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ANALYSIS OF UTAH’SREGISTERED NURSEWORKFORCE- 2012Analysis completed in 2012 by:Clark Ruttinger
Analysis of Utah’s Registered Nurse Workforce Copyright 2012 by the Utah Medical Education Council230 South 500 East Suite 210 Salt Lake City, UT 84102-2062All Rights ReservedPrinted in the United States of AmericaInternet Address: www.utahmec.orgThis publication cannot be reproduced or distributed without permission. Please contact theUMEC at [email protected] or call (801)526-4550 for permission to do so.Suggested Citation: Utah Medical Education Council (2012). Analysis of Utah’s Registered NurseWorkforce. Salt Lake City, UT.
About UsThe Utah Medical Education Council (UMEC) was created in 1997 by H.B.141 out of a need tosecure and stabilize the state’s supply of healthcare clinicians. This legislation authorized theUMEC to conduct ongoing healthcare workforce analyses and to assess Utah’s training capacityand Graduate Medical Education (GME) financing policies. The UMEC is presided over by aneight member board appointed by the Governor to bridge the gap between public/privatehealth care workforce and education interests.Our Mission:To promote healthcare workforce planning, production, and policy through assessment,innovation, and collaboration with stakeholdersOur Vision:The Utah Medical Education Council holds assessment, collaboration, and innovation as its corevalues and focuses on the interdependency of the three to promote healthcare workforceplanning, production, and policy based upon the community's healthcare workforce needs.Core Responsibilities – Healthcare Workforce Assess – supply and demand Advise/develop policy Seek and disburse Graduate Medical Education (GME) funds Facilitate training in rural locationsFor more information please visit us at www.utahmec.org
Methods SummaryDataThis analysis was done by aggregating licensed registered nurse information obtained throughthe Utah Division of Occupational & Professional Licensing (DOPL) with employment dataobtained through the Utah Department of Workforce Services (DWS). The DOPL license datareflects all the licensed RNs in Utah as of January 31st, 2011. The DWS employment data is forthe 2011 calendar year.Information including age, gender, license issue and expiration dates, date of birth, and licenseaddress was obtained from DOPL data. Information regarding employer industry, county ofpractice and wage statistics was obtained from DWS data. The UMEC sorted the NorthAmerican Industry Classification System (NAICS) codes into 13 different healthcare workcategories for purposes of analysis.Data from University of Utah (U of U) and Intermountain Healthcare (IHC) employment recordswere used to adjust the across the state distribution of their employees. This was necessarybecause DWS information indicates that all RNs employed by these institutions are located inSalt Lake City where these organizations are headquartered.Data from a survey of all RN training programs in the state was provided by the UtahOrganization of Nurse Leaders. This information includes the number of applications for RNtraining received by Utah programs, the number of applicants accepted, the number ofgraduates from Utah programs, faculty information from each program and passing rates byprogram for the National Council Examination for Registered Nurses (NCLEX).RetirementAn assumption is made that RNs above the age of 55 years with expired licenses have let theirlicense expire due to retirement. RNs under 55 years of age are assumed to have allowed theirlicense to expire for reasons other than retirement. Data on reasons other than retirement forRN license expiration is not collected by any organization at this time.IncomeIncome for RNs is looked at in two different ways in this report. DWS publishes an OccupationalReport for RNs that provides annual inexperienced and experienced median income statisticsfor RNs statewide and by geographic area. DWS provided the UMEC with data on average RNincome by employer. Because the UMEC analysis only looks at average RN income by RNemployer, the average wage data in the report is lower than the average income data thatDWS provides in their Occupational Report for RNs. The UMEC analysis captures the differencesin income across RN healthcare work settings in the state that the Occupational Report doesnot show.
Executive SummaryThere were 24,370 RNs with active licenses issued by the state of Utah as of January 31, 2011.Of these, 81% (19,753) work in healthcare in Utah. Another 12% (3,044) of these are working innon-healthcare jobs in Utah and 6% (1,573) are not working in Utah.From 1989 to 2004 the State of Utah issued an average of 1,200 RN licenses per year. From2005 to 2010 the average has increased to 1,883 licenses per year.The largest percentage of RNs (26%) receive their RN license between the age of 25-29 years ofage. In addition, 20% of Utah’s RNs working in healthcare are over 55 years of age.Only 50% of all RN licenses issued 20 years ago are still active today. Through the age of 55,regardless of the age of an RN when a license is issued, an average of 49% of licenses haveexpired within 10 years of being issued. An average of 11% of RN licenses issued each year arenot renewed after the first licensing period. An average of 30% of RN licenses issued each yearare not renewed after three licensing periods.There could be a wide variety of explanations for these occurrences, from RN’s possibly leavingthe state or moving into an advanced practice role or RN’s deciding to focus on raising a familywith the intention of later returning to the workforce. There may also be the possibility of atendency toward professional burnout within 10 years. These trends warrant furtherinvestigation, including comparison to the license expiration trends of APRNs, PAs andPhysicians.Since 2005, an average of 1,563 RN licenses have expired in each 2-year license cycle (781expirations per year). Given the average 1,881 new licenses issued per year, this results in a netgrowth of 1,100 licenses per year. An average of 31% (242) of expired licenses per year can beattributed to retirement (over age 55).According to the DWS Occupational Report for RNs an inexperienced RN in Utah earns anaverage income of 48,530 per year. An experienced RN earns an average income of 59,420.UMEC wage analysis by healthcare work setting shows that the highest paid Utah RNs work inInsurance Activities and Administration/Government Support settings. These settings also havethe largest percentage of their workforce above 55 years of age. Additionally, 60% of Utah’s RNworkforce works in a hospital setting.There is a high demand for RN training in Utah. In the 2012 academic year there were 3,591qualified applicants for 2,172 positions in Utah’s training programs. About 40% (1,419) ofqualified applicants to Utah training programs were not accepted.
