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DPHHS Survey Shows Problems At Healthcare Facilities

A new survey released by the Department of Public Health and Human Services shows the state’s psychiatric hospital is not the only staterun health facility dealing with staff, culture and management challenges. While the Montana State Hospital in Warm Springs has been in the news for its failure to prevent patient deaths, resulting in a loss of federal funding, the new survey shows a significant chunk of employees at seven facilities across Montana are dissatisfied with management and are ready to find new work.

The “Climate and Culture Survey” showed that nearly 20 percent of employee respondents are planning to leave their jobs within the next year.

At the Montana Mental Health Nursing Care Center in Lewistown, 35 percent of respondents said they were planning to leave their jobs within the next year. At the Montana Chemical Dependency Center in Butte, 24 percent of respondents reported an intent to leave, and the figure at the chronically understaffed Montana State Hospital was 20 percent.

The potential exodus comes at a notably inconvenient time as industries in and outside of state government struggle to recruit and retain employees during a nationwide labor shortage.

Most strikingly, according to Matt Kuntz, was that 71 percent of advanced practice registered nurses who responded said they were planning on leaving their job in the next 12 months. Kuntz is the executive director of the Montana chapter of the National Alliance on Mental Illness.

“Those facilities rely so much on those nurses, and they are a really difficult commodity to get,” he told the Daily Montanan on Thursday.

The Climate and Culture Survey was conducted by the New York-based consulting firm Alvarez and Marsal, which earlier this year inked a $2.2 million contract with the Health Department to investigate all of its health care facilities.

DPHHS did not respond to a request for comment on the survey.

The seven facilities surveyed were the Montana State Hospital, Montana Mental Health Nursing Care Center, Intensive Behavior Center, in Boulder, Montana Chemical Dependency Center, Columbia Falls Montana Veterans’ Home, Southwest Montana Veterans Home in Butte and Eastern Montana Veterans’ Home, in Glendive. The response rate for all seven facilities was 33 percent.

Kuntz said he was discouraged by the response rate. “It shows that the administration has a long way to go to build the trust back with these employees,” he said.

But overall, he said the survey was a solid first step.

“I look forward to seeing the plan that the Gianforte administration develops to improve the challenges identified in this report. They did a great job of identifying the challenges, and the rubber meets the road with how you are going to implement ways to improve them,” he said. “I think that the main thing is that the issues are now identified instead of magically thinking everyone is going to stay and everything is going to go well.”

Across all facilities, the main reason employees cited for wanting to leave their job was poor management — with 17 percent of respondents listing that as the reason. Low morale/toxic environment and retirement were the second most common reasons, with each receiving 14 percent of responses.

Kuntz said it speaks volumes that poor management was ranked above low salaries as a reason for respondents saying they plan on leaving.

“It tells me that not all of this is COVID pay or the competition that is occurring for wages, but that is also something that can be improved. But the management can be improved,” he said.

The survey also looked at the main themes that emerged from the employees’ description of their facility’s culture — a combined 38% of respondents described their workplace culture as either “toxic and gossipy,” “negative, hostile, unfriendly” or “unhealthy, mistrust and stressful.”

At the same time, 13 percent of responders described their workplace culture as “kind, helpful, and friendly.”

While the results identified dissatisfaction, a bright spot from the survey was the accomplishment category, where all seven facilities scored above a three for overall accomplishment satisfaction. Within the responses from this category, employees at the facilities reported that they feel like they are making a difference in their jobs and that they feel a sense of accomplishment from doing their jobs.

Employees at the facilities reported an overall satisfaction level of 3.1 — on a fivepoint scale. Despite nearly a quarter of respondents reporting an intention to leave, the Montana Chemical Dependency Center had one of the highest overall employee satisfaction levels at 3.6.

Meanwhile, the Montana Mental Health Nursing Care Center and the Montana State Hospital reported the lowest overall employee satisfaction scoring 2.4 and 2.7 respectively.

Across all facilities, employees reported the highest satisfaction with accomplishment and lowest satisfaction with salary. For all facilities surveyed, the overall salary satisfaction score was 2.6.

Respondents at four of the facilities reported being emotionally exhausted from their jobs, with the Montana Mental Health Nursing Care Center scoring the lowest. The Montana Mental Health Nursing Care Center is located in Lewistown and has a capacity for 117 licensed beds.

At the Montana State Hospital, Montana Mental Health Nursing Care Center and Intensive Behavior Unit, respondents reported that they are not satisfied with the recognition they receive for their work — both internally and from the community.

The majority of the facilities also received poor marks for development. The Montana State Hospital, Montana Mental Health Nursing Care Center, Intensive Behavior Center and Columbia Falls Montana Veterans’ Home all received a score of less than three in overall development satisfaction.

Another positive category was supervision, which received an overall score of 3.4 from all seven facilities.

Respondents from four of the facilities said they are not satisfied with the support they receive from the DPHHS Central Office. Across all seven facilities, the overall support satisfaction score was a three.

Alvarez and Marsal also surveyed the facilities on their ideas to recruit and retain employees — the number one response, with 32 percent of responses was “increase wages and hiring/retention/ longevity bonuses.”

In summary, Kuntz said more work needs to be done.

“It really shows that these facilities which are the safety net … desperately need help and the clock is ticking for how we can continue to improve them and convince these workers to stay and bring more on board,” he said.

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