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Announcement:

Moody's: Nursing shortage will persist until 2025, weakening US NFP hospitals' operating margins

07 Mar 2018

New York, March 07, 2018 -- US NFP hospitals are currently experiencing an extreme nursing shortage, and the added expense pressure and personnel issues will negatively affect hospital margins for at least the next three to four years, Moody's Investors Service says in a new report.

The shortage is largely due to a growing demand for nurses and a lack of supply. Hospitals have implemented strategies to attract and retain nursing talent, including increased compensation, sign-on bonuses, and attractive fringe benefits. However, these incentives are increasing already rising expenses.

The Bureau of Labor Statistics predicts this nursing imbalance will persist until 2025.

"An aging population, increased incidents of chronic disease and alternative employment options, such as nurse staffing and traveler agencies, drive increased demand. Although the supply of nurses is expected to improve with the expanded nurse training programs and increase in the number of eligible nurse educators, it will still take three to four years for the supply to meet expected demand," Moody's Analyst Safat Hannan says.

Another tactic to reduce the need for expensive contract labor is the creation of an internal nursing pool. However, this can have drawbacks, as it requires the hospital to manage those resources, which can lead to an increase in labor costs. While nursing pools can reduce expensive contract labor, it may lead to higher attrition and lower productivity if nurses are not effectively trained across service lines.

"Labor is the largest hospital expense and is increasing faster than total expense growth while outpacing revenue growth," Hannan says. "The lack of qualified nurses will compound these expense pressures and negatively affect hospital margins."

The nursing shortage will also impact the southern and western US more heavily than the rest of the country. A growing and aging population and low numbers of nurses entering the workforce is most prevalent in Florida (Aa1 stable), Georgia (Aaa stable), Texas (Aaa stable), and California (Aa3 stable).

Louisiana (Aa3 negative), Mississippi (Aa2 negative), Alabama (Aa1 stable) and West Virginia (Aa2 stable) have at least a 35% obesity rate and incidents of obesity and diabetes is disproportionate in these states, according to the US Centers for Disease Control and Prevention.

The shortage of nurses will most adversely affect rural hospitals since large urban hospitals benefit from advantages such as their proximity to nursing schools, the ability to pay competitive wages, and greater job opportunities for spouses.

The report "Not-for-profit and public healthcare -- US: Nursing shortage will pressure hospital margins over the next three to four years," is available to Moody's subscribers at https://www.moodys.com/researchdocumentcontentpage.aspx?docid=PBM_1107862.

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This publication does not announce a credit rating action. For any credit ratings referenced in this publication, please see the ratings tab on the issuer/entity page on www.moodys.com for the most updated credit rating action information and rating history.

Safat Hannan
Analyst
Public Finance Group
Moody's Investors Service, Inc.
250 Greenwich Street
New York, NY 10007
U.S.A.
JOURNALISTS: 1 212 553 0376
Client Service: 1 212 553 1653

Lisa Goldstein
Associate Managing Director
Public Finance Group
JOURNALISTS: 1 212 553 0376
Client Service: 1 212 553 1653

Releasing Office:
Moody's Investors Service, Inc.
250 Greenwich Street
New York, NY 10007
U.S.A.
JOURNALISTS: 1 212 553 0376
Client Service: 1 212 553 1653

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