Strong Memorial Hospital routinely operates at near 100 percent occupancy. For the past month, however, the hospital has been over capacity consistently, officials said in a briefing Tuesday.
“We have 886 licensed beds, and on any given day, when we arrive in the morning, we can have upwards of 1,000 patients admitted and waiting for a bed,” said Kathy Parrinello, chief operating officer and executive vice president at Strong.
Hospitals in the Finger Lakes region, and especially in Monroe County, have fewer inpatient beds per 1,000 than any other place in New York, and are lower than the U.S. average as well, she noted.
A shortage of nursing home beds is the top reason for strained hospital capacity. As winter approaches and flu and respiratory-related illnesses infect Monroe County, the picture gets bleaker.
“By law, hospitals cannot release nursing home patients unless they have a nursing home bed to go to,” said Michael Mendoza M.D., public health commissioner. “Unfortunately, our hospitals are having increasing difficulty finding open nursing home beds. So, nursing home patients are waiting in hospital beds that should be available for hospital patients who need them.”
In October 2020, Strong was caring for 20 to 25 patients waiting for nursing home placements, typical for the hospital. Last year, it was up to 50 patients. This month, Parrinello said, the average number of patients waiting for a nursing home bed is 100 at Strong. At Highland Hospital, that number tops 30.
Parrinello stressed that the hospital does not fault the nursing homes for the problem. Those facilities are dealing with their own challenges including staff shortages and reimbursements that do not adequately cover the costs of care.
Robert Mayo M.D., chief medical officer at Rochester Regional Health, pointed to crowded emergency departments within the system as well.
“The crowding of emergency departments … can be related to the backup of patients within our hospitals who are awaiting discharge. But other times it can be related to patients who are seeking care, but actually don’t need full emergency-level care and services,” he said.
Mayo urged patients to be clear about their symptoms and communicate with their primary care providers.
The county is already seeing an early and severe respiratory syncytial virus season, affecting adults and children, and signs point to an early and more severe influenza season, Mendoza said. A COVID-19 surge is also a possibility.
“This means that our limited hospital capacity could become even more strained, and it could happen very quickly, and so that’s why this is a very serious concern for all of us,” said Mendoza, who encouraged vaccination, boosters and hand hygiene.
Michael Apostolakos M.D, chief medical officer at Strong, brought attention to the significant increase in RSV cases.
“Among our pediatric patients, this virus is up more than 50 percent,” he said. “From this time a year ago, we’re just beginning to see cases of flu in our community and hospitals. But we know this year’s strain of flu is particularly dangerous. Our health care teams are working heroically to maintain the high-quality care for our patients who need it. But that will be hard to sustain if our community doesn’t help.”
The system’s ability to meet demand for elective surgeries is already strained. A pause on those types of cases is possible, Apostolakos said.
While both health care systems consider transferring patients, when feasible, to regional hospitals, those facilities are also close to capacity.
“On occasion, we have been able to send some of these patients to those regional hospitals,” Parrinello said. “The challenge is many of these patients live in Monroe County and sending them out for weeks on end to outlying areas can be challenging for families and for the patient.”
She hopes county initiatives will help with the problem—funds have been allocated to the health systems to prepare staff for nursing homes that also need direct financial support. It is an ongoing effort in partnership with area nursing homes.
“It is going to take helping the nursing homes get a higher rate of financial support for taking care of these patients,” Parrinello said. “And also, it’s going to take creating a stronger workforce for the nursing home.”
“Our quality of care has been maintained,” Apostolakos said. “We are very concerned about overburdening our health care system, and what we’re trying to do is make sure we give the very best care to our community that they deserve.”