West Virginia
A look at pay for WV nurses and mid-levels, and some thoughts on the nurse shortage – Dominion Post
MORGANTOWN – Registered nurses in West Virginia rank relatively low for hourly pay compared to those in other states, but fare better when their pay is adjusted for cost of living.
Pay for nurse practitioners ranks even lower, but their adjusted rate places them even higher.
And the pay for physician assistants, when adjusted for cost of living, is among the best in the nation.
The numbers come from three articles in Becker’s Hospital Review. This story looks at the numbers and then focuses on registered nurses and the various factors – not just pay – affecting the nursing shortage statewide and across the nation.
The numbers
West Virginia registered nurses rank 45th in the nation among the 50 states and Washington, D.C., for mean hourly pay, at $36.53 per hour.
But adjusting for cost of living (COL), their pay amounts to $40.45 per hour, 35th in the nation.
Becker’s used May 2023 salary data from the U.S. Bureau of Labor Statistics and 2024 COL data from the World Population Review.
World Population Review averages COL across the nation and sets that as the baseline of 100. Individual states are then given a number reflecting costs there compared against the baseline. West Virginia’s index number is 90.3.
Among West Virginia’s neighbors, Maryland is 16th nationally at $44.27 per hour, but 45th adjusted for COL, at $37.05. It’s COL index is 119.5.
The other neighbors: Virginia, 23rd, $42.48; COL adjusted, 31st, $41.20. Pennsylvania, 25th, $42.08; COL adjusted, 21st, $42.51. Ohio, 29th, $40.59; COL adjusted, 17th, $43.18. Kentucky, 38th, $39.31; COL adjusted, 25th, $41.91.
West Virginia nurse practitioners rank 47th nationally, at $54.54. They rise to 28th nationally when adjusted for COL, at $60.40.
Maryland, 20th, $61.54; COL adjusted, 47th, $51.50. Pennsylvania, 24th, $61.27; COL adjusted, 21st, $61.89. Ohio, 33rd, $59.07; COL adjusted, 17th, $62.84. Virginia, 39th, $58.11; COL adjusted, 39th, $56.36. Kentucky, 49th, $53.06; COL adjusted, 37th, $56.57.
West Virginia’s physician assistants rank higher than all of our neighbors for actual mean hourly wage and adjusted for COL. For actual wage, they rank 37th, at $58.55. Adjusted for COL, they climb to 13th, at $64.84.
Virginia, 38th, $57.70; COL adjusted, 40th, $55.98. Ohio, 39th, $57.67; COL adjusted, 25th, $61.35. Pennsylvania, 40th, $57.58; COL adjusted, 33rd, $58.16. Maryland, 42nd, $56.39; COL adjusted, 47th, $47.18. Kentucky, 47th, $47.74; COL adjusted, 45th, $50.89.
The nurse shortage
Melanie Heuston is chief nursing executive for the entire WVU Health System and is overseeing the creation of the WVU Medicine Center for Nursing Education at the WVU Innovation Corp. building.
“The nursing shortage has been going on for quite some time,” she said – nationally and in West Virginia.
It preceded COVID, though the pandemic exacerbated it and brought more attention to it. Bottom line was not enough nurses were and are being produced to meet the demand, she said. “As a state we’ve continued to not put out enough nurses.”
Pay is one factor among several, she said, and not necessarily the chief factor.
“Pay is always important to people and it always matters,” she said. “Staying competitive to the local market is really important.”
They focus on the local market, she said. For registered nurses, West Virginia can’t compete with California, for instance – first in hourly wage at $66.20 and adjusted for COL at $49.22.
Just as important is how they’re treated and the work environment, Heuston said.
With that in mind, she said, WVUM within the past two years has revised the clinical ladder to increase nurses’ pay while allowing them to keep taking care of patients.
The clinical ladder has six steps of increases built on experience, responsibilities and education. “You don’t want a nurse to feel as though they need to leave bedside care to get an increase in salary.”
Like other systems, WVUM relies on contract nurses to fill the gaps. Part of that is good news – the system is growing and needs more nurses.
Meanwhile, the Center for Nursing Education is one way WVUM is building its own supply. As previously reported, there are people who’ve wanted to be nurses but weren’t able to go to school for various reasons, Heuston said, including money and time. The new school is designed to break down those barriers.
The center will have a tuitionless option. Even with tuition waivers, nursing students still have fees, uniform and book costs. At the center, all of those costs will be covered if the students agree to a three-year work commitment with WVU Medicine.
