Becker's Hospital Review

18 CFO / FINANCE Clinical labor now costs hospitals $24B more than before COVID-19 pandemic By Alia Paavola H ospitals and health systems across the country are paying $24 billion more per year for qualified clinical labor than before the COVID-19 pandem- ic, according to an analysis from Premier, a healthcare improvement company. For the study, Premier used its artificial in- telligence database to compare workforce trends from October 2019 through August 2021. The study looked at daily, biweekly and quarterly data from hundreds of hos- pitals and clinical employees. Titles includ- ed in the analysis were limited to clinical employees working in the emergency de- partment, intensive care unit or nursing areas. Six other key details from the study: 1. Clinical labor costs are up by an average of 8 percent per patient day compared to 2019, pre-pandemic. For a 500 bed hospi- tal, this equates to $17 million in additional annual labor expenses. 2. Compared to the pre-pandemic baseline in 2019, the number of overtime hours em- ployees worked was up 52 percent by the study's end. 3. The use of agency and temporary labor is up 132 percent for full-time workers and 131 percent for part-time workers. 4. Overtime and use of agency staff add about 50 percent or more to a typical em- ployee's hourly rate. 5. The annual rate of turnover in emergen- cy, ICU and nursing departments has near- ly doubled from pre-pandemic to 2021. Specifically, it increased from 18 percent pre-pandemic to 30 percent, according to the report. Premier noted that this number could increase as new vaccination man- dates take effect and more employees re- sign or get fired. 6. The study found the use of sick time for clinical staff in the ED is up 50 percent for full-time employees and more than 60 per- cent for part-time employees when com- pared to the pre-pandemic baseline. n CMS requests corrective action plan from 32 hospitals over undisclosed prices By Alia Paavola C MS sent 32 hospitals requests for a corrective action plan aer they still were not in compliance with the price disclosure rule, an agency spokesperson told Becker's Hospital Review on Oct. 14. Of the 32 hospitals that received corrective action plan requests, which is the second step in CMS' compliance process, six hospitals are now in compliance with the rule aer addressing citations outlined in warning letters, according to CMS. In April 2021, CMS began sending warning letters to hospitals not in compliance with the regulation. As of late September, CMS had sent 316 warning notices to hospitals out of compliance with the rule, the agency told Becker's. Hospitals have 90 days to address the findings in the noncompliance letter from CMS. e agency reviews compliance again upon expiration of that 90-day window. If the hospital is still not in compliance, it may receive a second warning letter or a request for a corrective action plan. If a hospital is still not compliant aer this request, CMS may assign a penalty of up to $300 per day. CMS told Becker's it has not yet issued any civil monetary penalties to any hospitals for noncompliance with the rule, but once it issues the fee, it will make the name of the hospital public. A July analysis of 500 hospitals conducted by nonprofit Patient Rights Advocate found that 94.4 percent of hospitals hadn't met at least one of the requirements since the rule took effect. To boost compliance, CMS proposed in July increasing the minimum fine for price transparency violations. Under the proposed rule, hospitals with more than 30 beds in violation of the rule would pay $10 per day for each bed, up to $5,500 per day. Hospitals with 30 beds or fewer would continue to pay up to $300 per day. is would make the annual penalty at least $109,500, or as high as $2 million a year for large hospitals that fail to make prices public. If the proposed rule is finalized, the penalty increase would be effective Jan. 1. n $2B Mass General Hospital expansion advances By Marissa Plescia M assachusetts General Hospital received approval Oct. 14 from the Boston Planning and Development Agency for a 1 million- square-foot, $2 billion expansion, The Boston Globe reported. The project includes two patient care towers, additional beds and new facilities for cardiac and cancer patients. The hospital would build an entryway for a potential city train station and improve sidewalks and bike lanes in the area. In addition, the hospital said it would provide financial support to the community and give up a hospital building for affordable housing. State health officials still must approve the expansion. n

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