West Central Florida Status Report on Nursing Supply and Demand July 2016

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West Central Florida Status Report on Nursing Supply and Demand July 2016 About the West Central Florida Region Regional Reports The Florida Center for Nursing was established in statute to address the nurse workforce issues in the state. To that end, the Center collects and analyzes data to evaluate changes in the state s nurse supply and its demand for nurses. This report provides a regional perspective to these topics as well as a demographic summary of the area. Data are current as of 2015. Community Demographic Information According to 2014 U.S. Census estimates 1, the population of the West Central Florida region represents 22.5% of the statewide population. Residents of West Central Florida earned an average income of $58,509. Almost 14% of the regional population lives below poverty level, compared to the statewide poverty rate of 12.2%. The largest percentage of residents (13.4%) are between the ages of 50 and 59, and the median age is 44 years. Less than 50% of the regional population are male and 51.5% are female. The majority of residents have obtained a high school diploma and have attended some college. Nurse Workforce In West Central Florida, s remain the largest of the nursing disciplines. s are employed in hospitals more so than any other setting, and the greatest number of vacancies are in a hospital setting. The majority of s specialize in acute and critical care. Since 2010, the number of positions have increased overall, particularly in hospitals and home health agencies. position growth has declined in hospices and public health agencies in the past five years. The percentage of s obtaining MSN degrees has increased since 2010. Further, the percentage of s entering retirement has also increased over time. APs have attained more advanced education and gained a greater workforce presence since 2010, and are employed in hospitals more so than any other setting. The majority of APs specialize in adult and family health and anesthesia. Since 2010, more APs are working in long-term care facilities. The percentage of black APs has increased since 2011. s have experienced a slight decline in growth since 2011. Currently, the majority of s work in longterm care settings, and the greatest number of vacancies are in home health agencies. The majority of s specialize in geriatrics. Since 2010, the number of s working in hospitals has decreased, and position growth in hospitals and hospices has declined. However, the number of vacancies in hospitals has increased over time (along with public health and home health agencies). position growth has also increased in home health agencies. July 2016 West Central Florida Status Report 1

The Supply of Nurses 1 Change in the Potential Nurse Workforce 2013 2015 % Change 42,575 46,672 9.6% AP/ CNS 3.686 4,490 21.8% 100% 95% 90% 85% 80% & AP Work Status, 2014-2015 5.2% 4.6% 2.6% 0.2% 2.0% 85.5% 3.7% 1.8% 1.5% 0.2% 1.0% 91.9% Not seeking work at this time Retired Seeking work as a nurse Seeking work in a field other than nursing NA 13.897 13,683-1.5% 75% AP/CNS Employed as a nurse 10 The potential and AP workforce (those with an active license, eligible to practice, and with a Florida address) in West Central Florida grew by 21.8%, with the greatest growth occurring for APs. The workforce declined by 1.5%. Over 85% of s were currently employed in a nursing position and 92% of APs were employed in nursing. Since 2010, the percentage of s entering retirement has increased. 70,000 60,000 50,000 40,000 30,000 20,000 10,000 Nurse Supply as of December 2015 59,309 Total In Database 54,667 Potential Workforce 46,672 Estimated # Working 20,257 16,636 13,683 5,163 4,943 4,490 AP/CNS Nurse Workforce Demographics Men Age 51+ Hispanic AP Black White 0% 20% 40% 60% 80% 100% West Central Florida had a potential supply of 54,667 nurses, but only 46,672 (85%) were actually working in nursing. Among working nurses, 10.6% of s and s, and 13.3% of APs, were men. In terms of age, 45.8% of s, 44.2% of APs, and 3.6% of s are over age 51. The percentage of white nurses is higher than the state average for all three disciplines and also higher than the 2014 Census estimates (for AP s and s) for the region. Since 2011, the percentage of black APs has increased. July 2016 West Central Florida Status Report 2

