Hospitals hit bump, but healthcare jobs showed steady growth in July

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Dive Brief:

  • A total of 30,000 healthcare jobs were added to the U.S. labor rolls in July, representing 18% of all new jobs added during the month, according to the Department of Labor.
  • Virtually all of the healthcare job growth occurred in ambulatory care — that segment accounted for 29,000 new jobs alone.
  • The weak spot was in hospital job growth, which was down by 2,000 jobs from the month before.

Dive Insight:

Hospitals are often the biggest employers in many towns and medium-sized cities, but their job creation has been uneven at best in recent months. According to an analyst note from Jefferies, employment by hospitals dropped by 2,000 on a seasonally adjusted basis, although that grew to a net 1,000 new jobs on an unadjusted basis.

By comparison, hospitals added a seasonally adjusted 9,000 new jobs in June, 25,000 on an unadjusted basis. However, much of that boost was created by the minting of new residents who just graduated from medical schools.

Hospital employment is still growing at a 1.8% annual clip (compared to 1.4% as of July 2018), although that’s down from the 2.1% rate reported in April.

“Overall, healthcare employment growth continues to demonstrate strong momentum, but hospital jobs growth appears to be moderating,” the analysts said. Inpatient providers account for more than 5.2 million jobs nationwide.

However, Jefferies’ analysts believe that healthcare will continue to be a big job engine for the foreseeable future.

“We believe the supply of clinical labor continues to struggle to keep pace with solid demand growth, resulting in tight clinician labor markets and strong demand for healthcare temp staffing services,” they said.

Although healthcare job growth has been extremely robust, wages have been stagnant in recent years, a phenomenon attributed in part to continued consolidation among industry players.

The ambulatory care segment has been growing rapidly in recent years. Its addition of 29,000 new jobs was up from 17,000 in June, and significantly outpaced the year-to-date average monthly growth of 22,000.

Home healthcare services added 11,000 new jobs last month alone — the highest rate since 2017. The segment’s annual growth rate is currently 5.3%, up from 3.2% in July 2018.

The nursing home segment added another 1,000 jobs.



Hackensack Meridian acquires three northern NJ nursing homes

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Hackensack Meridian Health, the 17-hospital system in New Jersey, said Tuesday that it has added three nearby nursing homes to its network as it looks to better coordinate hospital and post-acute care.

The nursing homes are the 210-bed Prospect Heights Care Center in Hackensack, the 180-bed Regent Care Center in Hackensack and the 180-bed West Caldwell Care Center in West Caldwell. Prospect Heights is exclusively a subacute-care facility that provides rehab services after people leave the hospital. The facilities have a combined 750 employees.

Hackensack Meridian acquired 100% of Regent Care and 51% each of Prospect Heights and West Caldwell in a deal valued around $65 million, including cash and the assumption of debt. Tandem Management Co. owned all three facilities and will continue as a joint partner in Prospect Heights and West Caldwell.

With the deal, Hackensack Meridian now operates 13 post-acute-care facilities and has rebranded the new additions under the system’s name.

“Patients are staying fewer and fewer days in acute-care facilities,” said Robert Garrett, CEO of Hackensack Meridian Health. “Changes in technology are allowing patients to go home quicker even after receiving pretty intense care and receiving complicated procedures. The best way to ensure that there is a good hand-off is if we own and operate these post-acute-care facilities.”

Hospitals can benefit from having a strong relationship with the nursing homes they refer people to by avoiding federal readmission penalties.

Garrett said the deal will make it easier to find a nursing home bed for patients ready to be discharged and free up beds for patients waiting in the hospital’s emergency department. Hackensack Meridian Medical Center is about a mile away from two of the nursing homes.

The system did not commit a defined amount to capital improvements but plans to make significant investments in the facilities’ IT systems so they can share electronic medical records with its hospitals, said Stephen Baker, Hackensack Meridian’s president of post-acute care.

Baker said Hackensack Meridian’s staffing model is different from other nursing homes in that its facilities use mostly registered nurses; other nursing homes use mostly licensed practical nurses. Its patients tend to be more complex, which allows the system’s facilities to receive higher payments from Medicare. Some of its facilities earn 50% to 60% from Medicaid, which typically pays lower rates.

“We’re able to subsidize lower rates with higher rates from subacute care and favorable rates from managed care organizations,” Baker said. —Jonathan LaMantia





Government to start posting list of troubled nursing homes

In this Oct. 26, 2018, file photo, Sen.Bob Casey, D-Pa., speaks to reporters in the studio of KDKA-TV in Pittsburgh. For years the federal government for years has kept under wraps the names of hundreds of nursing homes around the country found to have serious health, safety or sanitary problems. Lawmakers say the silence calls into question the government’s commitment to families going through the difficult process of finding a nursing home for a loved one. The secrecy began to crack Monday when two U.S. senators from Pennsylvania released the government’s list.

In a turnabout, the government said Wednesday it will start posting a list of some 400 troubled nursing homes , days after senators released the “secret” document along with a report questioning oversight of poor-quality facilities.

Dr. Kate Goodrich, chief medical officer with the Centers for Medicare and Medicaid Services, said the agency soon will post the list and update it regularly. She didn’t set a date.

“We are working actively to get the list posted,” Goodrich told reporters, saying that attention focused on the issue “has amplified a very important national dialogue on nursing home quality.”

The Associated Press reported Monday that Sens. Bob Casey, D-Pa., and Pat Toomey, R-Pa., had found that conditions at the 400 facilities were “indistinguishable” from those at about 80 poor-performing nursing homes that are publicly identified by the government and undergo an additional level of inspections.

In a statement, Casey welcomed the commitment to post the list, but said more work is needed to make sure the government’s program to improve poor-performing nursing homes is running properly and has enough financing.

About 1.3 million Americans live in nursing homes, with more than 15,700 such facilities nationwide. The troubled nursing homes that Casey and Toomey identified are part of the government’s Special Focus Facility program, representing about 3 percent of all homes.

Budget cuts appear to be contributing to the problem by reducing money available for focused inspections, according to documents and interviews.

Agency officials say they currently only have enough money for 88 slots in the special focus program. Those facilities are publicly identified. Consumers can spot them on the government’s Nursing Home Compare website by looking for an icon that resembles a traffic “caution” sign.

But a larger group of some 400 nursing homes are designated as “candidates” for the program, and their names have not been publicly disclosed. The agency says that’s now about to change.

It pushed back against the suggestion it was keeping secrets, saying its nursing home website uses starred ratings that allow consumers to readily identify troubled facilities. Nursing homes with five stars have much better than average quality and nursing homes with a single star are considered to be much below average. Nationwide, there are about 2,900 of the latter.

Goodrich said starred ratings are the best way for consumers to get a sense of quality, but the senators’ report concluded that the ratings can be misleading. For example, nearly 3 in 10 of the 400 “candidate” nursing homes with problems had two stars out of five overall.

The government spends about $400 million a year on all Medicare-related inspections, and Goodrich said most of that goes for nursing home checks. The Trump administration has asked Congress for nearly $45 million more.