The shortages are most acute at hospitals like Watsonville that rely on government funding to treat poorer patients, since they have fewer resources to compete against the rising cost of keeping staff. The situation adds to the stress facilities have already experienced responding to the early onset of the virus, just as the last of federal aid is being doled out.

“This is like survival stakes,” said Steven Shill, head of the health-care practice at advisory firm BDO USA. Winners are “whoever’s highest on the food chain and who has the biggest checkbook.” The staffing companies — agencies that provide nurses and other staff on a temporary basis — are “really, really, really gouging hospitals.”…

“This is the worst nursing shortage that I have witnessed in my career,” Maureen May, a 30-year veteran of the pediatric ICU and the president of the Pennsylvania Association of Staff Nurses and Allied Professionals, a union, said in an interview.

The issue is emerging in the capital markets, too. Aveanna Healthcare Holdings Inc. went public in April in an effort to expand beyond its leading position in pediatric home health services. But a shortage of caregivers has pummeled its stock, while credit raters gave a debt issue to fund acquisitions low-tier junk level assessments.