How 2 hospitals in tourist towns are using employee housing to fight staff shortages

At St. Luke's McCall (Idaho) Medical Center, four people turned down a job for a building service manager position. 

Their reason for declining the offer? The inability to find housing, St. Luke's McCall COO and Chief Nursing Officer Amber Green, MSN, RN, told Becker's.

At St. Luke's Wood River Medical Center in Ketchum, Idaho, travel nurses are living in RVs in the hospital's parking lots, also because of a lack of affordable housing, Director of Community Health and Engagement Erin Pfaeffle said.

It is for this reason that both hospitals are exploring ways to provide housing to their employees. St. Luke's Wood River is in the process of building 12 housing units, while St. Luke's McCall purchased a few homes to provide to employees in the short term.

It is a unique strategy to retain and recruit employees as many hospitals and health systems struggle during the staffing shortage.

The housing problem

Housing has been a problem in McCall and Ketchum for some time. The pandemic just made it worse.

Both communities are popular tourist destinations for skiing, fishing, arts and more.

"We have an interesting dynamic of significant wealth here," Ms. Pfaeffle said. "Contrasted by members of our community who have to work three or four jobs in order to put a roof over their heads and feed their children and themselves."

A three-bedroom rental in 2019 in the Wood River community was on average $2,289 a month. By August this year, that number rose by almost 55 percent to $3,697 a month, Michelle Griffith, executive director of ARCH Community Housing, told Becker's. ARCH is partnering with the hospital to build the housing facilities.

The average annual wage needed to afford that would be $147,887 per year, which is 300 percent of the starting salary for an EMT, Ms. Griffith also said.

In McCall, the median house price in January 2019 was $447,500, according to BoiseDev. That number slightly dropped in 2020 to $414,000, but increased to $779,500 by March 2021.

Being in an area that receives a lot of snow, it can be difficult to get workers to come out and build more housing, creating a shortage. 

But during the pandemic, more people started coming out to the community and staying because of its popular outdoor scene, worsening that shortage and making prices skyrocket.

"We've always had a shortage of housing," Ms. Griffith said. "It became more acute when people came here during the pandemic and stayed and said, 'OK, I can work remote. I might as well work remote from a place where I can hike and bike and ski and fish.' So certainly the increase in members of our community has contributed to the problem."

The problem is leading to some leaving the community to find jobs elsewhere, while also causing those being recruited to turn down jobs.

At St. Luke's Wood River, there are currently 73 job openings, with 16 of them for nurses. It takes typically three or four months to fill a role, Ms. Pfaeffle said.

At St. Luke's McCall, there are typically 30 to 45 open positions, mostly entry level. The jobs can take about 60 to 90 days to fill, Ms. Green said.

"Really, often the first question we ask is, do they have a plan for housing in McCall?" Ms. Green said of the hiring process. "Because if they don't, it's not likely that it's going to work out for them."

The solutions

The two hospitals decided they needed to do something in order to retain and recruit employees, which included finding affordable housing.

So St. Luke's Wood River is building the 12 housing units, which are a combination of single family homes and duplexes. But that's just the beginning for them, Ms. Pfaeffle said. They're exploring options for short-term rentals, master leases and building more units.

"Everything is on the table for us to explore," Ms. Pfaeffle said. "We think it's smart to have multiple strategies that we're looking at to create positive variability in our housing choices."

The first four of the housing units are expected to be completed a year from now, while the next eight will follow about six months after. The hospital is still determining criteria for which employees will receive housing.

The hospital has received guidance from ARCH to set the rental price of each unit to 30 percent of the household income, Ms. Pfaeffle said.

The funding is coming from the St. Luke's Health System and St. Luke's Wood River Foundation. The hospital is not sharing the cost of the facilities yet.

St. Luke's McCall has one home with multiple bedrooms and a shared kitchen. They also have two duplexes and a lease on a home, which are used in the same way.

This housing is typically for short-term stays, such as agency workers or employees who need a bridge before they find a more permanent living space. McCall charges them the market price of the home, which ranges from $500 to $1,300 a month, Ms. Green said.

Currently, no facilities like the housing units at Wood River are being built at McCall, but the hospital is exploring options with local stakeholders and businesses.

Ms. Pfaeffle said the decision to build housing was not only the right thing to do for the hospital, but necessary.

"This past year and a half has been incredibly difficult," she said. "Our staff continues to show up and work passionately and work diligently. The healthcare environment they're in right now is incredibly stressful and we started to see again this impact on unstable housing and accessibility to affordable housing … We just knew that we were at a place that was becoming really tenuous."

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