West Virginia state government must get out of the hospital business, and the sooner the better.
Currently, the state owns and operates four long-term care facilities, two psychiatric hospitals and a community hospital in Welch. A recent audit conducted by the Post Audit Division of the state legislature revealed a major issue with the facilities—hiring and retaining nurses.
West Virginia, like the rest of the country, is experiencing a nursing shortage. Hospitals compensate by hiring traveling nurses, and that gets expensive. The audit revealed that the state has spent $284 million on contract positions since 2015.
Mike Jones, audit manager with the Post Audit Division, told lawmakers this week, “From fiscal year 2015 to 2023, the total annual expenditure for contract clinical staff increased 955 percent.”
The staffing shortages are exacerbated by the hiring process. The audit found that it took an average of 23 months to post jobs and hire an individual. That prompted House Speaker Roger Hanshaw to quip, “That’s among the most ridiculous things I’ve heard in a long time.”
(Amelia Ferrell Knisely has more on this at West Virginia Watch.)
I am told that the hiring process has improved of late, but it still may take months to fill a position. Traveling nurses are a convenient but very expensive option.
Staffing and hiring are just one issue. State government is simply not set up to run hospitals efficiently. There is too much bureaucracy and too little incentive to try to provide care efficiently. One state government source told me the employees, “are trying to provide good care, but we’re not giving them a chance.”
Major changes may be on the way. As Jeff Jenkins reported last July, the state Department of Health Facilities has hired Lument Securities to help the state look for companies interested in buying and operating the state hospitals.
DHF Secretary Michael Caruso said at the time the move is intended to preserve and elevate the standard of care for our population served by the long-term care facilities.” I’m hearing of progress on that front, but nothing has been finalized.
But back to the audit. The first recommendation of the Legislative Auditor is this: “The Legislature should consider if the continued operation of health facilities by the state is in the best interests of the state and address the issue as it sees fit.”
Caruso’s response to the audit showed he is in full agreement, saying the agency’s plan for revitalizing the state’s nursing facilities includes “the sale and license transfer of these facilities, ensuring uninterrupted care and operational continuity throughout the transition.”
State government is not good at operating hospitals and nursing homes. It is, by nature, painfully bureaucratic and loath to change. Turning the seven facilities over to the private sector will lead to better working conditions for the employees, more cost effective operations and improved care for the patients.