2012 Healthcare Survey Results
This two part report is a compilation of results from a recent NSI survey of 3,257 hospitals (15.3% participating). These surveys contain information relating to the impact of the nursing shortage on hospitals, recruitment and staffing strategies, top CEO challenges and Healthcare Economics. Click the links below to read the full report and to learn how to receive an immediate return-on-the-investment, improve cash flow, enhance the bottom line and improve quality patient care services by converting contract nurses to hospital employed nurses.
Click Here For Part 1: Staffing Strategies Survey Results
Click Here For Part 2: Healthcare Economics Survey Results
Vacancy Creep Calculator (OPEN FIRST)
This calculator will help you forecast your RN vacancy rate post-recession. The current economic conditions have created a false lull in RN vacancies; which studies show can be twice as high post-recession.
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Vacancy Creep Presentation (OPEN SECOND)
To meet these challenging economic conditions, hospitals have instituted a variety of labor cost saving measures (ie: downsizing, wage freeze, hiring freeze, benefit cost-shifting, etc.). These short-term strategies will have a long term impact on staffing, particularly given the nursing shortage.
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2012 Nursing Workforce Report
This Report illustrates Executive Perceptions on the Nursing Shortage, The C-Suite’s Differences in Perception and Strategy, What RNs Think, the Cost of Turnover and RN Cost per Hire.
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Travel Nurse Use Study
This report is a compilation of survey responses from over 498 hospital executives, comparing the use and cost of travel nurses to a hospital hiring nurses as their employees.
Click on the link below to read the full article.
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Foreign Nurse Versus U.S. Nurse Recruitment Study
This report is compiled from survey responses from over 150 hospital executives. It compares the use and cost of foreign nurse recruitment to U.S. nurse recruitment.
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The 2012 Healthcare Predictions
According to Moody's Investor Services and Fitch Ratings, the outlook for hospitals is “Bearish but Bulling-Up” for 2012; further, PriceWaterhouseCoopers predicts: Cutting costs is not enough; organizations must grow to survive. Areas that CEOs, CNOs and CFOs should look at are service line growth and market consolidation. According to Moody's Investor Services and Fitch Ratings, the outlook for hospitals is “Bearish but Bulling-Up” for 2012; further, PriceWaterhouseCoopers predicts: Cutting costs is not enough; organizations must grow to survive. Areas that CEOs, CNOs and CFOs should look at are service line growth and market consolidation.
PREDICTION: The specialties with the best revenue growth potential are: Cardiology 57%, Orthopedics 76%, Gerontology 55% etc. Hospitals (65%) will seek to hire physicians. Physicians also seek hospital employment (i.e. PCPs-80%, etc). Depending on specialty, net revenues provide huge ROI justifications for physician hiring. Readmission strategies need to be in place by 2013. Readmissions cost is $7,200 per.
PREDICTION: Government mandates become more restrictive affecting capacity, governance and margins. The number of hospitals in the "red" will increase. Expect some margin compression. The Healthcare economic composite index is 5.39%. The hospital index is 4.86%. The hospital Medicare index is .093%. The hospital commercial index is 7.93%. Operating margins in 2011 at teaching hospitals is 4.22%, at Community at hospitals it's 6.9%. Net patient revenues per adjusted discharge is $9,300+. Acute care discharges average dropped 6.1%. ED visits to rise in 2012 .
PREDICTION: CEO and senior executive compensation programs will face more IRS scrutiny. Non-managerial staff raises to range 2% to 3.8%. RN wages to $70,668.
PREDICTION: Healthcare costs rise 8% to 10% putting pressure on pension plan funding. Prepare for difficult commercial payer negotiations, with bundling payments emphasized. Medicare reimbursements will be either flat or reduced. State to constrain Medicaid stays. Physician reimbursement may change. Surgery volumes to rise slowly. Health Reform cuts dialysis treatment and inpatient psychiatric dollars.
PREDICTION: RN turnover rate rises to 15%+, cost-of-turnover rises to $70,000 - $140.000+, and RN cost-of-hire rises to $36,567. Union activity increases, especially nurses. Union election win rate is 75%.
PREDICTION: Reimbursement cuts, will emphasize cost reductions. Labor cost represent the biggest hospital expense. Attention to lost productivity, contract nurse use, and excess overtime is vital. Non-productive time averages 13% per nurse. A hospital with 500 RNs loses $4,326,400/year; capturing 20% adds $865,280 to the bottom line. Strong 2012 job growth continues. Also hospitals will cut contract nurses and replace with employed staff. The 2012 average RN contract labor cost rises to $64.13 to $64.77/hour. Each eliminated contract nurse saves $48,880 of excess spending, resulting in millions saved.
Nurse Staffing Costs Must Be Viewed Holistically
"When revenues fall, hospitals stop investing in ... nurses. That's a bad short-term solution to a long-term problem...”, according to Kathy Douglas, president of the Institute for Staffing Excellence and Innovation. To deal with the challenges of value-based purchasing (VBP), profitability and Health Reform, hospitals must examine how nurse staffing affects a hospital's overall performance and base staffing on that study. There are direct links between nurse staffing and LOS, morbidity, mortality, readmissions, adverse events, fatigue-related errors, patient satisfaction, employee satisfaction, and turnover... and all relate to staffing, and have significant cost consequences. Some of these might even be considered 'soft costs,' like employee satisfaction or RN turnover, but money is money. Soft costs have hard financial implications. To make the link to staffing, stop looking at staffing numbers in isolation; and look at the whole picture, which includes everything associated with staffing, and until then we're not going to understand financial performance.
"Staffing costs sit in one part of the budget, so we think of the results there. Then the cost of errors sits in another part of the budget. If you look at top priorities—LOS, safety, quality—all of these things have direct links to staffing," says Douglas. An organization that has cut back on staffing may not notice that it is overusing overtime and that there's a relationship between the overtime and the number of infections on a unit. Hospitals need to examine all the factors and design a flexible system that allows flexing based on patient needs.
According to Wanted Analytics Inc., new nursing jobs postings in July, is up 46,000 (11%) year-over-year (SIA, August 18, 2011); while the U.S. BLS shows healthcare created 31,300 new jobs in July, and 170,900 this year. Why is this happening? The easiest answer is demographics. Americans are getting older (78 million baby boomers), fatter, and sicker, requiring more care and this is compounded by a 10.7% population growth since 2000. The Health Reform Law is also a factor, with 65% of hospitals now seeking to employ physicians and are adding 19.5% more nursing jobs to a currently veiled critical nurse shortage. The crash of 2008, prompted many nurses to delay retirements and others to return from retirement. At some point, beginning in 2012, regardless of what the stock market does, they will start to retire (4% to 6%). Hospitals in the midst of this physician and nursing shortage are hiring (now up 5.4%) for the expected ramp up of services created by Health Reform