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Empty beds and waiting lists. Missouri's veterans homes suffer from staffing shortages

Amanda Eldridge, a certified occupational therapist assistant, works with a veteran resident last week.
Brian Munoz
St. Louis Public Radio
Amanda Eldridge, a certified occupational therapist assistant, works with a veteran resident last week at the state-run St. James Veterans Home in St. James, Missouri.

Todd Callahan, a 50-year-old disabled Navy veteran, loves living at the St. James Veterans home in St. James, about 100 miles southwest of St. Louis. He would recommend it to his fellow veterans who need care.

“(The staff) is friendly, they’re nice. I get good care here. Everything’s nice. It’s a good place to live,” Callahan said. “If there is an opening here, that would be good for (a veteran).”

But the St. James Veterans home is not taking new residents, even though half the beds are empty. That’s because of the 185 jobs at the home, 75 of them are vacant, and that means the dozens of veterans on the waiting list can’t live there.

“It’s blatantly obvious that the pay is directly correlated to the staffing issues that we’re having,” said Brittany Ritter, administrator of the home.

Missouri pays certified nursing assistants between $12 and $14 per hour to work at the home, but other CNA jobs in the area are advertising $19-$20. The seven state-run veterans homes in Missouri have seen a 91% turnover in CNAs over the past two years.

Todd Callahan, a Navy veteran and St. James Veterans Home resident, on Monday, Feb. 7, 2022, at the home in St. James, Missouri.
Brian Munoz
St. Louis Public Radio
Todd Callahan, a Navy veteran and St. James Veterans Home resident.

Missouri isn’t alone. Texas, Kentucky and Mississippi are among the places with similar situations. Every state has at least one veterans home that's owned by the state government. They get federal funding to pay part of the operating costs, but states are expected to kick in money, too.

“Low levels of state funding and mandates on the level of care give the homes little choice but to serve fewer veterans,” says Heyward Hilliard, president of the National Association of State Veterans Homes.

The group doesn’t have specific numbers to quantify the extent of the problem.

“It is a widespread problem,” Hilliard said. “It’s systemic and not getting better. And because every state is a little bit different, there has to be 50 solutions.”

In Missouri, the proposed solutions are coming from a few different angles, but they all involve changing the way the state budgets for veterans homes.

State Rep. Dave Griffith, R-Jefferson City, is proposing dedicating half of the state’s gaming revenue to veterans services. That would triple the amount the Missouri Veterans Commission, which oversees the homes and other veterans services, receives each year.

“It would solve a lot of problems for our veterans. Veterans who want to go into a Missouri veterans home have earned that right. And we should not deny them that right,” Griffith told a group of 150 veterans who traveled to the Missouri Capitol to lobby lawmakers.

Currently, all of the state’s gaming revenue goes to education, and advocates for that cause are likely to fight back.

Gov. Mike Parson has proposed a 5.5% pay increase — and a $15 minimum wage — for state employees. That would make veterans home pay more competitive but wouldn’t close the gap completely, and some veterans advocates call that effort insufficient.

“We had a job fair and had a lot of people graduating from college or moving from job to job in the nursing, CNA, LPN jobs,” said Charlie Gooden, a Vietnam veteran and lobbyist for the Missouri Association of Veterans Organizations. “And they listened rather intently until it got time for the pay, and then it was almost a hang-up, like, click.”

While the care at state-run veterans homes can vary from state to state, in Missouri the homes recently won “Best in Class” Customer Experience Awards from the Pinnacle Quality Insight company.

The state-run St. James Veterans Home on Monday, Feb. 7, 2022, in St. James, Missouri.
Brian Munoz
St. Louis Public Radio
Snow blankets the St. James Veterans Home last week in St. James, Missouri.

St. James Home employees say it is frustrating that more of the state’s veterans can’t get the care they deserve.

“These veterans treat you like they’re your family,” said Darla Nebel, activities director in the Alzheimer’s wing at St. James. “When I first started here I was told if you can’t treat them like your family, then honestly you don’t need to be here, because that’s part of it. You have to treat these guys like they are part of your life and part of your family.”

Nebel said she works at the home to serve veterans, and the paycheck is secondary. But state-run veterans homes are finding it hard to staff their facilities with people like her, when other nursing homes are paying more.

“Those people end up getting burned out because they are having to work longer hours. They are being mandated to stay. So it’s a vicious cycle with a negative outcome, unless we are able to change that direction,” Ritter said.

Follow Jonathan on Twitter: @JonathanAhl

This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans. Funding comes from the Corporation for Public Broadcasting.

Jonathan is the Rolla correspondent for St. Louis Public Radio.

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