Becker's Hospital Review

12 CFO / FINANCE The cost of nurse turnover in 23 numbers By Molly Gamble N urse recruitment and retention is top of mind for every hos- pital and health system executive in 2022, particularly those responsible for ensuring health systems' financial stability. e 2022 NSI National Health Care Retention & RN Staffing Report features input from 272 hospitals in 32 states on registered nurse turn- over, retention, vacancy rates, recruitment metrics and staffing strat- egies. It found the average cost of turnover for one staff RN increased 15 percent from 2020 to 2021, to $46,100, among other dollar figures and statistics that are helpful to understand the financial implications of one of healthcare's most challenging labor disruptions. Here are 23 numbers that illustrate the cost of nurse turnover, accord- ing to the most recent edition of the report, which can be found in full here. 1. In 2021, the turnover rate for staff RNs increased by 8.4 percent, resulting in a national average of 27.1 percent. 2. e average cost of turnover for a staff RN is $46,100, with the range averaging $33,900 to $58,300. is is up from the average cost of turnover for an RN in 2020, which was $40,038. 3. Each percent change in RN turnover will cost or save the average hospital $262,300 per year. 4. More than 60 percent of respondents said the RN vacancy rate in their hospital tops 15 percent; 6.5 percent said they have an RN vacancy rate of less than 5 percent. 5. e RN Recruitment Difficulty Index is 87 days on average, re- gardless of specialty, meaning it essentially takes 3 months to recruit an experienced RN. 6. For every 20 travel RNs eliminated, a hospital can save $4,203,000 on average. 7. From 2020 to 2021, the percent change in regional RN turnover ranged from 3.2 percent to 12.2 percent. e Northeast saw the high end of this range while the North Central region saw the low end. 8. Over the past five years, RNs in step down, emergency services, behavioral health and telemetry were most mobile with a cumu- lative turnover rate between 101.3 percent and 111.4 percent. "Essentially, every five years, these departments will turn over their entire RN staff," the report states. 9. RNs in surgical services, women's health and pediatrics were less mobile, with 2021 turnover rates of 18.8 percent, 19.5 percent and 19.6 percent, respectively, compared to the national average of 27.1 percent. n Envision Healthcare at high risk of bankruptcy, Moody's says By Ayla Ellison N ashville, Tenn.-based Envision Healthcare, which operates ambu- latory surgery centers and provides physician staffing services, is on the brink of bankruptcy, according to Moody's Investors Service. The credit rating agency downgraded Envision's debt Sept. 21 to "C," indicating the debt is "typically in default, with little prospect for recov- ery of principal or interest," according to Moody's. "The ratings downgrade reflects Moody's view that Envision's capital structure is unsustainable, that the probability of a bankruptcy or major restructuring is high, and that recovery rates for much of the company's debt will be low," the credit rating agency said. Envision has seen a decline in profitability, and Moody's expects the company's operating performance to continue to deteriorate due to ris- ing interest rates and labor pressures affecting the healthcare industry. The No Surprises Act, which was implemented in January 2022, and Envision's out-of-network status with UnitedHealthcare will also present challenges for the company, Moody's said. The rating action comes after a series of transactions, including a re- structuring of Envision's senior secured credit facilities. n Pennsylvania hospital to lay off 334 workers By Ayla Ellison D elaware County Memorial Hospi- tal in Drexel Hill, Pa., will lay off 334 workers when it closes in November, according to a notice filed with state regu- lators. The layoffs are effective Nov. 26 and come after Springfield, Pa.-based Crozer Health, which owns the 168-bed hospital, an- nounced plans to halt all services at Dela- ware County Memorial Hospital. Crozer said the facility will be turned into an inpatient behavioral health center by spring 2023. Crozer, a four-hospital system owned by Los Angeles-based Prospect Medical Holdings, is also ending inpatient care at Springfield (Pa.) Hospital. The hospital will only offer outpatient services by next year. Crozer is one of several health systems across the nation cutting jobs and services. n

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