Vets homes short on staff

A solarium allowing natural light to fill the dining room of the Missouri Veterans Home in Cape Girardeau is one of the most noticeable features added during a $7 million "total makeover" of the 16-year-old nursing facility.

The two-year project is almost complete as construction workers outside add the final touches to the roof and staff inside prepare to move residents displaced during the final phase of the work back to the rooms they call home.

But even as the work is being finished, another job is underway -- persuading state lawmakers to authorize enough extra staff to fill the 150-bed nursing home to capacity.

The population of the Cape Girardeau home was deliberately allowed to fall prior to construction to make it easier to work through the phases of the construction project, administrator Jan Rau said. But the increasing needs of the residents, whose average age is 81, will keep 20 to 25 beds empty indefinitely without extra nursing staff.

The staffing shortage isn't a local problem. Statewide, there are about 200 empty beds in Missouri's state-operated veterans homes and about $4 million is needed to add the 127 full-time staff positions required to make those beds available.

Revenue rebound

With the rebound in state revenue -- some predictions put this year's budget surplus at $500 million -- the Missouri Veterans Commission, which operates the homes, and veterans organizations are preparing to push for the extra help. The Missouri Legislature returns to work Jan. 3.

"We probably have the best chance this year of increasing the employee count because of the budget," Rau said. "There are sob stories out there everywhere and they have a need and there are lots of good causes, but our veterans deserve the best we can give them."

Members of the veterans commission heard a report from executive director Hal Dulle at their Nov. 2 meeting that the request for extra staff had been turned down by the Division of Budget and Planning in the state Office of Administration. Now the commission is working to mobilize veterans groups to convince lawmakers to make the new staff positions a priority.

The homes aren't operating at less than capacity because of staffing cuts in the past, said Anne Payne, superintendent of the veterans home program. Instead, she said, beds are empty because of expansions at the homes and because federal regulations dictate how many nurses, nursing aides and other staff are needed based on the amount of care each veteran requires.

"Veterans are sicker when they enter the homes and require more hours of care," Payne said. "We have a fixed number of staff, so they take care of fewer veterans. That is kind of the situation."

As of Nov. 2, the homes were serving 1,190 residents with waiting lists totaling 1,091. The Cape Girardeau home has the longest waiting list, with 292 veterans seeking beds, Payne said.

The population of the homes is primarily World War II, Korean War and Vietnam-era veterans, disabled or with chronic health conditions who aren't able to care for themselves at home, she said. At the Cape Girardeau home, the average resident has been there 2.5 years, with three who have been residents for more than 10 years.

Bill Walker, 77, spent five years in the Army, serving in Korea, and he's been at the home for 16 years. He needs the care because of a head injury, Walker said, and he's happy with the home and most of the renovations. "I don't like the floor, but I can't do anything about it," he said.

Walker said he's most impressed with the dining hall and kitchen area, and enjoys the food, "whatever they put on the menu."

During the renovations, food preparation was handled in a mobile kitchen and meals were served in the small common areas at the center of each 50-bed unit. Now those common areas will be available for recreational activities, such as poker and a pool table, or for television viewing and other social activities.

"That was one of the most difficult challenges, to serve out of the semitrailer kitchen," Rau said. "The residents are really tired of all the noise and upsets and looking forward to being back in their own rooms."

The home will likely never use every available bed, Rau said. A few have to be in reserve so roommates who don't get along can be transferred or in case someone who is in their last days needs privacy for themselves and their family, she said.

And not everyone on the 292-name waiting list would take a bed if it was offered tomorrow, she said. Some veterans worried about having someplace to go if their health worsens keep their name on the list, Rau said, "but we still have a huge population out there we can't serve."

Unaware of situation

Local veterans are aware that the veterans home has been operating at less than capacity, but many don't know that the empty beds can't be filled as soon as renovation work is finished, said Pete Rhodes, canteen manager of VFW Post 3838 in Cape Girardeau.

"We didn't know anything about this here," Rhodes said. "I have to have a chat with Jan and see what the story is and why. We have a lot of veterans out here needing to get in there."

With the denial of the request for additional help from the state budget office, the Missouri Veterans Commission will turn to the Missouri Association of Veterans Organizations, an umbrella lobbying group, to help persuade legislators. Obtaining more staff for the homes has been a priority for the past two years, said Dewey Riehn of Ashland, Mo., legislative chairman of the Missouri Department of the VFW.

The council that directs the MAVO will meet Wednesday in Jefferson City to discuss legislative priorities and strategy, Riehn said.

The veterans groups realize there are pent-up demands for state funding following budget cuts in the early years of this decade, he said. For example, state colleges and universities are seeking an extra $120 million to return higher education funding to the level of 2002. And some legislators have begun talking about tax cuts now that the state treasury has a healthier balance.

"Obviously, because I do work solely with veterans issues, I have some degree of tunnel vision. But our priority is going to be to get sufficient staffing," Riehn said.

One advantage veterans groups have, Riehn said, is that almost every lawmaker has a VFW post or an American Legion post within their district. Veterans are active and vocal voters, he said.

During the 2006 session, pressure from veterans groups helped secure a handful of new nursing positions for the homes and an 8 percent pay raise for all nurses working for the state to reduce turnover. Turnover isn't a problem at the Cape Girardeau home, Rau said, with about 3 percent of the staff being replaced each year. But some staff members are working a great deal of overtime, risking burnout, to keep the home in compliance with federal rules directing the number of hours of care available for each veteran, she said.

State Sen. Jason Crowell, R-Cape Girardeau, is chairman of the Senate Pensions, Veterans Affairs and General Laws committee. He said he's hoping Gov. Matt Blunt includes the extra staffing in his budget proposal.

"I do realize the shortage is there," he said. "We'll do what we can to get the nursing care for state veterans who reside in the veterans homes."

rkeller@semissourian.com

335-6611, extension 126