Review of Personnel Shortages in Federal Health Care Programs During the COVID-19 Pandemic

The COVID-19 pandemic put an unprecedented strain on the nation’s federal healthcare systems. The Pandemic Response Accountability Committee (PRAC) Health Care Subgroup surveyed more than 300 facilities across four federal healthcare programs to determine if the facilities had sufficient medical staff during the pandemic. The VA Office of Inspector General (OIG) reviewed staffing at Veterans Health Administration facilities, the Department of Justice OIG reviewed Federal Bureau of Prisons facilities, the Department of Defense OIG reviewed medical treatment facilities, and the Health and Human Services OIG reviewed staffing within Medicare- and Medicaid-certified nursing homes. Collectively, the IGs learned that most facilities had challenges hiring and maintaining the staff they needed. This joint report provides insights into shortages in personnel positions most commonly reported; factors contributing to personnel shortages reported by facility officials; impacts to the healthcare personnel, the patients, and healthcare services provided by the federal healthcare programs; and strategies to mitigate personnel shortages caused by or exacerbated by the pandemic. Specific insights identified in the report include • Nurses and medical officers were the most commonly reported positions that experienced shortages during the pandemic. • A limited labor pool, noncompetitive pay, COVID-19 requirements, and a challenging hiring process were the most commonly reported factors that contributed to personnel shortages. • A decrease in patient access to care and patient satisfaction and an increase in health care personnel work hours and responsibilities were the most commonly reported impacts resulting from personnel shortages. • Monetary incentives were the most commonly reported strategy to recruit and retain personnel. These insights can help policymakers understand the challenges that federal healthcare programs experienced throughout the pandemic and determine the actions necessary to ensure sufficient staffing for ongoing health care needs and future pandemic response efforts.