Percent of U.S. Hospitals Reporting Critical Staffing Shortages

After an upswing during the Delta wave, the proportion of U.S. hospitals reporting critical staffing shortages had plateaued at about 19 percent. During the past two weeks, there are signs that critical staffing shortages may once again be on the rise.

We analyzed all U.S. hospitals reported by the Department of Health and Human Services. (HHS) The data, originally reported on a daily basis, are aggregated by week. The percentages of all reporting hospitals in each state are weighted by their inpatient bed capacity. HHS appears to rely on each hospital’s self-report of a critical staffing shortage.

During the Delta wave in the United States, the percentage of hospitals reporting critical staffing shortages rose from 12 to 19 percent. Even as hospital admission rates declined in October and November, the critical staffing percentage remained elevated at 19 percent. During the past two weeks, as the Omicron variant has begun to spread, this percentage has increased to 19.8 and 20.5 percent, respectively.

Vaccine Mandates are Unlikely to be the Primary Cause.

Some have contended that vaccine mandates are contributing to the emerging shortage of healthcare workers. But there is little concrete evidence to back up this contention. While a small minority of healthcare employees have chosen to leave their jobs, the vast majority have opted for vaccine protection. At large healthcare systems like Houston Methodist, Truman Medical Centers/University Health in Kansas City, the North Carolina hospital system, Advocate Aurora Health in Chicago, Mount Sinai Health System in New York, St. Claire Regional Medical Center in Kentucky, and Henry Ford Health System in Detroit, less than 1 percent of employees had to be let go.

The Labor Market for Skilled Nursing Care was Already Tight.

Still others have pointed to the increasing fees charged by traveling nurses and nurse staffing agencies to compensate for growing vacancies among nurse employees. The plain fact, however, is that the tight labor market for hospital-based nursing care predated the COVID-19 pandemic. Annual turnover among hospital-based registered nurses was already up to 15.9% in 2019 and increased to 18.7% in 2020.

It’s All About Pandemic Burnout.

Far and away the most critical determinant of rising staff shortages has been burnout, with more nurses leaving their employment as the pandemic drags out. While burnout among frontline healthcare workers has always been a serious problem, the percent of surveyed hospitals reporting 10% or more vacancies for RNs abruptly rose from 23.7% in 2019 to 31.8% in 2020 to 35.8% by early 2021. The evidence of burnout among frontline workers is overwhelming not only in the U.S., but other healthcare systems, including China during the initial Wuhan outbreak.

Stay Tuned.

We will continue to follow the aggregate U.S. hospital staffing situation as the Omicron wave plays out.

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