HJAR Mar/Apr 2024

HEALTHCARE JOURNAL OF ARKANSAS I  MAR / APR 2024 13 three years, and you saw hospitals getting a 3% increase, 2.6% increases fromMedicare, and no increases from Medicaid, or from the VA. You start adding that up and it's like you're getting a 2.5-3% increase when your costs are going up 9-10%. It doesn't take a genius to figure out you can't keep doing that forever. Editor I wanted to talk to you about the paradox of a labor shortage that happened during and after COVID and the layoffs that hospitals like yours have had to implement recently. Explain that to us. Peterson That is quite the paradox. I'm going to go back a little further, even. If I was the governor, I would've made the same call and believe that it was the right call at the time. When I look back, I would maybe have changed it, but that's easy to Monday- morning-quarterback. If you remember, for about eight weeks, we could not do any elective cases. We actually furloughed about 300 people right away. We thought we had way too many people working. Then as COVID came, there became this crisis. My question is, "Where did all the people go?" There became this crisis of not having enough workers, especially nurses. At one time, we had, I think, 52 positions in our environmental services department, and we had 27 openings. So, it wasn't just nursing that we were struggling with. We were trying to find any and everybody. People were afraid to work in hospitals because they didn't want to get COVID, especially in North Central Arkansas because we were requiring a vac- cine and, "I could go work somewhere else and not have to get vaccinated. I could go work somewhere else and get paid more per hour." There were just several factors. Then, you bring in the traveling nurses. We were up to, at one time, a high of 65 trav- eling nurses. We had gone the last five or seven years without a traveling nurse in this hospital. Then, all of a sudden, we have 65 in here. It's like, "Well, wait a minute. We can't afford that." We have to figure out how to take care of patients or how to limit patients, or something. We have to figure out how to take care of patients without having travel- ing nurses because there's no way we could continue to afford that. So, we've been very fortunate, worked very hard, been able to get our travelers down. I think through- out our whole organization, whether it's in nursing or in other areas, we have six trav- elers now in our hospital. We feel very for- tunate about that. What else hospitals and Baxter Health have realized is the cost structure has changed so significantly, and the reim- bursement has not changed with that cost structure, so we cannot afford to keep as many people on our workforce to take care of the same amount of people we previously did. Organizations that are still below the number of patients they used to take care of before COVID, or organizations that are at that level, or even organizations like us that have grown are all feeling the pinch of being able to figure out howwe can operate more efficiently and how to reduce the number of people working. That's a challenge because how do you do that and keep the quality up? We've focused very hard on trying to do that. I think that's why, across the industry, you're seeing layoffs because hospitals can't afford the same number of people they did before to take care of that same number of people. The wages have gone up so signifi- cantly, and yet, the reimbursement has not followed. So, that's why you've seen this tidal wave of, "Too many people,” “Oh, not enough people," and "Too many people."