Wages increased to spur interest in working for care facilities

Staffing both nursing homes in Madison county has been an ongoing problem. “The concerns have been in the works for awhile, mostly because in order to have a really full house you need to have enough staff, and the staffing challenges have been ongoing since I have been commissioner,” Jim Hart, Madison County Commissioner for 12 years reflected. Part of this is due to the nature of the job, but also to the fact that the pool of eligible applicants is smaller in Madison County than it would be in a larger area. Despite that, Commissioner Hart explained the struggle to find employees in nursing homes extends further than Madison County. It is a state and nationwide problem.

Madison Valley Manor and Tobacco Root Mountain Care Center need 50 employees at each location, Bonnie O’Neill, chief administrative officer for Madison County, reported. “Working in health care, as you can imagine, is a hard job. We’ve got 28 residents in Sheridan (Tobacco Root Mountain Center) and 26 approximate residents in Ennis (Madison Valley Manor) and we operate 24/7. You have to have enough staff to operate those facilities on a 24 hour basis,” she continued. “Its a tough job,” County Commissioner Dan Allhands agreed, bringing up the fact that being operational 24/7 means some employees miss spending time with their families on holidays.

Employees at either facility enjoy the benefits of working for the county. O’Neill described these benefits as including: health care at no extra cost through Blue Cross Blue Shield, life insurance, optional vision and dental insurance, contribution of wages into a retirement system, up to three weeks of paid vacation time dependent on number of hours worked, 12 paid sick days and 10-11 paid holidays.

When staffing does not met the ratios required by Centers for Medicare and Medicaid Services, the county uses travelers to fill the gaps. Travelers are sent by the company they work for to provide employment to places that need it, usually as a last resort for the businesses looking to hire. “It’s just a nation-wide deal. You’ve got assisted living now and home health and traveling nurses and everyone’s struggling to find CNAs (Certified Nurse’s Assistant),”Commissioner Allhands stated. Commissioner Hart explained travelers can be from virtually anywhere. One of the facilities had a traveler employee from Glendive, Montana, clear on the other side of the state. 

The biggest part of this problem is how expensive it is to hire travelers. “The total number we spent on travelers in the last fiscal year is unreal,” Madison County Commissioner Ron Nye stated. Commissioner Nye continued by saying if the amount of money spent on hiring travelers persisted, the nursing homes would go out of business. In an effort to keep this from happening, all three commissioners agreed a wage increase for nursing home staff needed to be put in place. It would contain a two-fold benefit: higher wages would increase interest locally in working for the care facilities and more local employees would reduce the need to hire travelers. 

“Our commissioners have been very supportive. In fact, we couldn’t have done it without them,” O’Neill explained.

The wage increase went into effect on June 25 after a commissioner’s meeting. As a result of this, hope in the hiring process was restored. “The pool is probably pretty slim regardless. We have already gotten some applicants from folks that have worked in other facilities in Dillon and Bozeman, and it’s kind of encouraging actually,” Commissioner Hart provided. She advocated for Madison County as a great place to live and work and wants to maintain that mentality with the current staff, and also show it to the wider population. “We think in the very near future we will actually have a waiting list for individuals that want to work for the county nursing homes,” she emphasized.

“We’re tickled with what we’re seeing right now,” Commissioner Allhands added.

Commissioner Hart hoped they would not have to ask any more from the residents, who pay two property taxes to support the nursing homes, in regards to this venture. He stressed how good the residents are to both homes and Commissioner Nye emphasized how much residents want these facilities to remain in place. “We may have to go to the voters to ask them to help us maintain these facilities the way they need to be maintained,” he said. Commissioner Nye believed a lot of residents know they may need a facility like either of these once they reach a certain age. He is confident residents will not mind “digging deeper into their pockets” to help provide local care for future generations of the county.