In March 2022, the American Hospital Association urged Congress to address workforce issues affecting health care facilities1. AHA called those workforce issues “a national emergency that demands immediate attention from all levels of government and workable solutions." According to the Kansas Hospital Association’s 2022 Workforce Report2 vacancy and turnover rates in 2021 for licensed practical nurses and staff nurses were higher than in all previous years dating back to 2013. Statewide, overall employee turnover rate for surveyed health care positions averaged 19%, with the highest turnover rates for housekeepers (33%), food service workers/dietary aids (31%) and Certified Nursing Assistants (29%).
During the pandemic, Rooks County Hospital (RCH) reported they were able to staff their facility during the pandemic without using agency staff by providing hazard pay for their staff. In some cases, they found that staff were willing to drive to Plainville from larger communities to work at RCH. Now that the dust has settled, Stephanie Bjornstad at RCH says, “Our people are burnt out. People are tired and we’re having trouble filling current vacancies.”
In addition to facing urgent health care workforce challenges post-pandemic, health care workers are faced with a childcare crisis. United WE, a nonprofit organization dedicated to improving women’s economic and social status, in partnership with the University of Kansas, published a 2021 report which found that many women have struggled to hold jobs due to lack of adequate childcare3. According to United WE president Wendy Doyle, more than 300 childcare facilities closed during the pandemic, many choosing not to re-open.
Kansas Childcare Crisis Statistics
In September of 2020, RCH, a 22 bed Critical Access Hospital in Plainville, Kansas, joined the Compass Hospital Quality Improvement Contract (HQIC) initiative, which is funded by CMS. RCH worked with the Kansas Healthcare Collaborative to select priorities for their Quality Improvement Work Plan, which identified Community Collaboration and Integration as one of their top three priorities for improvement. RCH set a goal to work with community partners to start a community childcare program in Plainville by December 2022. Not only did they meet that goal in 2022, but they have plans to open a second daycare center in 2023, which will be located on the hospital campus. With 170 employees, the hospital is the largest employer in Plainville (population 1,746) and Rooks County (population 4,937). This community collaboration has allowed RCH to address both workforce challenges, but also the childcare crisis in their community.
They say it takes a village to raise a child though, in this case, it helps to have a hospital employer and community partners who understand the relationship between health care, workforce, childcare, and early childhood education. USD 270 in Plainville, in partnership with RCH and the Blue Cross Blue Shield (BCBS) Pathways committee in Plainville, applied for grant funding from the Dane G. Hansen Foundation. They were one of only four communities selected for funding in 2022. In addition to the initial grant funding, they received funding from the BCBS Pathways program for playground equipment and fencing for the facility. RCH invested in the childcare facility to always reserve four slots for RCH staff.
The facility, which opened in August of 2022, provides 12 additional childcare slots for area children, and is staffed by USD 270. According to Stephanie Bjornstad with RCH, when the facility opened, RCH families could have filled all available slots at the new childcare facility. RCH worked with USD 270 and the BCBS Pathways committee to apply for funding for an additional childcare facility, located on the hospital campus, slated for 2023 completion. The childcare facility structure is what they refer to as a “group home” and is a modular home built in Logan County, Kansas. The homes are built and subsequently transported to the construction site, where the homes are placed on a permanent foundation. Basements or above ground storm shelters are included in the construction.
Bjornstad reports that childcare issues have been a particularly challenging staffing issue for their facility. One Physical Therapist who returned to work after the birth of her child could find no daycare openings between her home and the 40-mile commute to Plainville. Her return-to-work plan required that her parents and in-laws took turns living in their home every other week to care for the baby until they could find suitable childcare for their newborn. Bjornstad says the hospital is confident that onsite daycare will be a valuable recruitment and retention tool for the hospital. The onsite daycare center will allow staff to have lunch with their children or to simply be nearby their children. Currently, the community childcare center is open 7:00 a.m. to 6:00 p.m. though they may consider expanded hours or days of the week in the future, if the demand persists and they can provide staffing during expanded hours.
1 AHA Letter Re: Challenges Facing America’s Health Care Workforce as the U.S. Enters Third Year of COVID-19 Pandemic
2 Kansas Hospital Association Annual Workforce Survey 2022
3 The Status of Women in Kansas, A Summary Report to United WE
4 All in for Kansas Kids 2020 Needs Assessment via US Bureau of Labor
5 All in for Kansas Kids 2020 Needs Assessment via American Center for Progress
6 All in for Kansas Kids 2020 Needs Assessment via Center for the Study of Child Care Employment, 2020
7 All in for Kansas Kids 2020 Needs Assessment via Center for the Study of Child Care Employment, 2020
9 2020 Supply and Demand Report
10 2020 Supply and Demand Report
11 The Status of Women in Kansas: A Summary Report to United WE, February 2022