Minnesota National Guard to assist with long-term care staffing shortage

Gov. Tim Walz announced Friday a plan for the Minnesota National Guard and others to shore up staffing levels in long-term care facilities as a way to help hospitals stretched by an ongoing surge of COVID-19 patients.

More than 400 patients being treated in hospitals across the state are ready to be discharged, but the facilities that typically would receive them lack staff, Walz said at a news conference outside North Memorial Health Hospital in Robbinsdale.

The National Guard has been alerted to prepare for a mission to support long-term care facilities, the governor said, though no details were released about when or how many members would be deployed.

The state is giving long-term care providers more access to an emergency staffing pool that previously helped on short notice when facilities were struggling to find enough workers due to illness.

Walz also called on the Department of Human Services to free up capacity at state long-term care facilities, a move that officials said could help patients with behavioral health and substance abuse problems move out of hospitals.

"There's no ability to step down now, because there's no capacity in those facilities," Walz said. "So across the state of Minnesota, we have over 400 patients who … are in hospital beds taking up the space that is needed for the next group of folks to come in."

For weeks, long-term care providers have been highlighting what trade groups on Friday called "a crisis in caregiving." Walz's plan doesn't address the root financial problems behind short staffing, they said, but they applauded "efforts to address health care backups through strike teams."

"We greatly appreciate this health care decompression effort," the groups LeadingAge Minnesota and Care Providers of Minnesota said in a statement.

The governor's action comes in the wake of Thursday's report of 999 COVID patients in the state's hospitals. Only 5% of intensive care beds were open due to the surge of COVID patients, as well as trauma and other medical cases.

It's not just a problem in the Twin Cities. For the past few weeks, more COVID patients have been hospitalized in greater Minnesota, the state Health Department said, than in the metro area.

Hospitals have had a difficult time transferring patients into nursing facilities and transitional care units. Many in long-term care have stopped admitting new residents due to a lack of health care workers. "We are hopeful that today's announcement will provide much needed relief," said Dr. Kevin Croston, the chief executive at North Memorial Health.

COVID hospitalizations statewide still don't rival last November's peak of more than 1,800. But Croston said hospital teams "are now more stressed than they've ever been. And we have critical staffing shortages layered on top of that, that we didn't have a year ago."

Hospitals are facing their own staffing problems, but getting patients discharged more quickly "would free up hospital capacity almost overnight," said Dr. Brian Pollmann, a hospitalist at Hutchinson Health Hospital.

Medical centers have been dialing back surgical procedures when possible to create space for COVID and non-COVID patients who can't wait, but the crunch persists, said Dr. Mark Sannes, an infectious disease specialist at Bloomington-based HealthPartners.

Problems with discharging patients ripple through the system, resulting in more of them being "boarded" in emergency departments because there aren't enough available beds upstairs, said Dr. Craig Matticks of Emergency Physicians, a large medical group that works in ERs across the Twin Cities.

Matticks sees the problem both as a doctor who works in emergency departments (EDs) and as medical director of the Urgency Room, a group of three urgent care centers in the east metro that have been struggling to find beds for patients.

"Instead of patients being held in the ED for a couple of hours until their bed is available, they can be held in the ED across several shifts," Matticks said. "Occupying the ED bed prevents us from seeing patients in the lobby, keeps the ED nursing occupied with doing tasks that are normally done by inpatient nursing and increases the risk for medical error."

Walz's plan also calls for greater access to free and rapid COVID testing, with sites opening next week in Stillwater, Hutchinson and Crookston. Three additional sites will open the following week, and 16 local public health agencies will launch rapid testing programs as well.

The governor on Friday asked Republicans to agree to a series of regulatory waivers that he said would help hospitals, nursing homes and child care centers respond to the pandemic resurgence. He challenged the GOP to come up with proposals other than Senate Majority Leader Jeremy Miller's call to change the law on when governors can invoke emergency powers.

"Ridiculous," Walz said. "There is no state of emergency — I'm not using emergency powers. … How about you authorize the ability of the waiver to have more beds that relieves the pressure. That could happen today."

Rep. Anne Neu Brindley, R-North Branch, issued a statement Friday saying Walz's plan was "merely a band-aid that won't outweigh destructive government policies," such as mandates for COVID vaccines that "are driving health care worker resignations and layoffs."

Miller, R-Winona, said in a statement that Republicans are "prepared to come back for a special session to support front line workers and farmers in need of drought relief."

The Minnesota Department of Health announced on Friday another 3,352 new COVID cases along with 28 more deaths, bringing the pandemic totals to 755,401 infections and 8,407 fatalities. Eight of the deaths announced Friday were residents of long-term care facilities, while one person was in the 30- to 34-year age range.

The state's testing positivity rate was listed at 8.4%, higher than the state's caution threshold of 5% and a number that until recent days has not been seen since last December.

The numbers illustrate how Minnesota is not seeing the improved COVID trends being reported in many other states, said Health Commissioner Jan Malcolm. "We're still going up," she said.

Nearly 70% of Minnesota's vaccine-eligible population has completed the COVID vaccination series. About 219,000 residents have received either a booster shot or a third dose given to those who are immunocompromised.

North Memorial Health officials said Friday that people who haven't been immunized account for 96% of the COVID-positive patients in their system's ICUs, and 77% of those with COVID in medical-surgical units.

"The surge of COVID-19 hospitalizations is and continues to be avoidable," Croston said.