Hospital beds are in high demand due to the public’s growing need for acute care services. However, many hospitals have a shortage of nurses, forcing them to take seemingly drastic measures to stay afloat. One way they do this is limiting the number of beds they fill.
Although this seems self-limiting, some hospitals, like those that make up Rochester Regional Health (a healthcare system in Rochester, New York), are doing just that. According to a News10NBC report, the healthcare system took matters into its own hands by temporarily closing beds at some of its hospitals to navigate the system’s nursing shortage.
Closing hospital beds might be a reasonable solution for hospitals in New York since the state has mandated staffing ratios, albeit for critical care nurses only. Other states with this mandate include Massachusetts (also limited to critical care nurses) and California (for all nurses).
With mandated staffing ratios, if there aren’t enough nurses on staff, it’s illegal to keep filling beds. For example, a state-required maximum ratio of 2:1 (two patients to one critical care nurse) would require a 10-bed critical care unit to have at least five nurses on staff to fill all beds. If it’s short one nurse, the unit can only fill eight beds, leaving two empty beds.
In states without the mandate, closing the two beds wouldn’t necessarily be required although hospitals are encouraged to balance patient load with acuity level. This was the case during the COVID-19 pandemic when staffing mandates were temporarily lifted in California to ensure patients had access to every empty bed. This required some nurses to care for a greater number of critically ill patients at once than they typically would, which can pose a safety risk.
Closing beds to navigate a nursing shortage offers one way to ensure patient safety isn’t compromised. Per the News10NBC report, Rochester General Hospital (RGH) President Tammy Snyder assured that although the number of beds is lower at the hospital, patient care isn’t impacted.
Shifting focus to nurse retainment and recruitment is another way the hospital is cutting spending. In the report, Snyder said hospital leaders are searching for ways to attract and retain nurses, including reducing the amount of funds spent on travel nursing services.
According to a report by Spectrum News 1, RGH said 40% of its nursing staff are travel nurses and it spent $75 million on travel nurses last year—a jump from only $5 million just 5 years ago. Travel nursing agencies are a great resource for hospitals in times of critical shortage, but growing dependency on these agencies has significantly increased labor costs for hospitals nationwide. According to the American Hospital Association, U.S hospital spending on travel nursing services rose nearly 800% from 2019 to 2022.
In the News10NBC report, Snyder explained that although RGH still uses travel nurses, each travel nurse is offered permanent employment or another opportunity at the hospital.
Along with closing beds and addressing staffing issues, the hospital serves as a clinical training facility for students from local nursing schools as another attempt at nurse recruitment.
“We also are partnering with our local nursing schools. Those nursing students come to RGH as a part of their nursing training,” said Snyder in the report. “We want to make sure that they have a fantastic experience with us so that they choose RGH as their employer after graduation.”
According to the American Hospital Association, many U.S. hospitals are in a financial crunch. From growing staffing shortages to rising medical supply and pharmaceutical expenses, hospitals are doing the best they can to survive. According to Becker’s Hospital Review, Rochester Regional Health started losing around $1 million per day in 2022, sparking a multi-year cost transformation journey. Efforts have since “improved productivity, efficiency, and workforce development.”
Charmaine Robinson, MSN-Ed, BSN, RN, is a nurse writer with a background in medical–surgical nursing and nursing instruction. She has a passion to inspire others through education and motivation.
References
American Hospital Association. The current state of hospital finances: Fall 2022 update. September 15, 2022. aha.org/guidesreports/2022-09-15-current-state-hospital-finances-fall-2022-update
American Hospital Association. Massive growth in expenses & rising inflation fuel financial challenges for America’s hospitals & health systems. May 2024. aha.org/guidesreports/2022-04-22-massive-growth-expenses-and-rising-inflation-fuel-continued-financial
Damiani D. Rochester Regional Health looks to reduce temporary nursing staff. Spectrum News 1. January 8, 2025. spectrumlocalnews.com/nys/rochester/news/2025/01/08/rochester-regional-health-looks-to-reduce-temporary-nursing-staff
Dembosky A. California is overriding its limits on nurse workloads as COVID-19 surges. National Public Radio. December 30, 2020. npr.org/sections/health-shots/2020/12/30/950177471/california-is-overriding-its-limits-on-nurse-workloads-as-covid-19-surges
Dyrda L. New York hospital to close beds due to nursing shortage. Becker’s Hospital CFO Report. January 2, 2025. beckershospitalreview.com/finance/rochester-regional-to-close-beds-due-to-nursing-shortage.html
Kasprak J. California RN staffing ratio law. February 10, 2024. cga.ct.gov/2004/rpt/2004-r-0212.htm
Massachusetts Nurses Association. Landmark law to set safe patient limits for nurses in all Massachusetts hospital intensive care units went into effect on September 28, 2014. massnurses.org/legislation-politics/safe-patient-limits/safe-patient-limits-in-icus/
New York State Nurses Association. 2024 NYSNA staffing report. 2024. nysna.org/resources/2024-nysna-staffing-report
Tortorello A. Rochester Regional Health temporarily closes hospital beds amid nursing shortage, aims to cut spending. January 8, 2025. News10NBC. whec.com/top-news/rochester-regional-health-temporarily-closes-hospital-beds-amid-nursing-shortage-aims-to-cut-spending
