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Staffing shortages affecting Douglas County nursing homes; its staff and residents

A survey by the American Health Care association showed six out of 10 nursing homes are limiting new patients due to staffing shortages.

Hanah Hansen (left), a certified nursing assistant at Ecumen Bethany Community in Alexandria, chats with Evelyn LeSuer while checking her vital signs. (Lowell Anderson | Echo Press)
Hanah Hansen (left), a certified nursing assistant at Ecumen Bethany Community in Alexandria, chats with Evelyn LeSuer while checking her vital signs. (Lowell Anderson | Echo Press)
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DOUGLAS COUNTY — The American Health Care Association , which represents more than 14,000 nursing homes across the U.S., recently released the results of a survey that shows the industry faces a “serious staffing and economic crisis.”

“The survey shows the severe and persistent workforce shortage nursing home providers have been facing with too many facilities still struggling to hire and retain staff despite making every effort,” said Mark Parkinson, president and CEO of AHCA, in a press release.

Local nursing homes are feeling the impact too.

“Definitely struggling with staffing,” said Missy Englund, licensed assisted living director at Brandons Assisted Living . “There’s been positions that we’ve had open for a while. Both throughout here (Brandon) and our sister facilities.”

"Over the last couple of years, it's been extremely hard to find and retain staff," said Kayla Thoennes president/owner of  Woodcrest Assisted Living in Alexandria. "It affects Woodcrest because as the owner, that (responsibility) now lays on myself to work shifts, which becomes an issue when I have office things to get done."


Vista Prairie at Windmill Ponds hired a family of four.

"Bethany on the Lake is not immune to the struggles facing the healthcare industry nationwide," said Matthew Fischer executive director of Bethany on the Lake. "Thankfully, we have an amazing culture of staff committed to providing excellent care to our residents day in and out. We have adequate staff to provide the care necessary to meet the needs of our residents. However, we still obviously have opportunities with open positions that can be filled, more specifically, RNs LPNs and CNAs."

Matthew Fischer

From referral and sign-on bonuses to increased wages, Bethany, Woodcrest, along with Brandons' and its sister facilities — Evansville Care Center and Alex Assisted Living — have added incentives to retain and gain employees.

Englund added that while bonuses and incentives were offered, Brandons has still not received many applications. She said there is a lack of qualified applicants, but mostly a lack of applicants in general.

“We have had posts open for weeks, some for a month, and there is nobody applying,” said Englund.

She added that the small town care centers with lower income can not afford to compete with wages offered by corporate-owned facilities in the area.

“At this moment, it’s OK. I know it will be changing because I have a couple leaving at the end of the month,” Englund said. “My staffing crisis might kick in come July.”

Brandons and its affiliated facilities have had to limit their intake of new residents. Those with more medical issues and physical demands that require more attentive care are more likely to be turned away.

“We really have to be careful of what we take on for new admissions,” said Englund. “I need more staff to take care of them; we can’t take care of them if we don’t have more staff.”


With the intake limit, Brandons maintains enough staff to ensure the current residents receive proper care as each resident is a "one-assist" — a resident who only needs the care of one provider at a time.

Both Bethany and Woodcrest have been able to maintain adequate staff to prevent a pause or limit on resident admissions, according to Thoennes and Fischer.

“We hope we don’t have to go down that road. But, in the healthcare industry, every day is different and we take each day as it comes," said Fischer.

She is currently a registered nurse case manager at Woodcrest Assisted Living in Alexandria.

"I have not allowed this pandemic to stop helping the elderly with finding a home," said Thoennes.

To accommodate for the staffing shortage, current Bethany and Brandons' staff have had to put in long days and extra overtime hours to ensure residents are taken care of around the clock.

"As a smaller facility, I as the owner make sure there are no long hours being worked," said Thoennes. "I work them if needed."

Englund said one of her departing staff members is leaving because they want to get out of the health care industry.

Fischer added some of those who have left Bethany, also left the healthcare industry altogether.


Thoennes says she foresees a lot of elderly needing homes and not enough staff to participate in helping care for their elderly.

"It's a scary thing happening with our workforce right now," said Thoennes. "Something needs to change."

“It’s physically, emotionally, mentally demanding. It is not easy to take care of anyone," said Englund. "It’s a tough field to be in..They are getting burnt out... Why wouldn’t someone want to go work at Culver’s starting at $18 an hour and not have to worry about the physical demands of taking care of someone? I feel like people are going to slowly trickle out of healthcare. If this continues, there will not be people to care for the elderly. Then where will they go to get taken care of?”

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Englund, Thoennes and Fischer said they first noticed the shortage of applicants and a dwindling staff around the start of the COVID-19 pandemic.

Englund added the Evansville facility is experiencing a worse time. She says Brandon Borgstrom, administrator at the Evansville campus, has been pushing for legislators to pass bills for funding so they can increase wages and lower residents living rates.

Borgstrom was unable to be reached for comment.

Key findings from the survey:

  • Six out of 10 nursing homes across the U.S. are limiting the admission of new patients due to staffing shortages. 
  • 60% of nursing home providers said their workforce situation has worsened since January.
  • 87% are currently facing moderate to high staffing shortages.
  • 98% are experiencing difficulty hiring staff.
  • 99% are asking staff to work overtime or extra shifts.
  • Nine out of 10 have offered increased wages and bonuses
  • 71% said the lack of interested or qualified candidates is their top obstacle
  • 76% said their current financial situation and lack of funding prevent them from offering competitive wages. 
  • 61% are limiting new admissions due to staffing shortages.
  • 73% are concerned about having to close their facilities.
  • Providers estimate their average costs have increased by 41% since last year.
  • 53% said they can not sustain their current operating pace for more than one year. 

The survey came out around the same time 500 long-term care professionals went to Capitol Hill to meet with the nation’s lawmakers.
“We all agree that nursing homes need to hire more caregivers. The question is how,” said Parkinson. “ Unfunded staffing mandates would only make the crisis worse. Congress must invest in our long-term care workforce and protect access to care for millions of seniors.”

Thalen Zimmerman of Alexandria joined the Echo Press team as a full-time reporter in Aug. 2021, after graduating from Bemidji State University with a bachelor of science degree in mass communication in May of 2021.
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