About 100K Nurses Left the Workforce Due to Pandemic-Related Burnout and Stress, Survey Finds

CNN | By Kyla Russell

HICAGO — About 100,000 registered nurses in the U.S. left the workplace due to the stresses of the COVID-19 pandemic, according to the results of a survey published Thursday by the National Council of State Boards of Nursing.

Another 610,388 registered nurses, who had more than 10 years of experience and an average age of 57, said they planned to leave the workforce by 2027 because of stress, burnout or retirement. The same was true of 189,000 additional nurses with 10 or fewer years of experience and an average age of 36.

The survey found that there were over 5.2 million active registered nurses and 973,788 licensed practical nurses or vocational nurses in the U.S. in 2022. The researchers analyzed data from 29,472 registered and advanced nurses and more than 24,000 licensed practical or vocational nurses across 45 states. More than a quarter of those surveyed said they plan to leave the industry or retire in the next five years, the study says.

About 62% of the nurses surveyed said their workload increased during the pandemic, and 50.8% said they felt emotionally drained at work.

Almost half of nurses said they felt fatigued or burned out: 49.7% and 45.1%, respectively. These concerns were seen most in nurses with less than 10 years of experience.

This exhausted tone was a driving factor behind a strike in New York in January, when over 7,000 nurses took to the streets to call attention to staffing shortages and burnout.

"We are sick and tired of the hospital only doing the bare minimum," said Danny Fuentes, a union official who spoke to the crowd during the strike. "Time and time again, we are forced to take unsafe patient loads. We are humans, and we are burnt out. And we are tired. And the hospital doesn't seem to care. All they see are profits. We don't want to be out here. We would much rather be with our patients. We need a fair contract to protect our patients."

The strike ended when the New York State Nurses Association reached tentative deals with the two hospitals involved, Mount Sinai Health System and Montefiore Health System. The union said the deal would provide enforceable "safe staffing ratios" for all inpatient units at Mount Sinai and Montefiore.

Montefiore agreed to financial penalties for failing to comply with agreed-upon staffing levels in all units.

The researchers on the new survey say their findings pose a threat to the U.S. workforce, especially among younger and less experienced nurses. The National Council of State Boards of Nursing says hospitals and policymakers should be quick to enact solutions and address these challenges.

Home Health Leads Industry Job Gains in March

McKnight’s Home Care | By Diane Eastabrook
 
Home health led the healthcare industry in job gains last month, tallying 15,000 of the 34,000 positions filled during the month of March. The Bureau of Labor Statistics reported the findings Friday in its monthly employment report.
 
The news was a boost to the home health sector, which BLS says needs to fill approximately 700,000 jobs annually. However, the 34,000 additional healthcare jobs in March marked a significant decline from the 54,000 the industry has been averaging monthly over the past six months. 
 
Overall, the United States added 236,000 jobs in March — below the 239,000 economists had projected and well below the 326,000 the nation added in February. The unemployment rate remained at 3.5% and the number of people looking for work increased slightly. That is good news for employers for two reasons: not only has the pool of potential job candidates grown, but larger numbers of workers may put downward pressure on wages.  
 
Still, the labor shortage continues to be one of the biggest headwinds for home healthcare providers as they emerge from the COVID-19 pandemic. Executives at home health giant Amedisys told Wall Street analysts in February the supply of clinical staff is still falling far short of demand. Enhabit Home Health and Hospice executives also said recently 70 of its locations remain short-staffed, despite hiring 100 new nurses at the end of last year. 
 
Two weeks ago, the National Association for Home Care & Hospice and the Home Care Association of America released a report with a list of recommendations to help boost the number of direct care workers. The two groups called on Congress to use American Rescue Plan Act funds to forgive student nurse loans; make telehealth waivers permanent; waive 60-day recertifications regulations for nurses providing care under Medicaid; expedite, simplify and prioritize background screenings on new nurses; and allow for nurse certification reciprocity across state lines.

