DOUGLAS — A longtime Memorial Hospital of Converse County nurse known for not ever complaining looked wearily at CEO Matt Dammeyer as he checked in with her Friday.
She pulled her face mask down and remarked that the mask was rubbing her nose raw. A simple thing hardly worth mentioning in normal times. These are not normal times.
It’s September 2021, but such words harken back to the scary days of 2020 and what’s happening at hospitals across the country – and at MHCC in the last few weeks – is eerily reminiscent of the worst days of COVID.
On Friday, the 21-bed Douglas hospital had 18 beds filled, with nine of those – a hefty 50% – diagnosed with COVID.
But now add in another unexpected problem. Staffing. Or, rather, the lack thereof.
The national nursing shortage is hitting MHCC at a time when the community hospital is experiencing a huge surge in patient care needs. June hit a monthly record of $18.3 million in gross patient revenue – an amazing figure considering the county was coming out of a year of COVID woes and a shrinking economy.
But it wasn’t a simple fluke for a single month.
Since then, the hospital has continued on strong patient numbers and accompanying income. Just three weeks into September, the month was already among the top 10 months ever for the hospital.
What that means is demand for health care at MHCC and beyond the county borders is high, Dammeyer said, and while COVID is driving part of that demand, other health care demands are also driving it.
On the one side, from a business perspective, the increase in revenue is a good thing.
Without federal money flowing into the hospital this year as it did last year, the money will be needed to keep hospital operations in the black, he said.
“Health care is a people business,” said Dammeyer.
MHCC has to have the financial resources to keep the top-quality staff and be competitive. But the other side of that coin is the demand on staff, and not just with nurses.
The shortage and the hospital’s sudden return to recruiting staffing is somewhat of a surprise, given that a few months ago the hospital administration was limiting hiring everywhere and restricting recruiting of specialized skilled professionals.
Unlike many hospitals its size across the Rocky Mountains, MHCC did not lay off staff during the last year, but the administration and board did realize the drop in income in 2020 would be forcing cuts and reduced staffing, hopefully primarily through attrition. Those never materialized.
Instead, demand rose dramatically in June and stayed high ever since.
For comparison, MHCC averaged $12.4 million a month in gross patient revenue a year ago, but that climbed to $14.9 million average through June this year as patients began to flock back to MHCC, according to the hospital financial records.
By the end of August, that had already been pushed to an average of $15.5 million on the strength of the last three months.
Dammeyer said the hospital sees the same worker shortages as other businesses in the county and country, such as with the hospitality industry. Food services and environmental services (cleaning and sanitation) at MHCC are being impacted with longer hours and job shifting to cover needs just as other businesses have to do these days.
But nursing, especially in med surgery, emergency department and OB, has its own, somewhat unique, recruiting challenges.
“The nursing piece is the most concerning,” he admitted.
“We are actively recruiting nurses and areas across the hospital,” Dammeyer said, but the challenge has been that so are hospitals across the country — and the federal government’s response to the healthcare crisis has been to “incentivize” people to go into those fields.
In government terms, incentivize means to throw money at the problem, which has increased recruiting costs and pay demands – but at the same time has encouraged those with the right skills to consider becoming traveling nurses rather than commit to a single facility.
MHCC responded with a “re-recruitment package” for existing nursing staff, he explained.
Basically, that is a retention plan with bonuses to encourage nurses to stay for one or two more years and pay differentials for different shifts and duties.
Yet Dammeyer is acutely aware that he has to keep expenses in line with revenues this year.
In 2020, the federal government shored up many businesses with cash infusions and grants, including employee paycheck protection programs. MHCC took advantage of nearly $10 million worth of those programs, which kept it in the black last year. Without that money and funds from Converse County to cover indigent care, MHCC would have been in the red financially, Dammeyer said.
Now, most of those federal pandemic relief programs are over or phasing out quickly.
“We have to stand on our own feet this year,” he said, but some “calculated risks” MHCC took during the pandemic – such as expansions into other surrounding counties and renovations in Douglas – appear to be paying off now and that will help.
The CEO, who started his tenure in Douglas just before the pandemic took hold, had some kind and impressive words for his staff overall, however.
Noting how hard they are working and acknowledging they’re often taxed with longer hours and having to cover extra duties, he added, “Our culture (in Wyoming) is you do what you have to do to get it done, so you do (it). Our people are determined, but tired.”
How much longer the competing issues of high COVID cases, strong demand on other care services and staffing shortages continue is anyone’s guess, but Dammeyer offered some crystal ball gazing.
“I predict it will be steady (cases of COVID and health care needs) but not as intense as it has been. But that may be wishful thinking,” he said.
And we know we are not alone as an industry, Dammeyer pointed out.
“The help wanted signs,” he said. “They’re all over.”