By Mississippi Today’s Devna Bose

Amid continued risk of closures, Mississippi hospitals are increasingly missing one critical piece of their staff: Nurses.

Many of the state’s hospitals are emptying. Service lines are being discontinued, and full floors have been shuttered — for some, to preserve costs, but also because hospitals increasingly lack the staff.

According to data from the Mississippi Hospital Association, registered nurse vacancies and turnover rates skyrocketed in the past year to their highest numbers in at least a decade.

Kim Hoover, an RN who also serves as the MHA’s Education Foundation CEO, said the pandemic took an unprecedented toll on already-stressed health care workers and hospitals. Nurse departures, fueled by burnout and higher pay elsewhere, have put Mississippi’s hospitals in further peril.

“They’ve been running a tight ship,” she said. “So when you have something like the pandemic, which none of us could have ever imagined, it stresses the system that was really already on the brink.”

Statewide, Mississippi hospitals reported 3,038 open registered nurse positions in 2022. Of Mississippi’s hospitals, 82% responded to the MHA’s voluntary survey.

Mississippi hospitals in 2022 were missing a quarter of their total registered nurse staff, 21.4% of their licensed practical nurse staff and 21.3% of their certified nursing assistant staff.

Between 2021 and 2022, RN vacancies shot up from 15.9% to 24.5%. RN vacancies were most evident in central and southwestern Mississippi, including the Jackson metro area.

RN turnover rates statewide went from 23.5% to 31.9% from 2021 to 2022, meaning that almost a third of RNs left their jobs last year.

While Lt. Gov. Delbert Hosemann’s plan to address the hospital crisis includes millions for a nurse loan repayment program and even more for a grant that would use federal funds to help community college nursing programs is in motion, those solutions might not make a difference for months.

Senate Bill 2371, the grant for community college nursing programs, has passed the Senate and is awaiting a vote from the full House, while Senate Bill 2373, money for the nurse loan repayment program, has passed both chambers and is awaiting the governor’s signature.

But hospital administrators and advocates say they need help now.

‘I think the ultimate consequence of not doing something about this is that (hospitals) are going to close as they are right now,” Hoover said. “The doors are going to close.”

A report from the Center for Healthcare Quality and Payment Reform shows that 38% of Mississippi’s rural hospitals are at risk of closing.

As of February, there were 200 open nursing jobs out of a staff of 3,000 at the University of Mississippi Medical Center, according to Dr. Alan Jones, UMMC’s associate vice chancellor for clinical affairs.

Before COVID, UMMC’s open nursing positions would average closer to 30 at a time.

UMMC communications director Patrice Guilfoyle said the hospital just eliminated its $4-an-hour temporary incentive pay program, established during the height of the COVID pandemic.

It’s unclear whether the withdrawal of that pay led to more nurses leaving.

“It should also be noted that we have more beds open than we’ve ever had so this change in nursing premium is unrelated to staffing,” she said in a statement. “(There) continues to be a nursing shortage statewide and nationally as well, so that’s really the real crux of the issue.”

Philadelphia’s only hospital, Neshoba County General Hospital, has closed one of its two nurse stations because staff is limited.

“There were times during the pandemic that we’d have 15-plus nursing positions posted, and we weren’t getting any applications,” CEO Lee McCall said in an interview. “And that’s a common theme out there.”

The data from the MHA shows that the Delta has been hit the hardest.

Nurse vacancies and turnovers in most categories were highest in that region, where rural hospitals are also especially at risk.

Amy Walker, chief nursing officer at Delta Health System in Greenville, said the hospital’s daily census is down, but not because there aren’t people who need medical care. There are simply not enough nurses in the hospital to take care of any more patients.

Teresa Malone, executive director of the Mississippi Nurses’ Association, said when hospitals are short on nurses, it puts patient safety at risk.

“With the ever-continuing vacancies at facilities, patients are waiting longer in emergency departments, and obtaining transfers for patients to other facilities often takes longer than preferred,” she said. “The nursing crisis is adversely impacting all aspects of health care and is therefore adversely impacting patients.”

As for recruitment, Walker said it’s difficult to convince nurses to come to Mississippi, and even harder to convince them to come to the Delta.

Paying nurses more than rates in Jackson or Memphis doesn’t always work, she said.

“It’s always been a little bit worse for us,” Walker said. “It’s hard to get people to move here unless you’re from here, or you really have a servant’s heart.”

During the pandemic, the hospital system lost almost half of its nursing workforce — to other states, travel nursing or retirement. Currently, they have a staff of 250 per diem nurses, down from 468 pre-pandemic.

“And once they’re gone, we’re just not getting them back,” she said.

Greenwood Leflore Hospital had 350 nurses at the start of the pandemic. Now, they have 150.

Interim CEO Gary Marchand said the hospital can’t afford to pay competitive salaries because of how low reimbursement rates are in Mississippi.

“That’s going to translate down to wages you can afford to pay,” he said. “It doesn’t surprise anyone that in a national emergency … that our nurses would flee to the other states.

“I don’t fault any of them for leaving for greener pastures.”

The following hospitals declined to provide specific nurse shortage numbers, but searching job postings on their websites revealed the following number of openings:

• St. Dominic Hospital, based in Jackson: 204
• Anderson Regional Medical Center, based in Meridian: 177
• Singing River Health System, based in Pascagoula: 183
• Forrest General Hospital, based in Hattiesburg: 200