Employed Nurses per 100,000 Population % Nurses Employed by Setting, 2015 1200 1000 800 600 400 200 0 1,044 974 306 256 100 93 West Central Region Statewide AP Setting n=46,672 AP n=4,490 n=13,683 Hospital 62.1% 43.4% 8.3% Long-Term Care 5.1% 3.9% 39.8% Home Health 6.4% 1.8% 13.4% 5.9% 4.8% 6.4% Physician s Office 2.4% 20.6% 12.4% Ambulatory 4.7% 7.8% 2.7% As of December 2015, West Central Florida had more s, APs, and s per 100,000 population compared to the state overall. The proportion of APs has increased in the past five years. About 62% of s were employed in hospitals. 43.4% of APs worked in hospitals, almost 20.6% worked in health provider offices. The percentage of APs employed in long-term care facilities has increased since 2010. Almost 40% of s were employed in long-term care, and the percentage of those employed in hospitals has declined over time. Clinical Specialty Acute/Critical Care 18.3% Emergency/Trauma 5.8% Home Health 5.9% Medical Surgical 14.0% Operating Room 7.0% 13.6% % of s Clinical Specialty Adult/Family Health 9.7% Geriatric/Gerontology 30.9% Home Health 10.0% 14.8% Pediatrics 4.9% Rehabilitation (non psychiatric) 7.0% % of s AP Clinical Specialty Acute/Critical Care Adult/Family Health Anesthesia Pediatrics Women's Health/OB GYN 7.3% 9.2% 7.9% 5.3% 20.6% 18.7% % of APs July 2016 West Central Florida Status Report 3

Highest Education Degree among Employed Nurses Highest Degree Held AP Diploma/Associate 49.2% 2.7% BSN 33.7% 13.3% Bachelor's Non- Nursing 9.9% 1.2% MSN 4.6% 77.2% Master's Non-Nursing 2.0% 0.6% Doctorate in Nursing 0.3% 4.9% Doctorate Non-Nursing 0.3% 0.2% In West Central Florida, 18.3% of s specialized in acute and critical care, and 30.9% of s specialized in geriatrics. 20.6% of APs specialized in adult and family healthcare and 18.7% specialized in anesthesia. In terms of education, the majority of s held a diploma or Associate s degree. Most APs (77.2%) held MSNs. Since 2010, the percentage of s holding MSN degrees increased. The percentage of APs holding a diploma, Associate s, non-nursing Bachelor s, non-nursing Master s, and non-nursing Doctorate degrees has decreased; and the percentage of those holding a BSN or nursing-related Doctorate degree increased. Progress is being made toward achieving the Institute of Medicine s recommendation 4 to increase the proportion of employed s with a BSN to 80% by 2020. Currently, 40.8% of working s in the region meet this recommendation; up from 34.8% in 2011. July 2016 West Central Florida Status Report 4

The Demand for Nurses 2 Estimated Number of Full and Part- Time Vacancies as of 06/30/2015 Estimated # Vacancies Estimated # Vacancies Hospitals 2258.6 76.4 Skilled Nursing* - - Home Health 509.0 380.2 Hospice 62.0 10.0 Public Health 10.5 9.4 Psychiatric* - - Total 2,840.1 476.0 Estimated Full and Part-Time Position Growth through 2016 Position Growth Position Growth Hospitals 1353.3 12.6 Skilled Nursing* - - Home Health 977.4 726.5 Hospice 20.3 4.1 Public Health 9.1 0.0 Psychiatric* - - Total 2,360.2 743.0 * Data for Skilled Nursing Facilities and Psychiatric Facilities not reported due to low response rates In West Central Florida, most of vacancies were within hospitals and home health agencies. The number of vacancies have increased overall since 2010, particularly in hospitals and home health agencies. The majority of vacancies were in home health agencies. vacancies have increased overall since 2010, particularly in hospitals, home health, and public health agencies. An estimated 2,360 new positions and 743 new positions may be created in West Central Florida through 2016. Most of the new positions will be created in hospitals and home health agencies. Since 2010, position growth has increased overall, particularly in hospitals and home health agencies. position growth declined in hospices and public health agencies. Most of the new positions will be created in home health agencies. Since 2010, position growth increased in home health agencies, and declined in hospitals and hospices. There were too few skilled nursing and psychiatric hospital respondents in the West Central region to provide reliable estimates for these industries. Additionally, due to the low response rate of the Nursing Demand Report, data related to vacancy rates and turnover rates are not reported at the regional level. For more information: 1. Source: U.S. Census Bureau, 2010-2014 American Community Survey 5-Year Estimates 2. Nurse Supply Reports, http://www.flcenterfornursing.org/statewidedata/nursesupplyreports.aspx 3. Nurse Demand Reports, http://www.flcenterfornursing.org/statewidedata/nursedemandreports.aspx July 2016 West Central Florida Status Report 5