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JEFFERSON CITY, Mo. — Many nursing homes in the state of Missouri are turning away new residents due to a lack of staff. 

There are more than 6,200 job openings at nursing home facilities throughout the state, according to the Missouri Health Care Association (MHCA), which represents more than half of the state’s nursing homes.

Some nursing homes are having to hire temporary staffing agencies to help with the shortage of workers, which is costly. 

It’s been almost a year since the state hired the company Vizient to provide additional workers for hospitals. Now, help is needed in long-term care facilities. 

“I think every day we are looking at how to adjust to that, and what we can do to bring in health care workers again if we needed to,” said Missouri Gov. Mike Parson. 

MHCA executive director Nikki Strong said in an email Friday the association surveyed facilities back in September and only 275 responded. Of those responses, Strong said there were more than 6,200 job openings. Since then, she said she has heard from facilities that staffing shortages have continued to worsen. 

“Our unemployment numbers are down to about 15,000 in the state, but we continue to have over 100,000 job openings in the state,” Parson said. “But more importantly, how do we get more Missourians back into the workforce, how do we give them an opportunity for jobs?”

In a statement Friday, Strong said MHCA supports vaccination but a vaccine mandate for nursing home staff could be detrimental. 

“We believe that the new federal COVID-19 vaccine mandate for health care workers will further exacerbate this staffing crisis and push many more caregivers out of long-term care, and the health care sector for good. Please note, we support efforts to increase vaccination rates, but the CMS [Center for Medicare and Medicaid Services] policy neglects to offer any resources to long term care facilities to address potential staffing shortages caused by the mandate.”

Strong said many facilities in the state are at 50% to 60% occupied but can no longer take any new admissions because they don’t have the staff. 

Parson said the mandate needs to go through the legislative process. 

“We’re in pretty good shape in this state, would we like to be better?” Parson said. “You always want to be a little better but the reality of it is the numbers are going down and hospitalizations are going down.”

Currently, Missouri has the lowest percentage of vaccinated nursing home staff in the country. According to CMS, only 56.71% of employees working in long-term care facilities are vaccinated compared to residents which are 86.6% vaccinated. 

In the past two weeks, Attorney General Eric Schmitt has filed three lawsuits in hopes of stopping the vaccine mandates. One would halt vaccinations for federal contractors and federally contracted employees, another for private employers with 100 or more employees, and a third for health care facilities serving Medicaid and Medicare patients. 

“Same way we did smallpox, the same way we did the measles vaccine, and all the things that are out there, those were all legislative actions,” Parson said. “They just weren’t made by one person.”

Our Missouri Chief Capitol Bureau Reporter Emily Manley reached out to a handful of nursing homes across the state, but most didn’t want to comment. The owner and founder of Dolan Memory Care Homes, Tim Dolan, said he has been dealing with staffing issues since the start of the pandemic which has resulted in paying employees more. He’s also spending more on overtime to make sure shifts are covered. 

Strong went on in her statement to say facilities are spending lots of money to either bring in temporary staffing agencies or on current staff to keep them on. 

“Most facilities rely on Medicaid to pay for the care for nursing home residents. Even prior to COVID, chronic Medicaid underfunding left long-term care providers struggling to compete for qualified, dedicated caregivers.

Pre-COVID the Medicaid rates paid to care for residents were significantly lower what it costs facilities to care for residents. COVID has only exacerbated this underfunding as providers have and continue to spend tens of billions of dollars across the country on PPE to keep our staff safe and labor costs.

The increased staffing costs including sign-on bonuses, hero pay, overtime and significantly increased hourly wages have caused an economic crisis, and many facilities are on the verge of closing their doors. In order to try to combat the staffing shortages, many long-term care providers are forced to turn to temporary staffing agencies in order to ensure residents have enough caregivers.

Now these agencies are recruiting staff away from nursing homes and charging exorbitant prices back to the facilities who are desperate to find staff, depleting the financial resources from facilities who would prefer to invest in full-time, dedicated employees.

It is not as simple as saying pay the staff more and they won’t leave because once a facility agrees to pay the staff more to compete with what a staffing agency charges, the agency will increase the pay to the worker to recruit them away. It is a vicious cycle our facilities cannot financially compete with due to the amount nursing homes are paid to care for their residents.”

The deadline for federally contracted employees to get vaccinated is Dec. 8. For individuals working at companies with more than 100 workers, it’s Jan. 4. Under the executive order, if a person is not vaccinated, he or she must test negative at least once a week.