Wyoming Health Facilities Struggle with Severe Staffing Gaps; Contract Labor Cost Nears $17M
October 29, 2025 | Appropriations, Joint & Standing, Committees, Legislative, Wyoming
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State officials warned the Joint Appropriations Subcommittee on Oct. 28 that persistent shortages of certified nursing assistants and nurses at five Wyoming Department of Health 24/7 facilities have forced leaders to buy short‑term contract labor and reduce bed capacity.
Director Stefan Johansson told the panel the department’s state‑run facilities — the Wyoming State Hospital in Evanston; the Wyoming Life Resource Center in Lander; the Retirement Center in Basin; the Pioneer Home in Thermopolis; and the Veterans Home in Buffalo — have experienced unusually high vacancy rates among direct‑care staff. The department’s August staffing snapshot showed CNA vacancy rates as high as 67 percent at the Life Resource Center and nursing vacancies reaching 72 percent at the Retirement Center in Basin; several other facilities reported nursing‑vacancy rates around 36–58 percent.
The shortfall, Johansson said, has pushed the department to buy agency nurses and CNAs. ‘‘We have made the decision to, as best we can, to essentially buy contract labor,’’ Johansson said, and the department reported FY25 contract‑labor spending at just under $17,000,000 across its facilities. He told the committee that contract nurses are commonly paid $70–$80 per hour and contract CNAs about $45–$50 per hour, while entry‑level state RN positions currently pay roughly $31–$33 per hour and CNAs around $18 per hour.
Those price disparities limit how much contract coverage the department can purchase from its vacancy savings, Johansson said. The agency converts salary vacancy savings in its 100‑series budget lines into contract expense, but the large hourly gap means the department cannot purchase a direct replacement hour‑for‑hour. ‘‘We essentially contract for a smaller amount of staff at a higher price, and we still have beds that are unavailable or offline because of that discrepancy,’’ he said; the department reported it is operating roughly 80 of the State Hospital’s 104 licensed beds at the time of the briefing.
Committee members and agency officials stressed downstream impacts. Johansson and other staff emphasized that closed beds increase wait lists for Title 25 civil commitments and Title 7 forensic patients, shifting demand to emergency departments, jails and court dockets. Representative Sherwood told the committee that a county sheriff reported people waiting in jail longer on evaluations than they would have served on a sentence because hospital admission is delayed.
Agency leaders described multiple causes for vacancies: national market pressure, regional competition, the rise of travel nursing and the particular challenges of working in high‑acuity public facilities. Johansson highlighted the Pioneer Home as an outlier that has managed to remain fully staffed but noted its population and staff‑to‑resident needs differ from the State Hospital and other higher‑acuity facilities.
What the department is doing
Johansson said the department uses three approaches: (1) local recruiting partnerships (community college pipelines, clinicals), (2) targeted exceptions and recruitment pay authorizations through Administration & Information, and (3) contracting for temporary agency labor to keep beds open when no permanent staff are available. He described efforts to lock vacancy savings centrally so funds are available if a facility must purchase contract labor.
The department asked the subcommittee for time to model how higher state wages would translate into reduced contract spending and additional available beds. Johansson and the department’s CFO said they would prepare scenarios for the Joint Appropriations Committee showing the relationship between pay increases, vacancy reductions and contract‑labor offsets.
Why it matters
The staffing shortages and contract costs affect access to inpatient psychiatric care, forensic restoration, long‑term care and veterans’ services. The committee and agency leaders framed the issue as a combination of public‑safety, fiscal and operational risk: closed beds raise costs elsewhere in the system (hospitals, jails, courts), while high contract rates strain agency budgets.
Provenance: Topic introduced at 00:03:11 (Chair) and developed in agency testimony from 00:04:52 through 00:38:10. Evidence in transcript includes Johansson’s staffing narrative and the contract‑labor cost tables.
Director Stefan Johansson told the panel the department’s state‑run facilities — the Wyoming State Hospital in Evanston; the Wyoming Life Resource Center in Lander; the Retirement Center in Basin; the Pioneer Home in Thermopolis; and the Veterans Home in Buffalo — have experienced unusually high vacancy rates among direct‑care staff. The department’s August staffing snapshot showed CNA vacancy rates as high as 67 percent at the Life Resource Center and nursing vacancies reaching 72 percent at the Retirement Center in Basin; several other facilities reported nursing‑vacancy rates around 36–58 percent.
The shortfall, Johansson said, has pushed the department to buy agency nurses and CNAs. ‘‘We have made the decision to, as best we can, to essentially buy contract labor,’’ Johansson said, and the department reported FY25 contract‑labor spending at just under $17,000,000 across its facilities. He told the committee that contract nurses are commonly paid $70–$80 per hour and contract CNAs about $45–$50 per hour, while entry‑level state RN positions currently pay roughly $31–$33 per hour and CNAs around $18 per hour.
Those price disparities limit how much contract coverage the department can purchase from its vacancy savings, Johansson said. The agency converts salary vacancy savings in its 100‑series budget lines into contract expense, but the large hourly gap means the department cannot purchase a direct replacement hour‑for‑hour. ‘‘We essentially contract for a smaller amount of staff at a higher price, and we still have beds that are unavailable or offline because of that discrepancy,’’ he said; the department reported it is operating roughly 80 of the State Hospital’s 104 licensed beds at the time of the briefing.
Committee members and agency officials stressed downstream impacts. Johansson and other staff emphasized that closed beds increase wait lists for Title 25 civil commitments and Title 7 forensic patients, shifting demand to emergency departments, jails and court dockets. Representative Sherwood told the committee that a county sheriff reported people waiting in jail longer on evaluations than they would have served on a sentence because hospital admission is delayed.
Agency leaders described multiple causes for vacancies: national market pressure, regional competition, the rise of travel nursing and the particular challenges of working in high‑acuity public facilities. Johansson highlighted the Pioneer Home as an outlier that has managed to remain fully staffed but noted its population and staff‑to‑resident needs differ from the State Hospital and other higher‑acuity facilities.
What the department is doing
Johansson said the department uses three approaches: (1) local recruiting partnerships (community college pipelines, clinicals), (2) targeted exceptions and recruitment pay authorizations through Administration & Information, and (3) contracting for temporary agency labor to keep beds open when no permanent staff are available. He described efforts to lock vacancy savings centrally so funds are available if a facility must purchase contract labor.
The department asked the subcommittee for time to model how higher state wages would translate into reduced contract spending and additional available beds. Johansson and the department’s CFO said they would prepare scenarios for the Joint Appropriations Committee showing the relationship between pay increases, vacancy reductions and contract‑labor offsets.
Why it matters
The staffing shortages and contract costs affect access to inpatient psychiatric care, forensic restoration, long‑term care and veterans’ services. The committee and agency leaders framed the issue as a combination of public‑safety, fiscal and operational risk: closed beds raise costs elsewhere in the system (hospitals, jails, courts), while high contract rates strain agency budgets.
Provenance: Topic introduced at 00:03:11 (Chair) and developed in agency testimony from 00:04:52 through 00:38:10. Evidence in transcript includes Johansson’s staffing narrative and the contract‑labor cost tables.
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