Another factor in the nurse shortage is a faculty shortage, Heuston said. “I think a lot of that is pay related.” Academia typically doesn’t pay as well as the private sector.
The nurse shortage is chiefly in acute care hospitals – mostly the medical/surgical areas, she said. “Nurses have more options today than they’ve ever had in the 40 years I’ve been a nurse. … The places where nurses are is endless.” They can work remotely, or for an insurance company, or advance to nurse practitioner, or many other options.
After talking about the barrier-breaking of the new school, Heuston talked a bit about other barriers to entering nursing. She cited the work of Peter Buerhaus, a nurse, healthcare economist and author.
One of his points, she said, is that social media, with its penchant for emphasizing the negative side of just about everything, has not been good for nursing. And today’s culture doesn’t provide opportunities for high school students to get an introduction – such as the candy stripers some Baby Boomers and Gen Xers might remember.
“We’ve got to figure out ways to shine a light on how wonderful nursing is so people can go into it,” she said.
One way WVU Medicine is doing that, she said, is through its Aspiring Nurse Program. The program offers financial and human-centered support to nursing students enrolled at select schools in West Virginia and neighboring states. This helps not only WVU, but other nursing schools fill their open seats, and helps the students have access to the education they want and need.
Under the program, the students can receive up to $5,000 per semester, twice a year, for a total $25,000 for the duration of their nursing education, in exchange for a three-year work commitment in the WVU Health System. There are now 200 students in the program, she said.
Mon Health Medical Center did not have anyone available to talk about nursing in time for this report.
Email: dbeard@dominionpost.com
West Virginia
Former West Virginia Jail Officer Pleads Guilty to Civil Rights Violation in Fatal Assault on Inmate
Some of the best of Mountaineer Week is still to come.
From beard growing to woodworking and folk dancing to fancy fiddling—plus biscuits and gravy, apple cobbler, and lots more homestyle cooking—Mountaineer Week, November 11–17, is WVU’s celebration of traditional West Virginia ways. A lot of the fun is still to come, and you can get in on the action this weekend with these Mountaineer Week and related events.
Thursday, November 14
A Celebration of West Virginia Folk Music Traditions
6 p.m. in the Mountainlair Gluck Theatre
Friday, November 15
Apple butter making
8 a.m.–4 p.m. in front of the Mountainlair
Pinto beans and cornbread, free samples while supplies last
11 a.m., Mountainlair Commons
Mountaineer Week Arts & Crafts Fair
11 a.m.–7 p.m., Mountainlair Ballrooms
Mountaineer Week Quilt Show
11 a.m.–7 p.m., E. Moore Hall
Bob Shank on hammered dulcimer
11 a.m.–7 p.m., E. Moore Hall
Pat Harper on hammered dulcimer
Noon–4 p.m., Mountainlair Ballroom stage
Line dancing
10 p.m.–2 a.m., Mountainlair Food Court
Saturday, November 16
Apple butter making
8 a.m.–4 p.m. in front of the Mountainlair
Mountaineer Week Arts & Crafts Fair
11 a.m.–7 p.m., Mountainlair Ballrooms
Mountaineer Week Quilt Show
11 a.m.–7 p.m., E. Moore Hall
Bob Shank on hammered dulcimer
11 a.m.–7 p.m., E. Moore Hall
Pat Harper on hammered dulcimer
Noon–4 p.m., Mountainlair Ballroom stage
WVU Bluegrass Band
2 p.m., Mountainlair Food Court
The WVU Mountaineers vs. the Baylor Bears
4 p.m., Milan Puskar Stadium
Jeff Fedan on hammered dulcimer
4 – 7 p.m., Mountainlair Potomac Room
The Hillbilly Biscuits
5 p.m., Mountainlair Food Court
Mountaineer Week Square Dance by Morgantown Friends of Old Time Music & Dance
7:30 p.m., The Encore
Line dancing
10 p.m.–2 a.m., Mountainlair Food Court
Sweaty Hands String Band
10 p.m., Mountainlair Gluck Theatre
Grace Campbell
11:30 p.m., Mountainlair Gluck Theatre
Sunday, November 17
Mountaineer Week Arts & Crafts Fair
11 a.m.–4 p.m., Mountainlair Ballrooms
Mountaineer Week Quilt Show
11 a.m.–4 p.m., E. Moore Hall
Bob Shank on hammered dulcimer
11 a.m.–4 p.m., E. Moore Hall
Pat Harper on hammered dulcimer
Noon–4 p.m., Mountainlair Ballroom stage
Jeff Fedan on hammered dulcimer
Noon–4 p.m., Mountainlair Potomac Room
READ MORE ARTICLES FROM MORGANTOWN LOWDOWN
West Virginia
Audit finds contract nursing in WV state facilities costs $284M, hiring process typically 688 days • West Virginia Watch
State-run hospitals, struggling to fill full-time nursing positions, are heavily reliant on contract positions to fill gaps. It cost the state $284 million since 2015 since contract positions pay more than the state’s own full-time nursing jobs.
