Nursing homes and senior living centers in Southeastern Minnesota are facing their worst shortage of caregivers in decades, area nursing home CEOs say.

And it's only going to get more challenging, they say.

Shortages are not new to the industry. Rochester nursing home CEOs point to the late 1990s as a particularly bleak time, when certified nursing assistants and nursing aides were in short supply. Back then, the scarcity was the creation of a humming economy and a tight job market.

This time the shortage is being turbocharged by demographics, driven by a surge of baby boomers flooding into their retirement years. A tide estimated at 60,000 Minnesotans is turning 65 every year, and yet the number of people entering the workforce at the other end is a trickle by comparison. The imbalance has caught nursing homes in an ever-tightening vise.

"I will tell you in the 20 years I've done this, staffing has been an issue. In 20 years, this is the worst I've seen it," said Christine Bakke, CEO of Madonna Towers.

The telltale signs of an ongoing shortage are growing: The inability to fill openings has forced senior facilities to put holds on admissions of new residents. In Minnesota, more than 5,000 nursing home admissions were denied in 2016 due to a shortage of staff, according to Leading Age Minnesota, a statewide organization of senior care providers.

At the local level, Homestead at Rochester had to slow the pace of admissions at a new facility as it struggled to fill openings. More than a year ago, Madonna Towers, for the first time, put a temporary hold on admissions.

Adding to the churn are low retention rates among nursing home workers. Many fly the coop to land better-paying jobs at hospitals. For nursing home residents, who develop relationships with workers who are akin to family, the departures can feel like abandonment.

Many nursing homes have turned to aggressive marketing techniques to get their message out about the need for more workers: billboards, ads in college and hometown papers and social media.

Nursing homes are coping with the early wedge of what one CEO called a "tsunami wave" waiting to happen. The bulk of baby boomers now are in their late 60s and early 70s and won't be moving into senior communities or nursing homes until their late 70s or early 80s.

"There's going to be a huge wave of people," said Eric Huntoon, CEO of Shorewood Senior Campus, of Rochester.

Not a single senior community in Rochester has been spared the effects of the shortage, interviews with CEOs show. For Shorewood operations manager Bryon Campbell, the job of interviewing, hiring and training new staff now commands half of his work day. Under more normal conditions, it would comprise only one-tenth of his work.

The crisis is being felt more acutely in Southeastern Minnesota. Rochester's 3.8 percent unemployment rate has exacerbated the situation. Another factor unique to the area is Mayo Clinic, whose own manpower demands and better pay and benefits act as a kind of vacuum on many workers.

At Samaritan Bethany on Eighth, the inability to staff positions means an entire floor of rooms goes unused, CEO Sue Knutson said. Samaritan Bethany employs about 350 people in its nursing home, about 80 people short of being fully staffed. Twenty-seven beds are not being used as a result.

"If you look at unemployment statistics, I mean there are just physically not enough people in Olmsted County," Knutson said. "It's hard. I wish i had a great answer. I'd be making a lot more money doing that."

Knutson said Samaritan Bethany has worked hard to put together "an amazing benefit package" for its employees. But its pay scale is constrained by rates set by the state. And even though assisted living and independent housing arrangements are "market rate," Samaritan Bethany takes residents on elderly waiver, a kind of medical assistance for people who run out of funds.

"It seems like we saw a light at the end of the tunnel at that time," Knutson said, referring to the last big caregiver shortage in 1999. "We're not quite seeing that same light this time."

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