Weather Forecast


Oil Patch nursing homes struggling, closing

FARGO -- Nursing homes in western North Dakota are struggling to maintain staffing in the face of a bidding war for workers that is rippling from the booming Oil Patch.

Two facilities -- one in Williston and another in Underwood -- are casualties of the high cost of labor and the problems in keeping staff to care for residents.

"The staffing is in crisis in many areas of the state, especially in northwest North Dakota," said Shelly Peterson, president of the North Dakota Long Term Care Association, which represents nursing homes and care facilities.

"We're not staying competitive, and we're below the market," she added. "We need funding to ensure we have the staff."

The Kensington, a basic care home in Williston, closed Dec. 31 because it could not maintain staffing. The Sanford Health Underwood Continuing Care Center announced last week it will close by March 15.

Linda Larkin, vice president of operations for Agemark, a firm that managed the Kensington, said an ongoing struggle to maintain staff, including flying in contract workers to fill vacancies, was not sustainable.

"It was horrible," she said. "We tried everything we could do to find employees who matched our values."

The Kensington provided 39 assisted living rooms and 71 basic care beds. Residents moved to other facilities in North Dakota and neighboring states, Larkin said.

Before making the decision to close, the Kensington tried to keep pace with wages in Williston, where fast food workers can earn as much as $18 an hour at peak times, she said.

"We raised and raised and raised the rates for the people we employed," Larkin said.

Bringing in contract workers from outside the area wasn't a good solution, since temporary staff don't get to know the residents and families as well, she said.

For a time, Agemark brought in its own employees from other locations, but that became unworkable over time.

"No matter what we tried to do, it seemed that nothing was sustainable," Larkin said.

The Bethel Lutheran Nursing and Rehabilitation Center in Williston now is the only nursing care facility in the rapidly growing hub of the Oil Patch.

"It is crazy, but it has been for the past three years," said Kurt Stoner, the center's administrator.

The average statewide pay for a certified nursing aide with experience at a nursing facility is $13.58 an hour. Bethel Lutheran's pay scale matches that level, "but our benefit package is probably more than competitive," Stoner said.

Last year, 14 percent of nursing facilities stopped admissions because of insufficient staffing, and 68 nursing facilities reported 751 openings as of July, according to figures from the North Dakota Long Term Care Association.

Last year, Bethel Lutheran paid $1.3 million hiring temporary help from agencies because of the shortage of workers, Stoner said.

Affordable housing for employees is another problem confronting nursing homes in the Oil Patch. "I've had employees sleep in vehicles in the summer or the fall," Stoner said.

Staffing problems played a large part in Sanford Health's decision to close the former Prairieview Nursing Home in Underwood.

"All of western and central North Dakota is struggling to hire and retain staff, and our ability to do so at the Sanford Health Underwood Continuing Care Center has reached a critical point," John Rieke, Sanford Health's chief operating officer in Bismarck, said in a statement.

The center has 16 full-time vacancies, some of which have been open for a year, representing 29 percent of its staff. Temporary replacements are "less than ideal" in maintaining care for residents, Rieke said.

A declining demand for rooms also contributed to the decision to close, a problem Peterson said is becoming common among rural facilities as seniors gravitate toward urban centers, often to be near family.

Gov. Jack Dalrymple's executive budget recommendations call for increased funding for nursing homes and other care providers in the state's Medicaid funding.

The proposal would provide an inflationary increase of 4 percent per year for the 2013-15 budget, plus an additional 50 cents per hour for nursing home aides and other care providers.

Maggie Anderson, interim executive director of the North Dakota Department of Human Services, said the state's proposal to increase funding recognizes the need to address staffing through Medicaid payments.

"So that funding was provided in the budget request," she said.

Funding for nursing homes would increase $41.5 million in the 2013-15 budget, she said. When other care facilities and support services, such as home health care are added, the increase totals $76.9 million.

The North Dakota Long Term Care Association welcomes Dalrymple's budget recommendations to address staffing needs, but would prefer to see a $1-per-hour payment increase instead of the proposed 50-cent.

Fifty cents an hour translates into an additional $20 a week for a full-time employee, Peterson said. Even an increase of $40 per week, before taxes, is quite modest, but would help, she said.

Testimony on the Medicaid budget as it applies to staffing for nursing homes and other providers is scheduled Tuesday morning before a House Appropriations subcommittee in the Capitol.