JEFFERSON CITY, Mo. – The Missouri Hospital Association (MHA) reports a decline in vacancy and turnover rates among nurses, but hospitals continue to struggle with staffing issues.

While workforce issues have slightly improved since the pandemic, this year’s workforce report highlights a surprising trend: some of the highest turnover rates ever seen are in dietary, housekeeping, and maintenance jobs at hospitals.

“It’s good news in that the rates that we saw, which were at their worst two years ago, are now beginning to come down,” Dave Dillon, spokesperson for MHA, said.

Despite this improvement, Missouri’s healthcare industry is still grappling with the aftereffects of COVID-19.

“The bad news is we’re not out of the woods,” Dillon adds.

Thousands of jobs at Missouri hospitals remain unfilled, with the nursing turnover and vacancy rate nearly at 16 percent.

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“If you see that throughout the state, seven thousand positions we would like to hire for but can’t, that means we’re probably filling most of those positions with agency staff that are expensive,” Dillon explains.

While the nurse vacancy and turnover rate are a few percentage points lower than in 2022, the report’s most surprising finding concerns the high turnover in less skilled positions such as maintenance, housekeeping, and dietary work.

“We see this huge turnover in those positions—rates that I don’t think we’ve seen in the near 20 years that we’ve been doing this survey,” Dillon notes.

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Workers in these positions often leave for better pay or benefits elsewhere. “They can trade in many cases for other jobs, so if they find it’s more attractive to work elsewhere, they can pick up and move to a hotel if they can get better pay, benefits, environment, or hours,” Dillon says.

Over the past decade, nearly 20 hospitals have closed in Missouri due to financial problems, forcing many hospitals to rely on costly outside help.

“What I think we don’t know is what the ideal window is for either getting back to what normal is or finding the perfect spot to create long-term equilibrium,” Dillon remarks.

The highest nurse turnover rates are in the South Central region of Missouri, whereas in St. Louis, hospitals are experiencing roughly 75 percent turnover in environmental and food services.

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