The Department of Health Facilities’ lengthy hiring process and questionable budgeting practices combined with a national nurse shortage have led to a reliance on contract labor, according to an audit presented to lawmakers on Tuesday. Meanwhile, contract labor’s price tag has risen.
“From fiscal year 2015 to 2023, the total annual expenditure for contract clinical staff increased 955%,” said Mike Jones, audit manager with the Post Audit Division.
The audit, conducted by the Legislature’s Post Audit Division, reviewed the Department of Health Facilities hiring process prior to it becoming its own agency this year. It found that, on average, it took 688 days to post jobs and hire full-time nurses.
“That’s among the most ridiculous things I’ve heard in a long time,” House Speaker Roger Hanshaw, R-Clay, said in response. “Can anyone respond to that? Anyone?”
Aaron Snodgrass, health facilities finance officer, said he couldn’t provide clarity but noted that the agency was posting jobs much more quickly at this time.
With the likely continued rising cost of contract nursing, the legislative auditor recommended that lawmakers “consider if the continued operation of health facilities by the state is in the best long-term interests of the state and address the issues as it sees fit. “
DHF leaders have said they’re already considering selling four of the state-run hospitals to private providers largely due to operation costs. Snodgrass told lawmakers that the audit was fair and he was not surprised by the findings.
“We are working with a broker to find investors who want to invest in these facilities. I can’t really provide any additional information on that because it’s not my project,” he said.
In DHF’s official response to the audit, it said the department contracted with Lument Securities earlier this year to look for outside buyers. West Virginia Watch on Sept. 23 filed a Freedom of Information Act request for a copy of DHF’s contract with Lument; an attorney with DHF recently delayed possibly sharing the contract until Dec. 20.
DHF operates four long-term care facilities: Hopemont Hospital in Terra Alta; Jackie Withrow Hospital in Beckley; John Manchin Health Care Center in Fairmont; and Lakin Hospital in West Columbia. The department also operates two psychiatric facilities — William R. Sharpe, Jr. Hospital in Weston and Mildred Mitchell-Bateman Hospital in Huntington — along with Welch Community Hospital.
Contract nurses involved in crimes, patient death at hospitals
Lawmakers requested the audit due to concerns about “ambiguous information around expenditures,” cost concerns with state-run hospitals and more.
There was not a line item dedicated to contract nursing, according to the audit.
There are 846 allocated positions in the seven hospitals for full-time clinical nurses. Del. Kayla Young, D-Kanawha, noted that the audit failed to say how many positions were being filled by contract nurses.
The COVID-19 pandemic worsened the state’s reliance on contract nursing, and from 2019 to 2020, the cost jumped from $20 million to more than $40 million.
“These staffing issues are not new or unique to hospitals in West Virginia. They existed before COVID, which only worsened the issue … No single policy has addressed the issue,” Jones said.
The millions of dollars spent on contract nursing were paid out to 33 vendors over the last nine years; 28 of those were out-of-state vendors. Sharpe Hospital, where multiple contract employees have been charged with crimes, spent $30 million on contract staffing last year.
The state spent $3.8 million on contract nursing in Hopemont Hospital in 2023. Three contract employees were fired there this year who were involved in a gruesome death of an elderly patient in a boiling whirlpool.
The audit noted that West Virginia was not immune to issues sparked by the national nursing shortage. Lawmakers and educators have attempted to bolster the state’s nursing programs, including the creation of a West Virginia Nursing Academy that starts for kids in ninth grade. The Legislature provided $20 million in surplus funding for continued education initiatives started in the Governor’s Nursing Workforce Program in 2024.
“Are any of the programs that we have done in the past few years to bolster the nursing programs working?” Young asked.
Snodgrass said that it will take years to graduate more nurses in the state.
“We are seeing positive results within the department,” he said. “When we come back in budget meetings in the spring, if trends continue that we’re seeing, we’ll have good positive results to report for contract nursing.”
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