Southeast Minnesota’s health care industry has regained jobs lost during pandemic, but nurse shortages remain

ROCHESTER — Jobs in the health care sector in Southeast Minnesota have rebounded since the COVID-19 pandemic and are at the highest level ever recorded, according to a new Minnesota Department of Employment and Economic Development analysis.

However, worker shortages remain, as hospitals, nursing homes and other facilities were short-staffed before 2020. And the job gains in recent years are not spread equally across the health care industry’s subsectors.

In the 11-county region of southeastern Minnesota, health care and social assistance makes up 27.3% of total employment, with 66,409 jobs. From 2019-2023, the number of jobs in this industry rose 0.2%, counteracting the loss of jobs amid the COVID-19 pandemic.

“Employment in the Health Care & Social Assistance industry has recovered all jobs lost due to the pandemic and now has the highest number of jobs ever recorded in Southeast Minnesota,”

the DEED report states.

“Two of the three subsectors have experienced job gains since 2019.”

While hospitals added 717 jobs (4.8% increase) and ambulatory health care services gained 590 jobs (1.8% increase) since 2019, the third subsector, nursing and residential care facilities, has experienced an 8.5% decline in jobs.

“This is not only a statewide trend, but a national trend,” said Nichole Mattson, vice president of strategic initiatives with Care Providers of Minnesota, a nonprofit advocacy group for long-term care providers. “Our sector has not recovered many of the job losses that the other sectors in health care have.”

Skilled nursing facilities have been hit the hardest in Southeast Minnesota, having lost 1,293 jobs (23% decrease) since 2019. Employment is also down for residential intellectual and developmental disability facilities, as well as mental health and substance abuse centers.

Assisted living facilities, however, have gained 664 jobs from 2019-2023, a 31.4% increase.

“When examining data over time, it seems that people are choosing to stay in retirement communities and assisted living facilities before moving into nursing homes,” said Amanda O’Connell, the Southeast and South Central regional analyst at DEED. “In other words, job declines in one area may be offset by job gains in another area based on consumer sentiment.”

At Sacred Heart Care Center in Austin — which offers skilled nursing, assisted living and adult day programs — filling open positions is still a challenge.

“We do have openings across the board,” said Laura Borris, Sacred Heart’s administrator. “I would say in every department there’s at least one opening at this time.”

Borris said the most staff turnover is in frontline workers, particularly certified nursing assistants. Across the region, the DEED report found 115 job vacancies for CNAs.

“We’ve had to fluctuate when we can do admission, and we’ve had to hold off on admission to make sure that our staffing levels are at (a place where) we can provide that quality care,” Borris said.

Another area where health care employment hasn’t rebounded is home health care services. Unlike other ambulatory health care services, such as doctors’ practices and dental offices, that have seen job gains, home health care services are down 347 jobs, or 29%, since 2019.

Both home health care and longterm care providers receive smaller federal and state reimbursements for their services, as compared to hospitals. This makes recruiting staff such as nurses, home health aides, personal care aides more difficult, said Kathy Messerli, executive director of the Minnesota Home Care Association.

“While Medicare rates are facing more cuts — and it’s quite concerning — the Medical Assistance … and the Medicare Advantage, which a lot of seniors are signing up for, those rates are incredibly low,” Messerli said. “That’s what’s making access to care more difficult. They’re not able to keep up with the wages.”

Reduced staff in those two service areas also contributes to the issue of

delayed hospital discharges

— when a hospital patient no longer needs hospital-level care, but nearby nursing homes, group homes and other care facilities cannot admit the patient due to capacity issues.

“The job loss that we’ve seen in nursing care facilities and skilled nursing, we can directly correlate that with the hospital backup issue,” Mattson said. “That is symptomatic of not having enough people in the skilled nursing sector.”

Across Southeast Minnesota’s health care sector, the largest job vacancies by role are for personal care aides (1,282 jobs), registered nurses (277), licensed practical and vocational nurses (123) and CNAs (115).

For the nursing workforce, “the problem is that there was a shortage before the pandemic,” said Jennifer Eccles, executive director for the Center for Nursing Equity and Excellence.

“That shortage is projected to get worse because, although we’re graduating about 4,000 new nurses in our state every year … this need is stacking up and up and up,” Eccles said. “But what we also have is an enrollment cliff coming in higher education.”

The DEED report does not include travel nurses, “since traveling nurses are typically employed by temporary agencies, their employment and wages are classified under that industry,” O’Connell said.

To remedy the shortage, both Messerli and Mattson said there are efforts to recruit high school students into health care careers and emphasizing the urgency to bolster the workforce as the country’s aging population continues to grow.

“The only way to do that is to make some priorities and to say, ‘We need to make health care possible,'” Mattson said. “Making this job really attractive to folks both from a financial standpoint, but also … feeling like you’re contributing to something larger than yourself.”

At Sacred Heart, Borris said one way the facility tries to retain staff is by offering scholarships to CNAs who want to further their education.

“Currently we have four CNAs that have graduated from either an LPN or RN program and are staying with our facility,” Borris said. “When we’re able to offer that career growth, that’s a huge recruiting tool that we utilize to fill the vacancies.”

Other job roles facing steep vacancies in the region are psychiatric technicians (21 open roles, 41% vacancy rate) and speech-language pathologists (40 open roles, 16.5% vacancy rate).

Mayo Clinic, which operates hospitals, longterm care and clinics in the region, said it did not have an expert available for an interview on the DEED report.