OIG: U.S. Hospitals in 'Survival Mode'

Hospital finances are stressed, care access is threatened, and staff are burned out.

The nation's hospitals are reporting that the year-long battle with the coronavirus pandemic has put them in "survival mode," contending with stressed margins, burned-out staff, and exacerbated concerns about care access for vulnerable communities, a federal report said.

"Hospitals described difficulty balancing the complex and resource-intensive care needed for COVID-19 patients with efforts to resume routine hospital care," the Department of Health and Human Services' Office of the Inspector General said in a report made public Wednesday.

"(Hospitals) reported that staffing shortages have affected patient care, and that exhaustion and trauma have taken a toll on staff's mental health," the report said. "Administrators detailed challenges associated with vaccine distribution efforts and concerns about vaccine hesitancy among staff and members of their communities."

The report is based on a February 22–26 survey of hospital administrators from 320 hospitals across 45 States, the District of Columbia, and Puerto Rico. They were asked three questions: 

1. What are your most difficult challenges in responding to the COVID-19 pandemic right now, and what strategies have you been using to address the challenges?
    
2. What are your organization's greatest concerns going forward?
    
3. How can government best support hospitals?
    

"Hospitals also raised concerns that the pandemic has exacerbated existing disparities in access to care and health outcomes," the report said. "Additionally, many hospitals reported experiencing financial instability because of increased expenses associated with responding to a pandemic and lower revenues from decreased use of other hospital services."

The report noted that many of the challenges posed by the pandemic are even more severe for rural hospitals.

Beyond providing more money, especially for hospitals in rural and underserved areas -- the hospitals said government could best help them by offering guidance on COVID-19 treatment and prevention, including safe discharges of COVID-19 patients, help to reduce depleted staff, especially nurses and specialists, and continuing to encourage the public to get vaccinated.

In the long-term, the hospitals said the pandemic has exposed existing gaps in the nation's care delivery system. The recommend that the federal and state governments and healthcare stakeholders use the public health emergency to address issues that predate the pandemic, such as healthcare disparities and access.

"These improvements include reducing disparities in access to healthcare and in health outcomes, building and maintaining a more robust health care workforce, and strengthening the resiliency of our health care system to respond to pandemics and other public health emergencies and disasters," the report said.