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CoxHealth looks to Puerto Rico to supplement hiring

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CoxHealth is growing its employment ranks through hires inside and outside the Springfield market as a nursing shortage continues nationwide.

Following 2016 efforts to recruit English-speaking nurses in the Philippines, the Springfield-based health system last month made its fourth in a series of planned visits to Puerto Rico. The method drew the attention of CNNMoney, which posted an article about CoxHealth and other health systems visiting the island for new hires. Celeste Cramer, CoxHealth’s director of recruitment and retention, said CNN approached the health system after hearing about Branson’s continued efforts to hire workers from Puerto Rico.

“Before that, we were meeting with partners – just to make sure that it was viable for us,” she said, referring to meetings with higher-education institutions before hiring began.

Andy Hedgpeth, the health system’s human resources vice president, said CoxHealth has signed 13 nurses so far in Puerto Rico.

“That is a good number for us to start with and get them established and get them into our culture,” he said. “We haven’t really established, for lack of a better term, a quota. What we are looking for are highly trained individuals.”

Unlike workers from the Philippines, Hedgpeth said nurses hired from Puerto Rico – a U.S. territory – don’t need visas to work in the Ozarks, a key distinction for CoxHealth’s global recruitment efforts.

“It’s not different from someone moving from Oregon or Delaware,” he said.

Recruitment in the Philippines has been delayed by work visa approvals, Hedgpeth said. A cap imposed by the U.S. government that allows 65,000 H-1B visas issued per fiscal year, according to U.S. Citizenship and Immigration Services.

About 20 nurses have moved over from the Philippines, and dozens more are in the queue, Hedgpeth said.

“Honestly, it’s just a matter of time before they are here,” he said.

The health system also is recruiting nurses in other countries, including the United Kingdom and Canada.

Hiring is up 3.5 percent systemwide with employment as of Jan. 1 at 11,371, including 2,472 nurses. Employment was at 10,981, including 2,370 nurses, as of Jan. 1, 2017, according to data provided by CoxHealth spokeswoman Kaitlyn McConnell.

The majority of CoxHealth’s nursing hires are homegrown. On Feb. 27, the hospital hosted a recruitment event seeking 100 hires, including nurses and nurse assistants.  

Hedgpeth said its own Cox College, for instance, produces 200 students per graduation. Many choose to remain in the area after performing their rounds at CoxHealth or Mercy Hospital Springfield.

“The overwhelming majority are from here locally,” Hedgpeth said.

He also pointed to CoxHealth’s retention rate. In fiscal 2017, the system’s first-year nurse retention rate was 92 percent.

CoxHealth also added more than 150 employees through its Jan. 1 purchase of Barton County Memorial Hospital in Lamar, located 77 miles northwest of Springfield.

CoxHealth added 25 beds at what’s now called Cox Barton County Hospital. It retained — at least for one year — Barton County Hospital’s employees, including President Wendy Duvall.

Throughout its system, CoxHealth officials continue to battle a well-documented nursing industry shortage.

A 2017 report by the Missouri Hospital Association found nearly 16 percent, or about 6,000, of staff nursing positions at Show-Me State hospitals were vacant. The organization also previously predicted a need of 117 registered nurses per year through 2022 in the seven-county Ozark Workforce Investment Area. The turnover rate in the region has been reported at 17.4 percent, nearly two percentage points higher than the state average.

A U.S. Health Resources and Services Administration report, however, shows the gap may be closing. In Missouri, for instance, the report found 135,100 nurses would be employed statewide by 2030. The projected demand through 2030 is 118,600, meaning at estimates, there would be a surplus of 16,500 nurses in Missouri at that time, according to the report.

Right now, CoxHealth is meeting its patient needs, Hedgpeth said, but local and international hiring efforts underway are meant to address future projections.

“Certainly, the focus on existing staff is the single easiest way to cut down on your vacancies,” he said, but noted, “We’re always hiring.”


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