In a recent survey of parents who use the Learning Center, 91% indicated that the child care facility was the reason they remained in their jobs. Roper St. Francis loses money operating the Learning Center, but it's still considering an expansion of child care services as it builds a bigger hospital in nearby Berkeley County.

That's not to say, historically, that money hasn't been made in child care. Bright Horizons, founded in the 1980s with an investment from Bain Capital, made hundreds of millions of dollars for the private equity firm. Now publicly traded, its shares are worth about half what they were at the peak of their value in February of last year.

Some hospitals still consider child care a good investment.

"I look at this as being a really, really vital piece of the benefits package, especially for families with kids who are infants to school-age," said Rebecca Gomez, a clinical health psychologist at Wellstar Health System, based in the Atlanta area. Both of her children are enrolled in Wellstar's Learning Academy operated by Bright Horizons.

"Everything about it has made my life so much easier," Gomez said.

As with the Roper St. Francis Healthcare Learning Center in Charleston, Wellstar employees often end up waiting for an available spot. And Wellstar doesn't operate child care facilities on every hospital campus, Gomez said.

Even so, the breadth of Wellstar's child care offerings makes it an outlier. Other notable examples include Mass General Brigham in Boston and NewYork-Presbyterian, both of which have long offered child care for employees. And while providing on-site child care remains rare, hospitals are increasingly exploring options for it.

Ballad Health — a hospital system with medical facilities in Appalachian Tennessee, Virginia, and North Carolina — recently announced it will invest $37 million over the next three years to build 11 child care centers, in addition to the three it already operates. The expansion will allow the system based in Johnson City, Tennessee, to increase its child care capacity from 200 slots to 2,000.

For employees, hospital-based child care isn't typically free. Roper St. Francis Healthcare in Charleston charges all parents who use the Learning Center a weekly rate, ranging from $200 to $220, based on the age of the child, slightly higher than the market average.

Some hospital systems create a sliding scale that takes into consideration the employee's salary. A doctor, for example, might pay more than an X-ray tech to enroll a child. Ballad Health recently polled employees, who indicated, on average, they could afford to pay about $145 per child per week.

Like many hospital systems, Ballad has struggled to keep nurses from leaving during the pandemic. But it's also competing with other regional employers for jobs. Tony Keck, executive vice president of system innovation at Ballad Health, said a new casino in Bristol, Virginia, recently hired 600 people. It's expected over the next few years to hire thousands more, he said.

"We're not just competing for doctors and nurses," Keck said. The hospital also needs to attract housekeeping staff and other lower-wage workers whom the casino and others are targeting.

But nurses are particularly crucial. Keck said Ballad Health raised its starting nursing salary by more than 30% over the past two years, but hospitals in nearby markets such as Knoxville — which paid nurses higher salaries to begin with — raised their rates, too.

"We can't keep up with that," he said. Ballad Health leaders hope the new child care centers will offer the system a competitive advantage, "which is why we're trying to move as quickly as possible," he said.

全文翻译（仅供参考）

当 Jennifer Lucier 和她的丈夫发现他们在 2016 年怀孕时，他们立即打了三个电话。

第一个是给她妈妈的。第二个是她丈夫的家人。第三个是 Roper St. Francis 医疗保健学习中心。

她觉得最后一个电话特别紧急。Lucier 想在托儿所的长长等候名单上为她未出生的婴儿争取一个位置。

Lucier 在 Roper St. Francis Healthcare 担任心血管 ICU 护士，这是南卡罗来纳州查尔斯顿附近唯一一家为员工子女经营托儿中心的医院系统。

问题是每个人都没有空间。Roper St. Francis 拥有 5,000 名员工，其日托只能容纳 130 名婴儿和儿童。等候名单上通常有 100 多名儿童。Lucier 的新生儿 9 个月大时才开始有空缺。

“我们欣喜若狂，”Lucier 说，她还在 2020 年生下了双胞胎。她的孩子们仍在学习中心注册。

Roper St. Francis Healthcare 于 30 多年前开设了该设施，以解决长期存在的人力资源问题：招聘和保留。今天，它仍然是美国为数不多的为其员工运营全日制托儿中心的医院系统之一，尽管这种情况似乎正在发生变化。一些医院现在正在考虑将托儿中心作为解决大流行时代面临的一大挑战的一种手段：说服员工留下来。