The Delaware Veterans Home continues to struggle with staffing. Would privatization help?

The Delaware Veterans Home continues to deal with staffing shortages that Secretary of State Jeff Bullock said may be best tackled by shifting the nursing home to the private sector.

Dozens of positions at the veterans home in Milford remain unfilled, preventing the state’s skilled nursing facility for veterans from expanding its services.

The veterans home has been plagued by unhappy employees and low pay in recent years, making it challenging for the nursing home to attract and maintain qualified nurses and other medical practitioners.

During last year’s budget presentation, Bullock stressed that unhappy employees and low pay remained major hurdles. At that time, the nursing home had about 76 open positions. There are 78 open positions currently, Department of State officials said Friday.

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Department spokesperson Rony Baltazar said the current practice of "using employment agencies to staff the Veterans Home" is unsustainable, and Bullock was emphasizing to lawmakers that public-private partnerships should be considered.

“I wish I had a brilliant answer for you … but I think the answer might be the private sector is the way to go if you are going to be competitive, or you are going to have to pay what the real market cost is,” Bullock told legislators on the state Joint Finance Committee on Tuesday, Feb. 13.

Recommendations for improving the Delaware Veterans Home

The problems at the veterans home prompted Delaware to hire consultants to provide recommendations on how to improve the facility, particularly with staffing.

Gibbous Consulting Services published its report in October 2022, which found that the nursing home provides quality care but struggles with staff morale and high turnovers, which impacts the number of patients it can serve.

The Delaware Veterans Home can have 144 beds occupied, but at the time of the consultant’s report, the census hovered at 53. “The nursing home has “suffered from low census, high staff turnover and negative reviews from current and former staff and family members,” the report found.

In 2021, the veterans home saw a staff turnover rate of nearly 32%. It dropped to about 18% in 2022, according to the report.

Bullock said during this year’s budget presentation that the problems at the veterans home in “terms of staffing are no better, and in some ways worse than they were a year ago.”

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The census currently hovers around 70, Bullock said but cautioned that the facility’s census can’t grow until the staffing shortage is addressed.

Baltazar said there are legal requirements for staffing ratios and the facility has struggled to attract new hires, which has prevented the veterans home from taking on more residents.

Among the recommendations in the consultant’s report was for the Delaware Veterans Home’s leadership to create models to identify staffing needs and training opportunities as well as improve internal systems and communication with staff and residents to improve the work environment.

Is privatizing the veterans home the right move?

Delaware Sen. Trey Paradee, who chairs the General Assembly’s Joint Finance Committee, said he’s not sure privatizing the nursing home is the right move.

The senator said he’s unconvinced that privatizing the nursing home for veterans would improve services or be more cost-effective. Paradee pointed to the “mixed results” Delaware has seen when it comes to contracting out health care services in state prisons.

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“I think we owe it to our veterans to make sure that they have the best care available. To control that, (we need to) make sure that the state has direct control and oversight of the workers in the veterans home,” Paradee said. “I am very skeptical of the idea that privatizing it would be helpful in terms of care or quality.”

Paradee and public commenters during Tuesday’s joint committee meeting stressed that the private sector is facing similar challenges when it comes to staffing in the medical community.

Delaware, particularly in its southern counties, faces an OB-GYN shortage that has left pregnant people and new parents without adequate prenatal, or postnatal care.

“The fundamental underlying problem is we don’t have enough nurses. We are poaching nurses from Bay Health and Christiana (Care), and they are poaching nurses from us,” Paradee said. “It’s kind of an endless carousel. Until we get more young people into health care, we are going to continue to have this problem.”

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The positions at the veterans home are collectively bargained, which makes things a bit more complicated, Paradee said, but he acknowledged that to attract more people to the field, salaries will need to increase.

“We’ll explore possible alternatives and see if there is something we can do to make working there more attractive,” he said. “If we could do a better job of compensating these employees it would solve a lot of problems.”

Because the state struggles to attract candidates to fill the open positions, Delaware must use employment agencies to find qualified professionals.

"The costs of filling these positions this way are significantly more expensive, sometimes twice as much," Baltazar said. "We have done a number of things to address this challenge, but we have not been able to overcome the disparities in the much higher private sector salaries."

Got a tip? Contact Amanda Fries at afries@delawareonline.com, or call or text at 302-598-5507. Follow her on X at @mandy_fries.

This article originally appeared on Delaware News Journal: With staffing shortages, some consider privatizing state Veterans Home