CMS Failed to Publicly Post Deficiencies for Two-Thirds of Nursing Homes, OIG Find

McKnight’s Long-Term Care News | By Kimberly Marselas
 
Medicare’s Care Compare site did not accurately reflect nursing home deficiencies in two-thirds of listings reviewed by a federal watchdog agency, a finding that implies more than 10,000 health, life safety or emergency preparedness violations may have been left out of view of consumers.
 
The report, issued early [last] Wednesday by the Department of Health and Human Services Office of Inspector General, also found that the Centers for Medicare & Medicaid Services sometimes reported deficiencies to Care Compare that were not found in survey documentation. Scope and severity levels were also inaccurate for one out of every three nursing homes reviewed in a small sample, the OIG said.
 
While the OIG’s attention was trained on CMS, the findings also stand to malign nursing homes by reinforcing the idea that deficiencies are widespread in the sector. It could also lead to renewed CMS attention to public reporting accuracy, which in some cases could benefit consumers and nursing homes.
 
“Consumers rely on the information they find on Care Compare to make informed healthcare decisions and expect it to be accurate; the information can set the expectation for a consumer’s experience with a particular nursing home,” the OIG said in a report reviewed exclusively by McKnight’s Long-Term Care News Tuesday. 
 
“The findings in this report demonstrate the need for CMS to take additional measures to ensure that the information it reports on Care Compare for nursing homes is accurate.”
OIG said CMS’ processes for reviewing inspection results both before and after they were reported on Care Compare “were not adequate.” Though CMS hires contractors to upload deficiency information to Care Compare, OIG found the agency relied on state survey staff to confirm accuracy after posting and on nursing homes to self-report inaccuracies.
 
CMS had not replied to a McKnight’s request for comment by deadline.
 
The OIG audit was based on a sample of 100 nursing homes and their Care Compare listings. Overall, the watchdog found that there were missed deficiencies in 67 cases.
 
Those included missed health deficiencies for 34 nursing homes — one of which was a J-level deficiency issued during a complaint inspection following the fire-related death of a patient who used in-room oxygen. 
 
OIG also found missing fire safety deficiencies for 52 nursing homes, and emergency preparedness deficiencies missing for two nursing homes. In addition, for 42 of the 100 sampled nursing homes, CMS did not report results on Care Compare about the yearly fire safety and emergency preparedness inspections. Each sample was compared to deficiencies documented in state surveyors’ inspection and complaint reports dating back three years.
Extrapolating that, OIG estimated inaccurate deficiency listings for 10,303 of the nation’s 15,377 nursing homes at the time the samples were pulled in December 2020.

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NHPCO Analysis of the FY 2024 Hospice Wage Index and Quality Reporting Proposed Rule

Summary at a Glance 

The FY 2024 Hospice Wage Index and Quality Reporting proposed rule went on display for public inspection on the Federal Register website on Friday, March 31, 2023. The proposals for fiscal year 2024 include the following:

• Proposed rate increase of 2.8%. Rates for each level of care are available below.

• Cap amount: The proposed hospice cap amount for the FY 2024 cap year is $33,396.55

• 4% payment penalty will apply for FY 2024 rates based on CY 2022 data submission.

• The Hospice Outcomes & Patient Evaluation (HOPE) tool is still under review.

• The Hospice CAHPS® tool modes are still under consideration.

• The proposal to implement the Hospice Special Focus Program will be published in the CY 2024 Home Health Prospective Payment Update Rate proposed rule, which will be issued this summer.

• Proposed addition of hospice physicians to the Medicare enrollment process required for covered hospice services.

• CMS Fact Sheet: Fiscal Year (FY) 2024 Hospice Payment Rate Update Proposed Rule (CMS-1787-P) l CMS

Click to read the full proposed rule

Comments are due no later than May 30, 2023, with file code: CMS-1787-P