It's really bad.

The area hospitals have the physical capacity to take care of patients (beds, equipment) but inadequate staffing and are unable to hire sufficient full-time staff (physicians, nurses, etc.). The common problem is lack of housing that is affordable with respect to the relevant salaries.

Many hospitals are rationing who they accept in transfer (and likely skirting EMTLA requirements) and patients are frequently boarding in hospitals where they are at or exceeding the level of care at that hospital can provide. Prior to Covid, these patients would generally be transferred in a timely manner. At this stage, many patients are receiving somewhat sub optimal care at they aren't be transferred to larger hospitals to have the appropriate specialists to take care of their condition.

To give an example, let's say you have a full-time RN position paying $80,000 per year, this will allow that individual to purchase a house at 3X-4X gross income -> $240,000-$320,000. Understandably, it is exceedingly difficult to find a house within a reasonable commute and in a decent community from the UVM medical center. As such, there are over 490 open nursing positions at UVM medical center. People go where they are wanted, and these nurses are largely taking jobs in other communities where they can have a more viable lifestyle.

Additionally, the green mountain care board provides another regulatory layer with increased overhead expenses and the UVM Medical Center has a near monopoly of care for much of Vermont. As such, Vermont has the fifth highest health costs per capita in the country (despite being relatively healthy otherwise) and difficulty in accessing health care. For instance, obtaining an MRI brain in the Burlington area via UVM Medical Center will cost 4X – 5X the cost of an MRI brain and an imaging center in the neighboring state.