Wave after wave of ill patients are landing at the emergency room of Memorial Healthcare in Owosso. The century-old critical-care community hospital 25 miles due west of Flint treated 92 inpatients on Nov. 15, nearly a third of which were COVID-19 positive.
The hospital and its 1,500 employees are equipped to handle 85 inpatients — but operating above that threshold is standard now.
The lasting labor shortage and hospitals' need to raise wages is straining operations for rural hospitals that don't have large medical networks on which to fall back. The final straw may be the Centers for Medicare and Medicaid Services' new rule forcing healthcare organizations to mandate the COVID-19 vaccine for all employees by Jan. 4.
Memorial is paying roughly 300 percent above its projected annual market costs for labor and just 70.9 percent of Memorial's staff is vaccinated — bad vital signs.
"There have been several waves of extinction for community hospitals and we're facing another one," said COO Jim Nemeth, who spent more than 20 years in nursing leadership at Beaumont Health before going to Memorial. "The island chains of community hospitals are trying to survive. We're working our hardest to provide the same level of care, at least for the first hour of an ER visit, that the large systems do ... we're drowning."
Memorial is an evolving hospital, one that's invested millions in improved care. For example, its $45 million orthopedics, neurology and wellness center is under construction, casting a modern shadow against the aging hospital facade 400 yards to the east. It's slated to open next fall.
But Memorial and other independent hospitals like it are still a distant island in the archipelago of healthcare, Nemeth said, lacking the resources to "be all it can be." It's a system that's racing the rising tides of regulation, increased costs during the pandemic and an inability to get larger reimbursements from insurers, all of which is sinking the rural hospital's cash flow.