Capital Region

Lacking staff, some Capital Region urgent care facilities cut hours or close

Ellis Hospital in Schenectady is shown in a 2020 file photo. The facility has not cut hours or services offered.
PHOTOGRAPHER:

Ellis Hospital in Schenectady is shown in a 2020 file photo. The facility has not cut hours or services offered.

ALBANY — Multiple urgent care facilities across the Capital Region have limited their operations and hospitals are considering cuts of their own to respond to a staffing shortage.

The situation, which some are calling a crisis, has been simmering for years but worsened during a physically and emotionally draining 19-month pandemic that has raised the burnout rate among healthcare providers.

The next shoe fell at midnight Monday, when a state-mandated deadline for COVID vaccination arrived and New York caregivers who’d refused to vaccinate were ordered suspended from their jobs.

Late Monday evening, Gov. Kathy Hochul signed an executive order easing the replacement of these unvaccinated healthcare workers and creating a Department of Health operations center staffed around the clock to troubleshoot and solve any acute staffing crises that may arise at individual facilities.

On Tuesday, Hochul provided a hopeful update indicating a significant number of holdouts receiving late-hour vaccinations.

The percentages are small — just 4.9% of hospital staff, 5.7% of nursing home staff and 6.6% of adult care facility staff who are medically eligible to get vaccinated still are refusing to do so as of Tuesday.

But that’s out of a combined workforce of 692,000. Those small percentages add up to more than 35,000 people refusing to be vaccinated, plus more than 10,000 others who say they plan to get vaccinated but haven’t yet. 

Albany Medical Center CEO Dr. Dennis McKenna said his hospital and the Capital Region as a whole are doing much better than average but not good enough.

“It truly is a crisis, there is no two ways about that,” he said.

INITIAL CUTS

Here’s a sample of the impact around the region:

  • Albany Med has temporarily shuttered its EmUrgent Care facilities in Guilderland and Mechanicville and moved their personnel to the main hospital to relieve pressure on the emergency department.
  • WellNow has temporarily halted urgent care at its clinics in Glenville, Latham, North Greenbush and Rotterdam; COVID testing remains available at those sites. The company said the shift at these and eight other sites across the state was in response to increased demand for testing.
  • Nathan Littauer Hospital has temporarily closed its Broadalbin-Perth and town of Johnstown primary care clinics to conserve support staff; it’s also preparing for longer wait times and greater difficulty transferring patients to other hospitals.
  • St. Mary’s Healthcare has temporarily halted urgent care at its Charlton clinic, which is transitioning to a primary care facility.
  • Community Care Physicians is anticipating temporary cuts in hours at one or two practices.
  • Priority 1 Urgent Care in Guilderland halted urgent care for part of Tuesday.
  • Hudson Headwaters advises the public that wait times may be longer than normal at its urgent care sites in Glens Falls and Warrensburg.

ONGOING PROBLEM

The flip side of this is that the vast majority of medical facilities across the region remain open. But there are normal fluctuations in patient volume from hour to hour, and there are sometimes too few staffers to promptly treat peak patient loads. So patients may find themselves waiting longer.

Ellis Medicine in Schenectady, for example, showed a five-minute wait to be seen at its Mohawk Harbor urgent care clinic and a 29-minute wait at its Clifton Park Medical Center at 2 p.m. Tuesday. By 5 p.m., wait times had grown to 58 and 114 minutes, respectively.

Ellis on Monday afternoon was looking at a loss of up to 100 unvaccinated employees, and potentially more if a court strikes down the religious exemption that 69 employees have secured. The state is pressing for that in court.

Meanwhile, Ellis is offering hiring bonuses of up to $20,000 for nurses and $25,000 for medical technologists, trying to gain an advantage in the super-tight labor market for skilled medical professionals. 

And it will be holding a job fair with on-the-spot interviews for numerous support staff job titles from noon to 4 p.m. Wednesday at its 1101 Nott St. headquarters.

As of Tuesday, spokesman Philip Schwartz said, Ellis hasn’t had to cut hours or services, but it is aware that it may need to do so. For some time, managers have been running tabletop drills on what to do if the outflow of employees leaves them unable to continue full patient services.

So far, none of the scenarios have come to pass, but they’re an ironic repeat of the drills the managers had much earlier in the pandemic, trying to decide what to do if a surge of patients was so great that the hospital couldn’t care for them all.

COMPLEX SITUATION

McKenna, the CEO of Albany Med, on Tuesday described a situation with multiple causes.

The vaccine mandate, which Albany Med firmly supports, is only part of it, he said. The pandemic itself, a crisis unprecedented in a century, is responsible for many healthcare workers leaving the field.

“A lot of people have worked hard and are tired,” McKenna said. “We totally understand that.”

Add an aging population that needs more healthcare, not less, and an insufficient number of young people replacing the retiring healthcare workers, and a fuller picture of the staffing crisis emerges.

“We need to inspire a new generation to follow in the footsteps of those exemplary caregivers who are here today,” McKenna said.

Albany Med has additional complicating factors: It is the designated trauma center for 22 counties and some of its facilities and care options are not offered elsewhere in this part of the state. 

It accepts about 16,000 transfers per year of patients who need different or more advanced care than is available at the hospital that first admitted them.

Albany Med needs to maintain the services that it alone can provide, McKenna said, so the staffing shortage may force it to limit elective surgical procedures, limit incoming transfers and limit hours at satellite facilities such as its EmUrgent Care clinics.

“We knew it was coming years ago,” McKenna said of the staffing crisis that is now materializing. But Albany Med isn’t able to exactly quantify the crisis, as some of its 204 employees who’ve refused to vaccinate may change their mind before they are fired; the 29 employees who’ve claimed religious exemptions may lose them; and the facility may gain reinforcements in the form of the retired or out-of-state or military medical personnel whom Hochul is moving to mobilize.

“We will not likely feel the full impact of what is happening with the vaccine mandate until next week … This is a fluid number and it will take us a few days to sort out that number,” McKenna said.

Reach John Cropley at [email protected], 518-395-3104 or @cropjohn on Twitter.

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