Nurse Staffing Shortages: Is Closing Beds The Right Answer?
For several years, nurse shortages in the US have forced healthcare facilities to make some difficult decisions. Do they collectively pay billions of dollars to recruit and retain nurses, or risk patient safety by closing beds or entire departments to match staffing levels?
Some hospitals are offering incentives to attract nursing talent, including higher salaries, retention and signing bonuses, student loan repayment, free housing, and career mentoring, while other facilities with limited nursing resources are making the tactical decision to close beds.
What Are The Implications?
While closing beds means nurses aren’t stretched beyond capacity, there are significant cost implications. Any fixed costs associated with empty beds, including heat, electric, or ancillary services, exist regardless of whether a bed is filled or empty. In fact, an empty bed costs approximately 70 percent (around $1-1,500 per day per bed) of what the full cost is when a bed is filled.
The cost of empty beds is covered through cost-shifting when other patients in the hospital pay more for their care through either private pay or private insurance pay. For example, take a hospital with a 90 percent occupancy rate versus one with a 40 percent occupancy rate: If both are reimbursed for $10,000, the 40 percent occupancy rate hospital is at more of a disadvantage as it would need to use funds to pay for the empty beds. On the other hand, the 90 percent occupancy hospital has revenues from all of its filled beds. Put simply, it’s always better to have a higher occupancy rate due to the increased revenues the beds generate. However, this doesn’t help those hospitals where staffing resources are stretched.
What Are The Alternatives?
There has been a growing reliance on travel nurses to fill gaps in recent years. Although they provide hospitals with instant access to qualified nurses when required, these contracts are typically only 13-weeks in length, and cost a high hourly rate in comparison to permanent staff. In 2017, the Staffing Industry Analysts (SIA) reported that the nationwide costs for travel nurses reached $4.8 billion, more than double what was spent three years earlier.
On the other hand, some healthcare facilities are going global to recruit international nurses through specialist and reputable staffing agencies. There are 3 million immigrants already in the healthcare system, accounting for 1 in 4 workers in that field, according to Harvard Medical School (2019).
International nurses can deliver significant monetary savings in comparison to travel nurses. While agencies that provide travel nurses offer housing stipends, per diem rates, and travel expenses, those that supply foreign nurses charge facilities a flat hourly rate with no extra costs.
Additionally, the continuous turnover of travel nurses can have a negative effect on a wider RN team. A 2015 report that analyzed nursing staff turnover found it led to higher levels of absenteeism and lower morale. With international nurses committed to long contracts with facilities, it enables existing nursing teams to build strong bonds with one another, share experiences, and offer support.
Working With Conexus
Conexus has sourced exceptional nursing talent for US hospitals and long-term care facilities from across the globe since 2010. Our goal is to provide the right expertize at the right time to ensure facilities always meet the high standards in healthcare delivery, without the need to close beds.
Find out more about international nurses and other staffing alternatives in our free guide - 'Alternatives to the traditional 13-week assignment'.
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