Amid a nationwide staffing crisis in the nursing industry, Missouri saw a statewide vacancy rate of 15.6% for registered nurses working in hospitals last year, with a 16.3% turnover rate, according to the Missouri Hospital Association's annual workforce report.
The report is based on data collected in 2023, surveying the turnover and vacancy rates in 33 positions at 128 Missouri hospitals. This means medical professionals who don’t work at a hospital are not included in the results.
Jill Williams, vice president of workforce development for MHA, said that nursing positions make up a majority of the medical jobs in the industry.
Statewide turnover rates in all surveyed positions were 22.2% in 2023, down from 23.1% in 2022. Vacancy rates were 13.7% in 2023, down from 14.8% in 2022.
Statewide vacancy and turnover rates are coming down from a peak that occurred in 2021 during the COVID-19 pandemic. Williams said a slow return to pre-pandemic levels is underway.
Leading the state in RN turnover rates is the south-central area of the state, which includes Ozark and Butler counties, with turnover rates greater than 35% in 2023. In 2021, the turnover rate peaked at 40.9% in this region.
“Rates are down from the extreme highs of the pandemic, but they are still not where we want them to be,” Williams said.
An area covering southeast Missouri, mostly made up of the Bootheel area, had an RN vacancy rate of 21.4% in 2023, the highest regional vacancy rate reported last year.
Williams said that turnover and vacancy rates tend to be higher in rural areas, and it will take longer for these hospitals to bounce back from the crisis.
She said that there are many roadblocks rural hospitals run into when it comes to hiring and retaining new staff.
Rural areas generally have smaller populations, meaning that there are usually fewer people with nursing degrees who are already living in the area. Williams said it can be challenging to entice younger nurses to move to rural Missouri.
“When you are trying to recruit out of the area, you are often recruiting spouses,” Williams said. “So they’re looking for quality of school for their kids and where the other spouse can work.”
Williams also said rural hospitals often can’t afford competitive pay rates or benefits, making it harder to entice new health care workers to the area. A 2020 study published in Health Affairs shows that rural hospitals frequently have a smaller profit margin compared to those in urban areas.
