Danielle Knudsen stepped in and out of the patient rooms in her hallway at the Mennonite Village in Albany near the end of a recent shift. As a charge nurse, Knudsen oversees people’s daily care.

“How’s your tummy feeling?” she asked one of her patients.

“Are you doing OK?” she asked another before returning her work station to complete electronic charting.

Knudsen, 25, has worked at the Mennonite Village for almost three years, after completing a one-year program to become a licensed practical nurse. Before that, she was a certified nursing assistant.

“I wanted to get a job where I could help people,” she said. “I have aspirations to get my RN.”

Over the past decade, jobs in the health care industry have provided fairly stable employment for workers like Knudsen. Overall, employment has steadily increased, even through the recession, and later bolstered by the state’s full embrace of Medicaid expansion and the Affordable Care Act. In the past decade, jobs in health care have increased by 31 percent in Benton and Linn counties. There are more than 11,500 health care jobs in the two counties, according to the latest figures from the Oregon Employment Department.

Economists predict that health care will continue to grow for the foreseeable future, as demand for health services increases as the population ages. But the forces of reform, advances in technology and pressure to hold down the increasing cost of care continue to transform the industry, shifting jobs away from traditional roles.

In the mid-valley, hospitals and clinics are holding steady or even reducing staff. But it’s a candidate’s market for jobs on the social assistance side of health care.

Mennonite Village is the second-largest continuing care retirement village in Oregon and is among the largest social assistance employers in Linn County. It offers independent living, assisted living, a traditional nursing home and memory care. It employs about 400 people in many different roles, from caregivers to cooks.

Hiring and retaining workers are among the greatest challenges for social assistance businesses and organizations. One reason is that there are many opportunities for upward mobility. With a little training, people can leave entry-level positions for higher-paying jobs. A common track is from nursing assistant to licensed or registered nursing, said Kristen Gregory, director of human resources at Mennonite Village. As an incentive to retain employees, Mennonite Village offers tuition assistance and scholarships.

“A lot of our staff go on to trade school or nursing school,” Gregory said. “We help pay for that.”

Home health care is another growing field within the industry. One reason for that is the baby-boom generation wants to stay at home, said Logan Dralle, marketing director with New Horizons In-Home Care. Compared to the previous generation, baby boomers are more likely to have long-term care insurance, which covers the cost for services that can keep people living independently longer.

New Horizons started in Eugene in 1985 and has grown to become the largest in-home care agency in Oregon with 1,100 employees serving communities in Benton, Lane, Linn and Marion counties. The newest office, in Salem, opened in 2015. Dralle said that hiring and retention is a constant challenge: “We’re always hiring.”

Uncertain times

For hospitals and health clinics, uncertainty over funding at both the state and national level, caused by repeated attempts to repeal the Affordable Care Act and then Oregon's Ballot Measure 101, to determine the outcome of a health care tax enacted by the Oregon Legislature in 2017, are having a negative impact on job growth.

The area’s largest health care employer, Samaritan Health Services, is down 120 employees across the Benton, Linn and Lincoln county service area. Most of the job losses have been through attrition when people leave or retire, said CEO and President Doug Boysen.

“We have tried to avoid cuts to the clinical care areas,” Boysen said. “It’s been a gradual thing over an eight-month period.”

Some people have speculated that the state’s rapid expansion of Medicaid, starting in 2012, may have created a health care bubble. Health care providers had to ramp up operations quickly. Through the area’s coordinated care organization, an additional 20,000 patients who previously did not have insurance — many more than expected — became covered in a very short time period. Health care organizations were not prepared for the influx of new patients.

“There was no infrastructure in place to handle that new demand,” Boysen said. “We’ve been working the last couple years to build up the infrastructure to make sure we had access.”

Samaritan is pleased with the passage of Measure 101 last month, which ensures funding for continued health care coverage for hundreds of thousands of Oregonians. Boysen said he is looking forward to working with legislators to find more sustainable sources of funding for health services.

Oregon has emerged as a leader in health care transformation, Boysen said, and the model is working to hold costs down and provide better care to more people. That’s good for the health care industry and the economy.

“We have a really good system here and other good independent providers in our service area,” he said. “We have communities that really support us. We’re in a good position.”

Rebecca Barrett, a mid-valley freelance writer, is a frequent contributor to InBusiness.

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