rectified, hospitals will have to cut services. He adds there is a need to create a workforce development fund to help hospitals meet staffing shortages.
"It's up to us to come up with solutions. Now. Money helps," said McDoanld. "And in this past year's budget, money was appropriated statewide, a little bit over $1.6 billion of which that money has been flowing to downstate and is starting to flow to the upstate hospitals. But to be very clear, it's not going to be enough. And that's why we are pushing to really focus the funding almost as like an economic development initiative, to focus on workforce investment, particularly in nursing in the healthcare field.”
Lawmakers are asking Governor Kathy Hochul to include money in the budget to bolster nursing education and attract more people into the field.
In August Hochul announced two new programs financed in the state budget as part of a $10 billion effort to address the chronic shortage in the health care workforce: a new scholarship program to provide 1,000 new nursing students with free tuition to the state’s and New York City’s public colleges and universities, along with a $1.3 billion program to pay recruitment and retention bonuses to all health care workers in the state who earn less than $125,000 a year.