Lack of housing is a concerning issue for all parts of Montana’s economy, including in health care, where it's hard for the industry to hire and retain workers, a recent survey found.

Hospitals are often the largest private employer in a community, according to Rich Rasmussen, president and CEO of the Montana Hospital Association, who added that every hospital has a housing issue impeding its recruiting. When workers can’t find housing, the hospital can’t hire them, so the hospital can’t operate well and the community doesn’t benefit, he said.

A recent survey by the MHA found housing is the biggest issue hospitals face when trying to recruit workers. A list of issues facing potential employees include limited inventory and high prices for both homes for sale and for rent, especially for people with lower incomes, the survey found.

The housing shortage problem is twofold: A lack of housing availability and high housing costs.

Realtor.com numbers reported by the Independent Record show that during any month over the past year, the peak number of active home listings was down compared to 2019, and in some places listings are only a third of what they were two years ago.

In Bozeman, housing costs have increased 26% over the past year, with the median price for a single-family home just over $734,500 in September, the Bozeman Daily Chronicle reported. Home sales website Zillow reported the median price for a house in Montana is almost $350,000, more than 27% higher than in September 2020.

Home values in other parts of the state like Helena are skyrocketing as well, Rasmussen said.

Rasmussen said that many people think of well-paid doctors and nurses when considering hospital workers, but most hospital staff have much lower incomes. And in Montana, he said, most physicians are primary care providers with lower salaries than a specialty doctor such as a neurosurgeon, or they might be new graduates with less experience but a lot of student debt who can't afford a high monthly rent or mortgage payment.

The housing shortage coupled with the increased need for hospital staff brought on by the COVID-19 pandemic has lead some hospitals to get creative.

Northern Rockies Medical Center in Cut Bank has converted unused hospital rooms into apartments for staff, Rasmussen said, and a hospital in Glendive acquired duplexes for housing. He said other health care systems could also provide housing, but lack support and resources.

“We’ve got hospitals that have property but they don't have partners to help them develop the property into housing,” Rasmussen said. “With a state that is dominated by small, critical-access hospitals, the ability for those small hospitals and those small communities to develop the property is a challenge. It’s a challenge from the standpoint of financing if you’re a small hospital as well as actually secure the contractors and do the development of the project.”

Despite some hospitals' efforts to help workers access affordable housing, most hospitals have had to turn to temporary or traveling workers, which is a very expensive approach to staffing, Rasmussen said.

Montana Gov. Greg Gianforte recently initiated an incentive program in the form of a $12,500 relocation bonus to help attract health care workers to the state. Rasmussen said hospital systems are very optimistic about the incentive, but cautions it is still only a short-term solution. He pointed out that Montana has the lowest health care costs in the country.

“In order to be able to keep it that way, we need to make sure we have the resources to keep costs under control. And the largest cost center in a hospital is staffing," Rasmussen said. "So if we can’t get staffing costs into a place that is sustainable, then you’re going to see cost increases.”

Keeping health care and housing costs reasonable will require a commitment to finding sustainable solutions that will last over the long term, he said, and that approach will also strengthen the state's overall economy.

“If we want to grow the state, we need to invest in our system,” Rasmussen told The Center Square. “If we want to keep costs down, we need to invest in our workforce, and if we don’t address those issues long-term, it is going to be hard for us to meet the demands to continue to grow our economy as we all want to see it grow.”