Aging with dignity: health care employee recruitment

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"So amazingly enough 60,000 people turn 65 every year in Minnesota."

Rob Lahammer knows senior care. He's the vice president of engagement and advocacy at Presbyterian Homes & Services (PHS), a network of over 50 senior living communities throughout Minnesota, Wisconsin and Iowa. He's been working for PHS for 34 years, almost 40 years in senior care generally.

"When I started it was eight, nine, 10% of the population was seniors. We're now sitting around 16, [but] it's going to be 25%. ... that's about 1 million people in Minnesota are 65 and older. So as far as the industry goes, there are more seniors right now, 65 older, I'm almost that so I hate to call them seniors, but 65 and older that are in K-12 education," Lahammer said.

He said that throughout his career, the services provided by these facilities has expanded and the bigger industry now is assisted living and memory care. A report by Cameron Macht and Anthony Schaffhauser for Minnesota's Department of Employment and Economic Development, says that Minnesota is projected to add nearly 60,000 new healthcare jobs over the next decade. At the same time, the report found that while nursing and residential care jobs were up to almost 106,000 in December of 2020, after an initial dip in March 2020 because of COVID-19, in the entire year of 2021, this area lost almost 6,000 workers, down to just over 99,500. This loss they say is because of facility closures, people quitting or retiring.

Located in Hutchinson, Minnesota population about 14,500, Harmony River joined the PHS network in 2012 and is one of the more rural locations. Pam Wolling, clinical administrator at Harmony River, said that they've maintained 75% of their staff over the last two years, which of course means 25% has been turning over.

Lahammer said that there are about 23,000 open positions in senior care in Minnesota alone. "23,000. This staggering number, and about 20% of positions are open. Now before the pandemic, it was somewhere in the 12% range. So what's really changed ... is we have to attract people who want to work here," Lahammer said.

Sometimes people feel called to senior care and caregiving work, what Lahammer calls, "God's work," but sometimes attracting potential employees has to be more intentional, like the Hutchinson High School's TigerPath Program.

"The TigerPath Program is where they prepare students for the workforce," said Luke Krueger, the campus administrator at Harmony River. "We have partnered with the Hutch High School to have students come in here and work and get their clinicals done. ... They actually started their own nursing assistant program at the Hutch High School."

A collaboration between the chamber of commerce, leaders from the economic development authority and local businesses, Hutchinson High School started the TigerPath Program about seven years ago to expose students to what Andrea Moore, the TigerPath coordinator, calls "logical career pathways."

"They're industry recognized credentials and certifications and then the student leaves not only with a high school diploma, but with a certification that's valuable in the workforce," Moore said. "So, you know, just taking that all into account and then realistically saying, 'what can we do here at Hutchinson High School? What's realistic for us? Can we do a welding certification or can we do CNA?' A lot of people say, 'I wish I had this when I was in high school,' and most of it is just things that schools have been doing, but it's just so much more intentional."

Each student in their approximately 1,000-person student body chooses one of the four TigerPath options: stream, sci high, business and human services. And in the 2020/2021 school year, a certified nursing assistant (CNA) certification was added, complete with onsite labs.

"We really had a vision that we wanted to offer the CNA course and certification here within the walls of the high school, because we really thought, and it has turned out to be true, that more students would be able to participate in that programming and get that certification, if they could do it during their school day as one of their electives," said Moore.

"So that's a college credit course that they're taking. They take all the classes there, then they come here for their clinical experience," said Krueger. "We've actually been able to hire on some of those students that took the class at the Hutch High School."

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And while Harmony river has been partnering with Hutchinson High School, Presbyterian Homes & Services has been working on recruitment efforts a little bit further away — over 7,000 miles away actually.

"We have about 120 nurses right now in our system, which is about one out of four, one out of five, of our hourly RNs are from the Philippines," said Lahammer.

PHS has been partnering with IPR, the International Personnel Resource of the Philippines, also referred to as INR, International Nurses Registry, for about 20 years. "We were first introduced to the INR program probably about five or six years ago," said Wolling. "And it's a program where we work with our corporate office to say we would like one, two, three INR staff members considered for our area."

Harmony river makes monthly payments for each nurse they receive through the program — a total of $25,000 per employee over the course of their three and a half year contract. "If you look at that $25,000, compare it to what you're spending on advertising, recruiting and retaining a staff member, we're actually are money ahead," Wolling said.

Bem Nonescan came to the United States with her family in 2019 through the program. She's a registered nurse in Harmony River. Nonescan's very cheerful demeanor when we spoke, almost masks how complicated the IPR process really is. Applicants have to pass the the National Licensure Examination and an English exam. There are Visa requirements, including limits on how many Visas are issued each year, plus finding an employer and interviewing. The process took Nonescan nine years to complete, but she had a dream and followed it.

"Because I've heard that America is everyone's dream, right? I wanted to go to America because I said I wanna feel the snow." Nonescan laughed. "And we got here during winter times."

Her husband is working as an IT contractor and they have two kids, 8 and 10 years old, and they've all felt the snow. The program helped Nonescan find housing and now she's working through her three and a half year contract.

"We have experienced ups and downs, ... because life in America is not easy, but all I can say is we're striving and thriving here in America and we are happy about it," Nonescan said.

"We have about 120 people currently that work at INR program. We have about 80 family members that also work for us. That's about 200 people," said Lahammer.

"I think something that is unique that we've needed to do to accommodate some of the staffing challenges, is think creatively on how can we get staff in our door? What can we do to meet them where they're at?" said Krueger.

Sometimes where potential employees are at, is down the street at the high school, and other times they're on the other side of the world. All these pieces work together to help organizations like PHS and Harmony River, adapt not only to changing and aging workforce demographics, but also to a reality where more people are going to need living assistance in order to age well. 

This story was made in partnership with the Minnesota River Area Agency on Aging. Over the past few months, Compass has been producing stories about people and programs in southwest Minnesota — and throughout the state — designed to help people age with dignity. To watch all of the stories in the series, visit www.pioneer.org/compass/agingwell.