Bev Mueller, director of patient care at the Paynesville Area Health Care System, said people don't want to enter the heath care field because it is a major commitment. "People don't want to work weekends and nights," Mueller said.
According to Tom Kooiman, director of the Good Samaritan Care Center, there are fewer and fewer people entering the nursing profession. Which means there are fewer people to take care of the elderly and sick.
According to a Minnesota Health and Housing Alliance survey, there are 9,260 open jobs in health care in Minnesota. Two-thirds of those are found in greater Minnesota.
According to Karen Ampe, director of nurses at the Koronis Manor, many nurses are opting for jobs in a non-nursing setting where they can have their nights, weekends, and holidays off. The jobs include: schools, wellness workshops, clinics, and representatives for businesses.
"We are fortunate we have a wonderful staff," Kooiman said of the Good Samaritan Care Center which has 50 full- and part-time employees. Still, they have a shortage of employees because people do not want to work holidays, weekends, or nights.
The Good Samaritan Care Center has had to use a pool agency to cover shifts until they can fill a vacancy. The pools charge more than paying an employee directly. "We are a small facility and do not have a large reserve to draw from," Kooiman said.
"It is hard to stay competitive when you can't raise your rates at will," Kooiman said. Nursing homes only receive percentage raises which are determined by the state.
Unlike other industries, nursing homes cannot raise their rates to provide more dollars for nursing to attract workers. Nursing home rates are set by the state government.
Limited income
Kooiman said four out of the top 10 nursing homes in Minnesota filed bankruptcy last year. "Homes are struggling financially," he added.
Kooiman said the government needs to be more supportive and give more reimbursement for expenses. "We have come a long way, but there is still a long way to go," he said. Last year nursing homes were able to give their employees a 37-cent per hour raise. The Legislature dedicated additional funds again this year, but Kooiman has not heard the exact amount yet.
According to Kooiman, the state is divided into metro (high rates); rural, (medium rates); and deep rural (low rates). At present, Paynesville is considered deep rural and is paying its employees about $10 per hour less than metro nurses make.
"We were good managers of our money and did not spend up to our limit. Because we were conservative in the past, we receive less funds to pay our employees from the state," Kooiman said.
Unlike nursing homes, hospitals can set their own rates; however, the insurance company, Medicare, and medical assistance determines how much they are paid. "About 70 percent of our business is through Medicare," Mueller said.
Ampe and Mueller agreed that on most patients, they are losing money because medical assistance and insurance companies do not want to pay what it costs to care for a patient.
"We provide everybody the same type of care, no matter who pays the bills," Ampe said.
Mueller said they have no problem staffing the labs or front office. The positions that are the hardest to fill are dietary and nursing.
Working conditions
An item of frustration for the nursing home industry is the regulations. "We are so regulated. We are second to nuclear waste," Kooiman said. "Instead of doing care work, our staff is busy doing paper work. We could run more efficiently if we weren't so regulated."
The Good Samaritan Care Center has hired one person just to do paper work. Mueller said it's scary to know that the majority of their work force is between the age of 38 and 45. When they retire, who will take their place?
Ampe at Koronis Manor said that reports indicate that the nursing shortage will be critical in five years. In 10 years, it will be severely critical.
Mueller said the Paynesville Health Care System tries to retain their staff by making the hospital, 700 Stearns, and Koronis Manor a better place to work. "We try to maintain a good working environment, treat our people well, and take time to say thank you for a job well done," she added.
"A rural facility is a hard place to work because you need to know everything from OB to ER. In a large city hospital, nurses stay in one department," Mueller said.
Mueller said they offer the employees at the hospital and Koronis Manor flexibility. "We try to oblige their requests for time off," she said. "That is when seniority is an asset."
"People come to the Paynesville Area Hospital because of our staff. They are a dedicated group who care," Mueller added. (See related story.)
Mueller urged parents to encourage their sons or daughters to enter the health care profession. According to the Minnesota Health and Housing Alliance, enrollment in nursing schools last year was down 6.6 percent from the previous year.
Part-time help
While dentists and some other health care providers in town reported no staffing problems, many still have had problems finding part-time workers lately.
"Four years ago, I had no problems finding help" said Dr. Liz Greguson, Paynesville Chiropractic. "After running an ad, I would get 37 applicants. Now I'm lucky if I get 10 over a three-week period."
"Most people with a degree are looking for a full-time position with benefits," Kathee Martinson, Peeper's Distinctive Eyewear, said. Because they are a part-time office, they have a difficult time finding trained employees.
Greguson said she can't afford to have two full-time employees. "It would be great if I could. However, a person needs business to be able to offer the benefit package," she said. "In the small business world, you don't always have the income to offer benefit packages."
Dr. Randy Jacklitch of the Jacklitch Chiropractic Clinic said he hasn't had problems hiring, but the scarcity has driven up wages.