Nebraska hospitals backed up with patients waiting for transfers

OMAHA, Neb. (WOWT) - Nebraska hospitals are getting crowded again, but not because people are getting sicker. It’s actually because patients are getting better — but have nowhere they can go to receive necessary continued care.

“Delays in patient discharges to post-acute care have become a growing challenge for our hospitals and it’s reaching crisis point, impacting hundreds of Nebraskans every single month,” said Jeremy Nordquist, president of the Nebraska Hospitals Association, during a video-conferencing call with health officials from across the state.

Nordquist said hundreds of Nebraskans are sitting in hospital beds unnecessarily each month because they need to be transferred to a lower level of care, like a skilled nursing facility, but several issues prevent it. Meanwhile, dozens of other patients are waiting in the ER for a bed to open up.

It also means those in rural hospitals who might need more specialized care can’t get a bed in a larger hospital.

“We’ve heard about stroke patients, cardiac patients in need of advanced interventions that smaller hospitals can’t provide but our larger hospitals do. Those patients are sitting there waiting because beds are being taken unnecessarily.”

Nordquist said on the call that the problem has reached crisis level.

“Delays in patient discharges to post-acute care settings have become a growing challenge for our hospitals,” a Wednesday release from the NHS states. “While difficulty to place patients is not a new issue, COVID-19 has exacerbated the situation and created a large volume of patients who are ready for discharge from hospitals but cannot find an appropriate bed in a post-acute care setting. ... Even with a recent decline in COVID-19 numbers, this transfer issue continues to pose problems for our hospitals.”

In September, the NHA started tracking patients awaiting discharges, Nordquist said.

Hospitals have since reported that at any given time, there are more than 220 patients sitting in a Nebraska hospital waiting to be discharged — patients who are medically ready to be moved to a lower more appropriate level of care, like a skilled nursing facility or a long-term care facility.

Out of those 220 patients last month, he said 104 had waited more than 30 days in the hospital for placement; 18 of them waited six months or more. Additionally, there were 154 patients waiting in small rural hospitals waiting for transfer.

“They do not need to be in an acute care hospital bed,” he said.

But nursing homes are struggling to recruit and retain staff; and Nebraska doesn’t have enough behavioral health capacity for patients who need to move out of hospitals’ care.

Additionally, there are bureaucratic delays in getting people enrolled in Medicaid so they can get transferred to a nursing facility. Meanwhile, payers like Medicare Advantage and Medicaid Advantage aren’t paying enough to secure post-acute placement spots.

There’s also a long waitlist at the Nebraska Office of the Public Guardian of patients waiting to be assigned a guardian so they can be transferred.

State health leaders are calling on Nebraska lawmakers to help them out.

“We need policymakers to not just throw their hands up and say, ‘This is too tough.’ We need everyone at the table to help address this crisis,” Nordquist said.

Nordquist was joined on Wednesday’s call by Mel McNea, interim CEO at Regional West Health Services in Scottsbluff; Melinda Kentfield, vice president and chief nursing executive at Methodist Fremont Health; and Beverly Nelson, manager of clinical quality and population health at Boone County Medical Clinic in Albion.

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