Report: Job turnover down but Missouri hospitals face many workforce challenges

(The Center Square) – Turnover decreased throughout Missouri’s hospitals in 2022, but remains higher than historical rates and health care faces numerous workforce challenges, according to a new report.

The Missouri Hospital Association published its 2023 Workforce Report and revealed the record-high vacancy and turnover rates in 2021 declined in 2022. The report also highlighted enrollment declines and faculty shortages at nursing schools.

Turnover statewide in positions the organization surveyed was 23.1%, down from 24.7% in 2021 but six percentage points higher than 2018 (17%). Staff vacancy rates dropped from 17% in 2021 to 14.8% in 2022, but higher than the 8.9% reported in 2018.

The turnover rate for environmental service and dietary workers was 40% in 2022. Staff nurses, the largest sector of hospital employees had a 20% turnover rate.

“This rate of flux within the health care workforce affects operations, cost and culture,” the report said.

The report cited the 2023 National Healthcare Retention & RN Staffing Report, published by Nursing Solutions, Inc., that each percentage change in nurse turnover will either annually cost or save the average hospital $380,600. It also noted a study by Definitive Healthcare that one in five health care workers have quit their jobs since 2020 and 47% of health care workers plan to leave by 2025.

“Every Missourian has a stake in the strength of the hospital workforce,” the report stated. “These clinical professionals –band the many workers who support them – are essential to the delivery of emergency care, disease management and health improvement activities. State and local governments, academic institutions, businesses, and other partners can play an important role in mitigating the hospital workforce crisis.”

The report said many hospitals increased starting wages and offered signing and retention bonuses to stabilize workforces.

“However, wage adjustments have been eroded by inflation, reducing hospitals’ ability to keep pace,” the report said. “The result is a decrease in real-wage growth and slower benefit gains for all employees. At the same time, hospitals are facing significant pressure overall. Reimbursement rates for care haven’t kept up with the cost of inflation.”

The report found nursing education programs throughout Missouri need 64 additional full-time faculty to accommodate all qualified applicants. During the last 20 years, many educators also served on clinical staffs while teaching.

“However, the impact of the pandemic on nursing practice, opportunities for nurses to earn much higher wages in clinical practice and compounded nurse burnout are leading to unprecedented challenges in their recruitment and retention,” the report said.

It noted the Missouri State Board of Nursing’s 2022 annual report found 1,221 qualified applicants were turned away from nursing schools.

“While some of these applicants may have applied to multiple schools, the number of qualified applicants that cannot be accommodated is too high given the demand within the profession,” the association reported.

The report cited research finding Missouri’s community colleges with nursing and health programs reported a 50% decrease in applications and enrollment in 2022. The report projected the number of high school graduates in Missouri will peak at 72,000 next year and drop to 66,000 by 2032, decreasing the size of the workforce.

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