Lack of home health nurses keeps baby stuck in hospital for 4 months

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On any given afternoon, there’s no question where you’ll find Katie Craven. She’ll be at the Neonatal Intensive Care Unit at M Health Fairview Masonic Children’s Hospital. This is where she’s spent nearly every single day since her twin baby boys were born in February of 2022.

Jamie and Tommy Craven were born eight weeks early with a condition called pulmonary interstitial glycogenosis. As Katie describes it, her boys’ air sacs in their lungs were really tough and rigid, making it difficult for them to expand. Because of that, both babies had to be on ventilators and both underwent several surgeries. Tommy’s symptoms were more complex and difficult to overcome. He didn’t survive and died at 5 months old. But in the time since Tommy’s death, his brother has made incredible strides. Other than having a tracheostomy to help him breathe, Jamie is healthy child and, according to his team of doctors and nurses, he’s ready to go home.

“We’ve been here for a little over 10 months,” Craven said. “Jamie is doing fantastic! Jamie could come home and has been able to come home since September and we just can’t find home nursing.”

Four months ago, Jamie’s medical team cleared him to go home, but because of a shortage in home health care nurses, he’s stuck at the hospital. M Health Fairview said it’s a problem for hospitals across the state. When babies are ready to go home, they’re not able to find the nurses needed to care for them at home — there simply aren’t enough.

“It’s been extremely difficult to recruit nurses with a lower level of pay,” Ashley Bogestad, a case manager with 1st Choice Pediatric said. 1st Choice Pediatric is the home healthcare agency looking to find nurses for Jamie. Bogestad said agencies can’t recruit home nurses because they can’t pay them what hospitals can offer.

“Our pay is capped by the reimbursement the state will pay us for,” Bogestad said.

The wages they can offer nurses are locked in based on the amount of reimbursement they receive from Medicaid and private insurance companies.

“We have hospitals that are offering huge sign-on bonuses, retention bonuses, they’re offering bonuses for extra shifts worked. They can’t compete,” Deb Lunak, a registered nurse care coordinator for Masonic Children’s NICU, said.

On average, Lunak said home health nurses make $10 an hour less than nurses at a hospital would make. And as nurses gain experience, those discrepancies continue to grow.

“These babies that go home with tracheostomies, they need someone awake in the house 24 hours a day because if that trach gets plugged or the ventilator gets disconnected, someone has to react immediately,” Lunak explained.

According to M Health, there are eight babies at Masonic Children’s hospital looking for home care. Five could go home today if only they had nurses to care for them.

According to the Minnesota Home Care Association, a group that represents more than 200 home health care agencies in the state, there are 48 children in Minnesota in need of home care. Of those 48 kids, 27 are ready to go home today.

Representatives with the Minnesota Home Care Association have been working with lawmakers to address these disparities in home health care pay. Back in September, Gov. Tim Walz sat down with home health agencies and five families looking for care. We reached out to the governor’s office for comment on this story but have not heard back.

Currently, there are two bills being considered that would address home health care: Senate Bill FS7 and House Bill HF32.

“They just need to become family. It’s hard to become a family when they’re locked inside this hospital,” Lunak said. “These babies just thrive better at home. Being at home, they don’t have the risk of infection like they do in the hospital.”

As for Katie, her goal was to bring her baby home by the start of the New Year; that didn’t happen. Jamie needs four nurses to care for him around the clock so Katie can continue to work. She’s optimistic they’ll be able to find the care Jamie needs to get him home by his first birthday, at the end of February.

Registered nurses interested in caring for Jamie can apply by CLICKING HERE, or by calling 612-770-4177.