ROCHESTER — Health care sector employment in southeastern Minnesota has rebounded since the COVID-19 pandemic, reaching record levels, according to a new analysis from the Minnesota Department of Employment and Economic Development.
But hospitals, nursing homes and other facilities were experiencing staffing shortages before 2020 and remain short-staffed, and job gains in recent years have not been evenly distributed across health care subsectors.
In southeastern Minnesota’s 11 counties, health care and social assistance accounts for 27.3% of total employment with 66,409 jobs. From 2019 to 2023, the number of jobs in this industry grew by 0.2%, offsetting job losses due to the COVID-19 pandemic.
“Health care and social services jobs have recovered all of the jobs lost due to the pandemic and are now at an all-time high in employment in southeastern Minnesota,” the DEED report states. “Two of the three subsectors have experienced job gains since 2019.”
Since 2019, hospitals added 717 jobs (up 4.8%) and outpatient medical services added 590 jobs (up 1.8%), while the third subsector, nursing homes and residential care facilities, saw an 8.5% decrease in employment.
“This is not only a statewide trend, it’s a national trend,” said Nicole Mattson, vice president of strategic initiatives for Minnesota Care Providers, a nonprofit advocacy group for long-term care providers. “Our sector hasn’t been able to recover as many job losses as other sectors of health care.”
In southeastern Minnesota, skilled nursing facilities have been hit hardest, losing 1,293 jobs (a 23 percent decrease) since 2019. Residential facilities for people with intellectual and developmental disabilities, mental health centers and substance abuse centers also saw job losses.
However, nursing homes are expected to add 664 jobs between 2019 and 2023, an increase of 31.4%.
“When we look at data over time, it appears that people are choosing to remain in retirement communities and assisted living facilities before moving to nursing homes,” said Amanda O’Connell, DEED’s Southeast and Southcentral regional analyst. “In other words, based on consumer sentiment, job losses in one region may be offset by job gains in another.”
Sacred Heart Care Center in Austin offers skilled nursing, assisted living and adult day programs, but filling vacancies remains a challenge.
“We have openings in every area,” Sacred Heart Administrator Laura Borris said, “I think there’s at least one opening in every department right now.”
Borris said the highest turnover is among frontline workers, especially certified nursing assistants, who the DEED report said have 115 open CNA jobs in the region.
“We’ve had to vary the days that people can be admitted and we’ve had to postpone admissions to ensure we have staffing levels that allow us to provide quality care,” Borris said.
Another area where health care jobs have not recovered is home health care services. Unlike other outpatient health care services, such as doctor’s offices and dental offices, which have seen job gains, home health care services have seen a decline of 347 jobs, or 29%, since 2019.
Home health and long-term care providers receive less federal and state compensation for their services than hospitals, which makes it harder to recruit nurses, home care aides, personal care aides and other staff, said Cathy Messerli, executive director of the Minnesota Home Care Association.
“This is very worrying as Medicare premiums are being cut even further, but the Medical Assistance and Medicare Advantage premiums that many seniors have are incredibly low,” Messerli said. “That makes it harder to access care because they can’t make the wages that they can.”
Staff reductions in these two service areas also contribute to the problem of delayed discharges, which occur when hospitalized patients no longer require hospital-level care but nearby nursing homes, group homes or other care facilities are unable to accept them due to capacity issues.
“The job losses we’ve seen in nursing homes and skilled nursing positions are directly related to the backup issues in hospitals,” Mattson said. “It’s a sign that there aren’t enough people in the skilled nursing sector.”
In southeastern Minnesota’s healthcare sector, the most job openings by role are personal care assistants (1,282 jobs), registered nurses (277 jobs), assistant and vocational nurses (123 jobs), and CNAs (115 jobs).
When it comes to the nursing workforce, “the issue is that there was a shortage even before the pandemic,” said Jennifer Eccles, executive director of the Center for Nursing Equity and Excellence.
“We have about 4,000 nurses graduating each year in the state, and the nursing shortage is expected to get worse. The demand is growing,” Eccles said. “But we’re also at risk of seeing a dramatic decline in higher education enrollment.”
The DEED report does not include traveling nurses, “who are typically employed by staffing agencies, so their employment and wages are classified in that industry,” O’Connell said.
Messerli and Mattson said there are efforts to recruit high school students into health care jobs to help alleviate the shortage, emphasizing the urgency of bolstering the workforce as the country’s population ages.
“The only way to do that is to set some priorities and say, ‘We need to make healthcare possible,'” Mattson said. “Make sure that this job is really attractive to people, not just from an economic standpoint, but also from the feeling that they’re contributing to something bigger than themselves.”
Sacred Heart offers scholarships to CNAs who want to further their education as one way the facility tries to retain staff, Borris said.
“We currently have four CNAs who have graduated from either our LPN or RN programs and are employed at our facility,” Borris said. “Having the opportunity for career advancement is a great recruiting tool that we can utilize to fill vacancies.”
Other occupations facing significant vacancies in the region include psychiatric technicians (21 vacant positions, 41% vacancy rate) and speech-language pathologists (40 vacant positions, 16.5% vacancy rate).
The Mayo Clinic, which runs hospitals, long-term care facilities and clinics in the region, said it had no experts available for interviews about the DEED report.