2 Arkansas vets homes struggle to fill nursing posts

Expenses swell as facilities use overtime, contract labor

The Arkansas Department of Veterans Affairs is on pace this year to triple its spending on overtime pay and contract labor at its two veterans homes.

The department has struggled to fill jobs, especially licensed practical nurse positions, at the state Veterans Home in North Little Rock since it opened a year ago. To maintain adequate staffing levels, the agency resorted to hiring contract workers and having employees work overtime.

Through six months of fiscal 2018, the state VA spent $209,414 in overtime pay compared with $278,587 for all of fiscal 2017. On contract labor, the agency spent $428,227 in the past six months, up from $124,721 for the entire previous year.

The state VA is working to reduce contract labor and overtime, but those costs will continue unless staff hiring and retention improve, said Karen Watkins, the department's chief fiscal officer.

"ADVA has found it difficult to compete for LPNs in the current market and is working with [the Department of Finance and Administration]/Office of Personnel Management (OPM) to explore ways to improve the ADVA's ability to compete for nursing staff," Watkins said in an email Wednesday.

The new state-of-the-art facility in North Little Rock has filled 55 of its 96 beds since opening, and department officials hope to reach capacity between June and August. State leaders decided to build the facility to address the increasing population of aging veterans, which a University of Arkansas at Little Rock study found would steadily increase until peaking in 2034. The other state Veterans Home is in Fayetteville and has a maximum capacity of 108 beds.

The U.S. Department of Veterans Affairs has faced similar staffing shortfalls locally and nationally. The Central Arkansas Veterans Healthcare System in July started an aggressive recruitment campaign to address nursing shortfalls at its pair of hospitals in Pulaski County.

Veterans homes in other states have encountered the same problem. In a New Mexico veterans home, a new $26 million unit for veterans who have memory loss has remained vacant since it was completed in November because of a lack of staff, according to The Associated Press.

The Illinois Department of Veterans Affairs has battled staffing shortages at its homes for the past decade, and it has explored a variety of remedies, including recruitment campaigns and contract labor. Still, worker shortfalls have persisted.

In addition to a nursing shortage, long-term-care facilities face an uphill battle attracting nurses, who usually prefer working in clinics or hospitals.

Nursing industry experts estimated last year that Arkansas had a nursing shortfall of about 700. Several local hospitals are partnering with colleges to increase the number of nursing students.

Starting pay for LPNs at Arkansas' veterans home ranges from $36,155 a year to $44,290, according to the agency. Registered nurses start at between $63,830 and $75,944 annually.

Several Little Rock hospitals declined Wednesday to provide nursing pay schedules.

The state VA on Wednesday asked lawmakers for permission to spend an additional $210,000 for overtime for the rest of fiscal 2018. The agency pays for overtime and contract labor out of its own cash funds, which come from revenue generated from the veterans homes' operations. A legislative panel -- the Performance Evaluation and Expenditure Review Subcommittee -- recommended that the Arkansas Legislative Council approve the request when it meets Friday.

At the committee hearing Wednesday, Rep. Kim Hammer, R-Benton, questioned whether the agency would continue to ask for additional appropriations in the future.

In response, Duncan Baird, the state's budget administrator, noted that the North Little Rock home only recently opened.

"They're really, in essence, entering into a business there, and I think that every step along the way they've had to adjust as they've gone along," Baird said.

Watkins said the agency would adjust its budget accordingly for fiscal 2019, which begins July 1.

The department expects to soon begin billing the federal VA for the care of veterans that have federal benefits. The state will be able to bill the federal VA for back pay to August, when federal surveyors inspected the facility.

Watkins said the agency will bill the federal VA for more than $1.3 million for the final four months of 2017.

Metro on 01/18/2018

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