A county-run nursing home and rehab facility in Montana is trying to beat the staffing crisis with an “earn-as-you-learn” training program, but the class isn’t attracting as many as needed.
Darcel Vaugh, administrator of the Gallatin County Rest Home in Bozeman, MT, told McKnight’s Long-Term Care News on Thursday that three students in an April class of approximately a dozen individuals enrolled through the facility’s training program but only one completed the course. Students are paid $19 per hour for their time in class, and the rest home covers tuition and textbooks, which totals approximately $900. Students agree to work for six months in exchange for being paid and having their class expenses covered.
“If you’re paying for someone’s education, that might be an incentive for the opportunity to get a start in healthcare,” Vaughn said. “The county has great benefits, but when you can work at McDonald’s or Taco Bell and make $20 an hour, what are you going to do?”
Certified nursing assistants at the rest home earn $20 per hour, but Vaughn said the physical requirements of the job can make the less labor-intensive job at a fast-food restaurant more attractive.
Meanwhile, Vaughn is stuck paying staffing agencies to meet staffing needs, spending more than $5 million on contract agencies in the last fiscal year alone. In 2022, voters in Gallatin County approved a tax increase to support the rest home. Vaughn said the facility would have gone out of business without that funding. In 2021, the Gallatin County Commission subsidized the building with $1.5 million.
Huge agency influence
Vaughn said she tries to keep 32 CNAs on-staff at the 69-bed facility, which she acknowledges is high, but believes that is the staffing required to properly care for residents. She currently has eight employees who are a combination of full- and part-time workers while the rest are contract workers. Nursing students from Montana State University sometimes work part-time while they are in school, she said.
When students graduate from the training program the rest home is participating in, they receive a $1 per hour raise to a CNA starting salary of $20 per hour. A staffing agency CNA, though, earns between $40 and $55 per hour.
There are similar disparities for other kinds of nurses.
An on-staff registered nurse earns $40 per hour while a staffing agency RN pulls down $80 to $88 per hour. A licensed practical nurse who is an employee earns $35 per hour while an agency LPN can earn $70 to $80 per hour.
Vaughn said that she believes CNAs should start at $25 per hour.
“They’re the backbone of nursing homes, and the need to get paid more,” she said.
