One of the biggest issues facing healthcare currently is staffing. After enduring years of stressful and heartbreaking work through the Covid-19 pandemic, healthcare workers had hoped that this crisis would motivate the changes we desperately need to fix our health system, only to find out that nothing meaningful has changed.
Now, they’re quitting in droves. In 2021, healthcare and social services workers quit at a the highest rate in twenty years, according to data from the Bureau of Labor Statistics. At the peak in November 2021, 3% of these workers quit their jobs.
Hospitals reducing staff
While the pandemic was a breaking point for many healthcare workers, hospital policies implemented before 2020 in some ways laid the groundwork for the current staffing crisis. A recent New York Times investigation finds that large nonprofit hospital chain Ascension, along with other hospital systems, took steps before the pandemic to reduce labor costs, leaving hospitals woefully unprepared for Covid-19.
According to the Times, Ascension executives decided to lay off thousands of workers in 2013, as a response to a $5 billion deficit forecast in their five-year plan. In the subsequent years, Ascension often refused requests to hire more medical workers or fill open jobs, employees reported. Ascension also lobbied against laws in Michigan and Illinois that would have required minimum nurse-to-patient staffing ratios.
A Times review of nurse logs and interviews revealed the consequences of low staffing a some Ascension hospitals, including: delayed surgeries, bed sores, medications given late, and diverted ambulances. At one hospital, nurses arrived to the emergency department and were told they had to care for 11 patients each (the industry standard is just two patients per nurse).
Ascension is not the only hospital system to cut staff to dangerously low levels. Nurses across the country have been striking to protest understaffing. One CommonSpirit hospital in Washington state was so short-staffed that a nurse called the local emergency dispatch line to request that the fire department come help with the backlog patients in the hospital’s emergency department.
Where did the money go?
Ascension had started cutting costs to avoid a predicted deficit, but in the end, the system was not in financial danger. “Over the five years in which Ascension executives had projected the $5.2 billion loss, the system instead earned $2.7 billion in profits,” according to The Times.
Ascension also benefits from large tax breaks because of its nonprofit status. The Times article cites Lown Institute research showing that “because of its nonprofit status, Ascension avoids more than $1 billion a year in federal, state and local taxes.”
Not only that, Ascension has a booming investment wing. Last year, Ascension won a Shkreli Award (our top ten list of the worst actors in healthcare) for partnering with a global equity firm to create a $1 billion private equity operation.
Lastly, Ascension paid their CEO Joseph Impecciche $13 million last year (most of it in bonuses), according to their tax forms.
For an institution that claims to be a “ministry, not a business,” Ascension’s priorities are clearly amiss. When patient care and staff well-being are sacrificed for the sake of increased profits, CEO bonuses, and investment ventures, leadership should be held accountable.