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FAH Hospital Policy Blog

Perspectives on health policy affecting America's hospitals and the patients we serve.

Hospital Workforce Crisis: How It Affects Patient Care

Workforce shortages are impacting industries and communities across America as the country rebuilds from the darkest days of the COVID-19 pandemic. Without a doubt, this workforce crisis is most acutely felt by our nation’s hospitals and frontline health care providers. As responsive as our health care system has been in addressing the pandemic and ensuring all who come through our doors receive lifesaving care, the shortage of qualified health care workers is threatening access and impeding hospitals’ ability to respond to the pandemic and prepare for the next emergency around the corner. 

Over the past two years, the resiliency of America’s health care workforce has been tested to its limits. Because of this stress, hospitals are seeing unprecedented frontline worker burnout and record retirement among veteran caretakers. As hospitals attempt to reinforce gaps in the provider workforce, there is a growing need for adequately trained workers to fill long vacant and newly open positions. Hospitals have been doing our part to support and recruit employees, but federal action is critical.

Talk to any hospital administrator across the country and they will describe the difficult decisions they face daily to ensure capacity can be met with the current workforce, such as which departments may be too understaffed to operate. Rural hospitals and the communities they serve are especially vulnerable to limitations in access to care due to understaffing.

Policymakers can act now to support immediate and longer-term staffing needs.

Expedite Processing for Verified & Qualified International Health Care Providers

Thousands of international nurses from well-established nursing programs are ready to provide critical care in America, but their applications are not moving swiftly enough through the immigration system. This backlog, if addressed, could begin to alleviate worker shortages, and immediately place nurses in communities with a dire need. We call on the Administration to amend its tiered visa application system priority list to include qualified nurses and health care workers in Tier 1 to ensure the swiftest consideration. We are at a stage where further delays will have real consequences.

End Nurse Staffing Company Abuses

Government regulators must keep an eye on nurse staffing companies that are engaging in predatory pricing tactics during a pandemic. Nurse staffing companies are fully aware of the difficulties hospitals are facing and are capitalizing on a scarce workforce by overcharging and price gouging for traveling nurse services. These inflated prices and unsavory practices lead to increased costs for patients.

Ensure Equity in Pell Grant Program for Health Care Students

Lawmakers must ensure that public policy solutions match the need. While we applaud the additional resources for Pell Grants included in the proposed Build Back Better legislation, students attending taxpaying nursing schools are entirely excluded from this benefit. Students attending the Galen College of Nursing, for example, would be denied the additional funding despite Galen being student-focused, fully accredited and delivering high-quality outcomes including higher-than-average licensure passage rates. 

For-profit colleges produced 30% of the nursing degrees overall during the 2019-2020 academic year. That’s 55,438 new entrants to the nursing workforce. Further, 44% of nursing degrees earned by minority students are achieved at for-profit colleges and this new limit to Pell Grant funds could force students to decide to either receive more Pell Grant dollars or seek a nursing career. Fewer students – a large share of whom are minority – would have the opportunity to enter the nursing workforce if this provision is enacted.

Alexis, a student at the Galen College of Nursing and medical technician at Medical Center of Trinity in Tampa, Florida, put it clearly: 

“I chose Galen College of Nursing because I was able to start in nursing immediately, with prerequisite classes included in the nursing program, versus having to take prerequisites first before entering the nursing program. Galen is a great college and I believe it will prepare me to be a great nurse.

I have met my max on student loans and restricting the Pell Grant could be highly detrimental to myself and many of my fellow students. Without the Pell Grant, I would not have been able to further my education and career.”

The restriction on the increase in Pell Grants is without precedent. The program is designed to follow the student where they decide to enroll. Placing restrictions based on school type would undoubtedly discourage students from seeking nursing care, in the middle of a nursing workforce crisis. Now is the time to incentivize the training of nursing professionals through all high-quality educational avenues, regardless of tax status. We encourage policymakers to support student choice and ensure a level playing field for the next generation of nurses.

Protect Hospital-based Nursing School Programs

Policymakers can support the enactment of the Technical Reset to Advance the Instruction of Nurses (TRAIN) Act to address the impending recoupment of millions of dollars from hospital-based nursing schools based on a historical miscalculation by the Department of Health and Human Services (HHS). Nursing schools are already facing staffing challenges and rising costs. Recouping millions of dollars while they are focused on supporting nursing workforce shortages and training future nurses across the country would distract from their efforts and lead to reductions in class sizes and closures. The TRAIN Act would prohibit the Centers for Medicare and Medicaid Services (CMS) from recouping overpayments made in past years to hospital-based programs when CMS failed to make technical annual updates to the program.

Conclusion 

By all accounts, demand for health care services will continue to increase. Providers are still responding to new strains of COVID-19 and emerging hotspots across the country. We are also working through a backlog of delayed care from the cancelation of elective procedures. And as we look to the future, we anticipate the challenging responsibility of caring for our nation’s aging population. All factors which will make this crisis worse and emphasize the need for short and longer-term solutions. 

Every hospital in the country is facing staffing shortages that are impacting access to care and unless action is taken, we will be limited in our ability to provide for patients and communities. We urge policymakers to work expeditiously to address this crisis with every solution at their disposal.