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association panels and conferences and speak with state and national col- leagues, and one topic would always be at the forefront.
“It was always workforce, workforce, workforce,” he said. “This was pre- COVID, and it’s what kept providers up at night.”
However, at Legacy’s two partner companies, JGS Lifecare and Chelsea Jewish Lifecare, Berman agrees with Hatiras that the pandemic took an already-worrisome problem and worsened it.
“When COVID came, many individuals who may have been considering careers in healthcare went for it, but for others, COVID gave them pause. And some people elected to retire earlier than they were otherwise going to. For many people, there was the calculus of determining whether they’d stay at home taking care of somebody versus re-entering the workforce.
“That’s not just in healthcare; that’s in general,” Berman added. “You see it across every industry. There are fewer people overall than were previously in the workforce.”
The growing labor shortage in healthcare is starting to have serious bottom-line effects, as organizations boost wages to compete for scarce talent and swallow skyrocketing rates being demanded by travel-nurse agencies.
A recent study conducted by Premier, a national healthcare-improvement
“When COVID came, many individuals who may have been considering careers in healthcare went for it, but for others, COVID gave them pause. And some people elected to retire earlier than they were otherwise going to.”
  company, found that U.S. hospitals and health systems are paying $24 billion more per year for qualified clinical labor than they did pre-pandemic, and ap- proximately two-thirds of hospitals’ current costs are from wages and salary.
As reported by the Massachusetts Hospital Assoc., Premier found that “overtime hours are up 52% as of September of 2021 when compared to a pre-pandemic baseline. At the same time, use of agency and temporary labor is up 132% for full-time and 131% for part-time workers. Use of contingency labor (or positions created to complete a temporary project or work function) is up nearly 126%.”
The Premier study follows a September study from Kaufman Hall project- ing that hospitals nationwide will lose an estimated $54 billion in net income over the course of 2021, even taking into account the funding they received from the federal CARES Act.
Meanwhile, Moody’s Investor Services also predicted hospital margins will continue to fall. “Over the next year, we expect margins to decline given wage inflation, use of expensive nursing agencies, increased recruitment and retention efforts, and expanded benefit packages that include more behavior- al-health services and offerings such as childcare. Even after the pandemic, competition for labor is likely to continue as the population ages — a key social risk — and demand for services increases.”
All of this results in what healthcare leaders are increasingly calling an unsustainable situation — one that’s necessitating a great deal of flexibility, creativity, and, yes, anxiety.
Heightened Competition
In the world of home care, COVID posed some very specific issues, said Mary Flahive-Dickson, chief development officer and chief medical officer at Golden Years Homecare Services and Golden Years Staffing Agency.
“We already had an ongoing issue with a shortage of healthcare providers, but with COVID, people were moving loved ones out of facilities and into their homes — getting them out of skilled nursing and assisted living, keeping them out of hospitals. But now they needed home care, and a lot of it — not
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