JEFFERSON CITY, Mo. — The Missouri Hospital Association said there’s been a decline in the vacancy turnover rates among nurses, but hospitals are still struggling to fund and retain staff. 

On the same day two major Missouri hospital systems announced a merger worth billions of dollars, a new report by the Missouri Hospital Association (MHA) shows that while workforce issues have only slightly improved, they remain a major concern. 

“We don’t know how long it will take to get back to the levels that we saw in 2019,” vice president of public and media relations for MHA Dave Dillon said. “The truth is, yes, we have made progress since last year. Last year’s data represented the worst and darkest days of the pandemic relative to the healthcare workforce.”

It’s good news and it’s bad news. Missouri’s healthcare industry is still feeling the effects of COVID-19, as the nursing turnover and vacant rates are nearly 20%. 

“Vacancy is more troubling in some ways because you put ads out there and there is no one applying because there aren’t people to do it,” Dillon said. 

According to the MHA’s 2023 Workforce Report, the statewide turnover rate in 2022 was 23.1% while in 2021 it was 24.7%. The vacancy rate among the majority of health care positions included in the report, in 2021 was 17% and in 2022 it was 14.8%. Before the pandemic in 2019, the turnover rate was 19.8% and the vacancy rate was 9.5%. Dillon said there’s a big problem that lies within the education. 

“To get where we need to be, we need to add dozens of new professors of nursing,” Dillon said. 

The report says an additional 64 full-time positions are needed to accommodate all the nursing school applicants who are qualified for admission. That’s not including the 100 nursing educators expected to retire within the next five years. 

The vacancy rate for staff nurse in 2022 was 17.4% compared to 19.8% in 2021. The turnover rate also decreased from 22.1% in 2021 and 19.4% in 2022. 

Later this month, an emergency rule will go into effect, doubling the training time for some workers, like nursing aids. Nursing assistants are among the top 10 hospital professions with the highest vacancy and turnover rate. 

The rule would allow unlicensed nursing aides 180 days to complete a training program, up from the current 90-day requirement. The emergency regulation goes into effect June 6 and will run through the end of the year. 

“I think we have people’s attention now, post pandemic because people heard a lot of about healthcare in the last three years than they probably have in the last 30,” Dillon said. 

MHA said high turnover rates are costly and disruptive for health care systems, requiring some hospitals to contract for outside help. 

“There are hospitals that because of the kind of problems that we’re talking about with vacancies that have to rely on agencies full-time, all year around,” Dillon said. 

Dillon said more Missouri hospitals will operate in the red this year due to inflation. Since 2014, 18 hospitals in Missouri have closed. 

“We’re going to go into the most difficult financial times that hospitals have ever seen,” Dillon said. “How individual hospitals manage that will determine whether they are viable within their communities and whether they become stronger institutions, or if they’ll have to make a hard decision to close. 

St. Louis-based BJC Healthcare and Kansas City-based Saint Luke’s Health System announced Wednesday the plan to merge and form an integrated Missouri-based health system. The two healthcare entities signed a non-binding letter of intent to expand health care access in Missouri, reaching more than six million patients. 

The MHA report shows that southeast and south central Missouri have the most troubling rates of turnover. The state currently has roughly 33,000 nurses working in hospitals, with an additional 7,000 vacant nurse positions. 

Other professions with the highest employee turnover in hospitals include environmental services, food service workers and pharmacy technicians. 

Dillon said many hospitals have a hard time hiring entry-level staff due to competitive pay from outside the healthcare industry. 

To read MHA’s full report, click here.