Nursing pay increased — Hospital works to develop CNA staffing

Mary Stroka

NLJ Reporter

Weston County Health Services CEO Cathy Harshbarger told the hospital board at the group’s April 25 meeting that the hospital needs more staff, and the board responded by approving an increase in starting pay for certified nursing assistants to $18 per hour.

Harshbarger told the News Letter Journal on May 12 that the hospital currently has eight full-time CNAs, two part-time CNAs, seven PRN CNAs and seven traveler CNAs. (PRN means pro re nata or “as needed.”) 

Home health and in-home services have four total: two full -time, one part -time and one PRN (“as needed”). There are no travelers.

The Manor has eight full time, three part time CNAs and seven PRN. Eight of the Manor’s CNAs are on night shift, and three are on day shift. The seven PRN include some college students who are back for the summer.

She noted that some CNAs are on family and medical leave of absence. For example, acute care has eight CNAs: three full time (of whom two are on a leave of absence) and four PRN. 

Harshbarger said that the hospital is trying to move away from using traveling nurses and toward having local staff, with an eye on supporting the community’s economy. Traveling CNAs make $45 to $48 per hour but do not receive any benefits. The hospital spent $178,000 on traveling nurses in March 2025 alone.

Although she noted that month’s total was particularly high, Harshbarger told the NLJ that the hospital cannot support travelers as a regular expense.

“Few hospitals, if any, can,” she said.

Trustee Nathan Ballard said at the meeting that he believes the move will benefit residents because they want to develop connections with staff, and Harshbarger acknowledged the additional benefit attracting local talent will provide.

“We believe in having our own team that believes in and provides high-quality, compassionate service that is accessible for Weston County and Wyoming,” she told the NLJ. “We appreciate the service and dedication of travelers to support our growth; however, the best option is one that is served by local talents who are fully invested in our community and the residents we serve.”

Harshbarger said the hospital sees private-duty, in-home and the Mondell Heights  assisted living facility as local competitors for CNA applicants. The hospital also lost some candidates to other community businesses that paid new hires a higher wage.

The increase from $17 per hour to $18 per hour for new CNAs is meant to attract prospective hires.

“This does not go above our competitors, but it also doesn’t leave us behind in hiring choices,” Harshbarger said, noting that some new CNAs have already started at up to $18 per hour based on experience.

She said the hospital has also developed a hybrid CNA class to facilitate staffing goals, which involves online didactic lessons and a test. After passing the test, CNAs train at the Manor.

“We have seven CNAs taking this path, as it is much more flexible for them and will help us to have the permanent staff we need,” Harshbarger said.

The span of experience among the hospital’s CNAs ranges from new graduates of CNA certification to staff with over 33 years’ experience, according to Harshbarger.

CMS Staffing Requirements

To participate in and receive ratings from the Centers for Medicare and Medicaid Services, certain staff to resident ratios are required to make sure every resident received all the services they need, such as baths and meals, according to Harshbarger. Those metrics are reviewed by a state survey.

CMS ruled on April 22, 2024, that Medicare- and Medicaid-certified long-term care facilities, by April 2027 (for rural hospitals), must provide residents with at least 3.48 hours per day of total direct nursing care. By April 2029, the facility must have nurse aides provide 2.45 hours per day of that amount.

Since summer 2024, the hospital’s census of residents has risen by 12, which means the hospital would need to run 41.75 hours more than it had been. That amounts to seven travelers. The hospital has three traveler nurses and has added two based on the census. The hospital has hired a licensed practical nurse for one position. An interview was conducted May 12 for another position, and another traveler is out due to surgery.

The hospital currently has 48 residents at the Manor and aims to have 52 residents by the end of next week. At that point, six open beds would remain. The hospital could add staffing at that point, too. It is considering adjusting the shift schedule to help accommodate for the additions in residents count.