Johan Lee Thompson has been a registered nurse for three years at Saint Francis Hospital and Medical Center in Hartford, a member of Trinity Health of New England.
She was working in the radiology department but was prepared for the possibility of getting redeployed to another area of the hospital because of the pandemic.
“I was ready because I knew COVID was just starting off, and if anything, we thought that our job would be more secure because of it,” she said. “But it was the complete opposite.”
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Thompson was furloughed in early April, right before the pandemic would reach a statewide peak with nearly 2,000 people hospitalized. Before she could return to work, the hospital system notified her last week that she’d been laid off.
“Everyone out there is so confused how, at this time during a pandemic, you’re laying off so many nurses when I felt like we were needed,” Thompson said.
The answer -- at least from hospitals and health systems -- lies in financial losses because of the COVID-19 pandemic. Revenues took a dive when elective or non-urgent surgeries and procedures were postponed. Other types of patient visits also slowed as people complied with state social distancing and quarantine directives.
At the same time, hospitals were suddenly spending more to prepare for and treat COVID-19 patients, creating a shortfall in their finances. Now some of the same health care workers responding to the pandemic are being cut as health systems shed operating expenses.
In an emailed statement, officials from Trinity Health of New England, which includes Saint Francis and three other Connecticut hospitals, said the system will reduce positions in “mostly non-clinical, administrative functions” in the first quarter of the fiscal year, which began July 1.
The organization did not specify how many staff members will be laid off, but it will include letting go people who were furloughed in the past few months and eliminating other positions. The system will also extend furloughs or reduced schedules.
“Though there are positive signs that patients are returning for services, the organization expects the recovery will be gradual,” Trinity officials said, “and there are many unknowns, with possible resurgence of the virus and the country’s economic recovery.”
Adding Up The Losses, Expenses And Relief Aid
The Connecticut Hospital Association projects that the state industry will face about $2 billion in losses by September.
Mark Schaefer, vice president of system innovation and financing at the association, calls it a steep loss that weakens the hospital industry.
“And one that will make it very difficult for them to respond with the aggressiveness and with such effectiveness in averting a public health disaster during the first waves,” he said.
Federal emergency funding has provided some level of financial relief. Connecticut hospitals and health systems received about $628 million, Schaefer said. Other relief dollars have gone to private practices, ambulatory companies, skilled nursing facilities and other providers, according to the latest data from the U.S. Department of Health and Human Services.
That relief makes up about a third of what Connecticut hospitals and health systems are projected to lose, “so it doesn’t come close to getting hospitals to the point where they [can] finish the year in a healthy position,” Schaefer said.
Health systems could also get money in the form of accelerated and advanced payments from Medicare -- a May report showed that more than $1 billion was sent to Connecticut providers, but the funds act as loans and hospitals will have to gradually pay back the money beginning next month.
All of this, Schaefer said, creates a financial strain on hospitals and health systems, especially ones that did not get high amounts of relief funding, and ones that had less cash on hand and lower reserves before the pandemic.
"Unfortunately, there are hospitals having to do a range of difficult things in order to minimize expenses and frankly lose as little as possible,” Schaefer said.
In Connecticut and elsewhere, that has included furloughing and laying off health care workers. Employment numbers have fluctuated month to month, but nationally there were 904,000 fewer employed health care workers in June than there were in February, according to the U.S. Bureau of Labor Statistics.
That included a loss of nearly 150,000 hospital health care workers.
“What we’re looking at is a contraction in the industry, one that is bad for Connecticut’s economic recovery,” Schaefer said, “but also makes it more challenging for them, they won’t have the same workforce on hand to handle what lies ahead with regard to whatever COVID-19 presents to us in the coming months.”
Impacting The Workforce
Bill Garrity worked as a registered nurse for 30 years and said cuts to the workforce can negatively affect other employees and their patients, and they’re not entirely without costs. Before the pandemic derailed the regular legislative session, Garrity had planned to testify in support of policies that strengthen health care staffing ratios.
“If you furlough a nurse who’s at the bedside, if you furlough a medical assistant, you furlough a respiratory therapist or a radiology tech, guess what? You still have to pay someone overtime to fill their spot,” he said.
Garrity is the president of University Health Professionals, a local AFT Connecticut union representing 2,800 employees in the UConn Health system. He said the union and university have worked hard to avoid furloughs and layoffs during the pandemic.
UConn Health officials said the public health system, which includes a teaching hospital, is expected to end this fiscal year with a $114.9 million deficit, largely due to COVID-19-related revenue losses. They plan to address the shortfall with management furloughs and expense reductions -- they have not made any layoff decisions “but will continue to monitor staffing and other expenses closely.”
Current union contracts protect a majority of union employees from layoffs, Garrity said, but as a bargaining leader, he has to think about the long game.
“Are we going to be in any better fiscal situation one year from now, 12 months from now, trying to sit down and negotiate a contract?” he questioned.
For registered nurse Christen Curtis, the last couple weeks have been a whirlwind, she said. Curtis worked on a COVID-19 floor at Saint Francis for the last three months in a contracted position that recently ended.
Curtis and her family had already decided to relocate out of state, and she knew when her last day would be. But she didn’t realize it would also be the last day for several colleagues whom she had worked side by side with on COVID-19 patients.
“Going through what we went through and having to take care of the patient loads that we took care of, concerned over your own safety, watching people die, over and over and over,” she said, “and then on top of all of that, to be doing that on months on end and then to be let go, disgracefully, by your organization, that’s awful.”
Curtis said she understands the financial predicament health systems are in, but she worries that cutting clinical health care workers in an ongoing pandemic will make for an unsafe situation in the event of another coronavirus surge.
She posted on social media about her last day and the health system’s layoffs last week, hearing from other health care workers who have also experienced recent furloughs and layoffs.
“I can tell you from all the messages I’ve received this week,” Curtis said, “you’re not alone.”