Administrator: agency nursing staff cost 24%–35% more than county hires; CNAs drive spending

Carmen Meyer, administrator of the Neighbors nursing facilities, told the Dunn County Neighbors committee on June 19 that contracted agency staffing costs substantially more than fully burdened county employees and that the bulk of agency spending comes from CNA coverage.

Meyer said the staff report and chart in the committee packet compare agency bill rates with the county’s fully burdened internal hourly rates, which include retirement and family health insurance. "So for CNAs it's 24% higher. For LPNs 35 and RNs 26," she said, adding that the analysis has several limitations and represents averages rather than every individual case.

Why it matters: CNAs account for the largest share of staffing costs because the facilities employ many CNAs per shift compared with relatively few nurses, Meyer said. "That is primarily due to it takes a lot of CNAs. It takes only a handful of nurses on any given shift," she said, noting CNA vacancies drive the need for agency coverage.

Committee members pressed for detail on the headcount implications. Andrew Hagen asked whether the listed 49 open CNA positions included the 20 agency staff currently covering full‑time equivalents; Meyer said the 49 figure reflects many small part‑time positions (a minimum 0.2 FTE) and that about 20 FTEs are covered by agencies to meet current needs.

Meyer also outlined budget reporting practices and said the county prepares periodic agency financial reports that compare total agency spending against budgeted nursing costs; she expects the committee will see a full financial breakdown next month. Members noted that recruiting from local training programs and internships can help reduce agency reliance.

The committee took no formal vote on policy changes. Meyer said staff will continue producing monthly agency vs. internal staffing financial reports to help the committee track trends and budget implications.