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Certified nursing assistant shortage stretches Missouri health care industry

An empty hospital bed with a white pillow and blue blanket. A shelf with pill bottles is behind it.
Bret Kavanaugh
Karren Ganschinietz has been a certified nursing assistant for 38 years. She said she is concerned about how the shortage of CNAs will affect older Missourians. “Without us, I am really afraid there won’t be that care that is needed for our elders to survive in this world. They’re going to be forgotten without us.”

Karren Ganschinietz has been a certified nursing assistant for 38 years.

In this role, she helps patients with everyday activities such as getting dressed, eating meals and bathing. Certified nursing assistants, or CNAs, are everywhere in the health industry, from hospitals to hospice.

Ganschinietz lives in Boss in southeast Missouri. She has stayed in the field for decades because she loves connecting with patients every day.

“If I can just touch one person's life, I know that I'm making a difference,” Ganschinietz said.

She’s seen people come and go from the field for a variety of reasons. Ganschinietz said it’s difficult to be a CNA due to low pay, lack of respect and the constant death of patients.

There is a shortage of CNAs all over Missouri, according to a 2023 workforce report from the Missouri Hospital Association. Ganschinietz has noticed more shortages since the start of the pandemic, although it’s not a new issue.

“The shortages have always been there,” Ganschinietz said.

Along with hospitals, staffing nursing homes is a cause for concern. The aging baby boomer generation has created an influx of residents. Census Bureau data shows that the number of people over the age of 65 has grown by over a third since 2010. More employees will be needed to keep up with demand.

“There needs to be a constant focus (and) effort on bringing new people into this field,” said Lori Porter, the CEO of National Association of Health Care Assistants.

Retention needs

While recruitment and training options do exist, there needs to be more resources, Porter said. She is a former CNA who co-founded the organization in southern Missouri to advocate for better conditions for CNAs. Porter said that positive work culture is vital to solving the shortage

“That's been the biggest problem I've seen throughout my career is that people want to treat these incredible humans as workers (or) tasks," Porter said. "And no one wants their grandma treated like a task.”

In the Ozarks, the vacancy rate for CNAs is around 16%, which affects the quality of care and workload for current positions. Hospitals rely on CNAs to keep the daily workflow moving. Mercy Hospital Springfield, a major hospital in the region, currently has a CNA vacancy rate of 25%, creating an issue for providing resources to patients.

However, some positions are starting to be filled in the area.

“I think we have not been immune to really staffing shortages and challenges throughout the last few months,” said Marsha Ballard, the executive director of nursing at Mercy Hospital Springfield. “We have seen a really nice gain and uptick in April and May, which has been helpful and exciting for us.”

To become a CNA, a person must do 75 hours of classwork, 100 hours of on-the-job training and a final exam, said Joy Mello, who teaches CNA training classes at Ozarks Technical Community College. The amount and type of CNA training required varies by state.

Increased wages

Prior to the pandemic, CNAs in Springfield were making around minimum wage. Mello said the shortage has led to higher pay. Traveling CNAs go to various regions on a contract to work for a facility or in a person’s home. Often, traveling CNAs make more money.

“We've seen the pay increase for minimum wage to $15, $16 an hour,” Mello said. “And in some of the travel agencies, I've had some CNAs that take a traveling contract, they're making $27 to $37 an hour.”

One way Springfield is recruiting new talent is through a paid CNA apprenticeship program. Students are hired by CoxHealth, the other major hospital in the area, and are paid to go through Mello’s class and subsequent clinical training. They are required to work for CoxHealth for one year after completing the educational portion.

It’s a possible solution to filling the gap in the CNA workforce. Increased pay and retention efforts have brought interest back to the field, but not enough.

“We put a lot of responsibility on our CNAs,” Mello said. “When they feel like they're valued, that they're part of the team, that they are that driving force, that they have been given that benefit and they're being rewarded financially, that's a huge bonus.”

Katie Quinn works for Missouri Business Alert. She studied radio journalism and political science at the University of Missouri- Columbia, and previously worked at KBIA.
Missouri Business Alert keeps business decision makers and entrepreneurs informed about the stories important to them, from corporate boardrooms to the state Capitol.
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