RN training programs in Utah graduated a total of 1,669 students in the 2010-11 school year.This is equal to 77% of the number of students accepted. Utah’s RN training programs have anaverage pass rate of 85.4% on the National Council Licensure Examination (NCLEX). This meansthat approximately 1,425 graduates from Utah’s RN training programs passed the exam toreceive their RN license. This equates to 65.6% of all Utah RN program enrollees passing alicensure exam after completion of a degree.An average of 1,883 new RN licenses are issued annually in the state of Utah. If 81% of theselicenses are working in healthcare in Utah, then we will have 1,525 new RNs in our workforceeach year. Our state training programs graduate about 1,425 NCLEX certified RNs each year. Ifall of these graduates are getting a Utah license, it is likely that Utah’s training programs arewithin 100 RNs per year of Utah’s entire annual supply of RNs.6 P a g e
Tables and FiguresTable 1: Utah’s RN Workforce. 8Table 2: Utah RNs by Age at Issue Year and Age at Expiration . 10Table 3: Utah RNs Working in Healthcare with Utah Wages Reported by Age and County of EmploymentAdjusted for IHC and University of Utah Employees . 11Table 4: Utah RNs Working in Healthcare in Utah by County and Work Setting. 13Table 5: Utah RN Income- DWS Occupational Report for RNs . 14Table 6: Utah RNs Annual Gross Compensation, By Healthcare Work Setting- UMEC Analysis . 15Table 7: Utah Organization of Nurse Leaders Survey Results. 15Figure 1: Utah RN Licenses Issue in Utah 1989 to 2010 . 8Figure 2: Utah RN Licenses Issued by Year- % Male 1989 to 2010. . 8Figure 3: Average Distribution of Age Cohorts at Issue Year . 9Figure 4: Percent of Utah RN Licenses Issued Not Renewed . 9Figure 5: Utah RN Licenses Issued by Year: % Living out of State, % Not Renewing After First LicensePeriod Living out of State 1989 to 2010. . 9Figure 6: Expired Utah RN Licenses by Age 1989 to 2010 . 10Figure 7: Age Distribution of Utah RNs Working in Healthcare- Single vs. Multiple Jobs . 12Figure 8: Utah RNs Working in Health Services by Healthcare Work Setting and Age . 12Figure 9: Utah RNs Average Annual Gross Compensation . 14Figure 10: Utah’s RN Workforce Supply and Employment Demand . 167 P a g e
Table 1: Utah’s RN WorkforceActive Utah RN Licenses Working In Health Care in UtahActive Utah RN Licenses Working Non-Healthcare JobsActive Utah RN Licenses Not Working in UtahTotal Active Utah RN Licenses19,7533,0441,57324,37081%12.5%6.5%100%81% of RNs with an active Utah license are working in a healthcare position in the state.Figure 1: Utah RN Licenses Issue in Utah 1989 to 2010Number of Licenses Issued2500100%2,222 34100084650046%50%52%57%48%60%1,119 1,132 93199720012005Issue Year% Currently ActiveLicenses Issued Per Year20092010From 1989 to 2004 the State of Utah issued an average of 1,200 RN licenses per year. From2005 to 2010 the average has increased to 1,883 licenses per year, indicating a growth patternin the workforce. Looking back to 1989-1991 though there also seems to be a trend of rapidlicense expiration with only 50% of all licenses issued 20 years ago still active today.Figure 2: Utah RN Licenses Issued by Year- % Male 1989 to 2010.19%17%Percent of Licenses 010% MaleAn average of 13% of Utah RN licenses are issued to males.8 P a g e
Figure 3: Average Distribution of Age Cohorts at Issue Yearfor Utah RN Licenses Issued 2005 to 201055-59, 4%60-64, 2% 65 , 1%50-54, 6% 25, 24%45-49, 6%40-44, 7%35-39, 10%25-29, 26%30-34, 15%From 2005 through 2010, 50% of RNs received their license before age 29.Percent of Licenses IssuedFigure 4: Percent of Utah RN Licenses Issued But Not RenewedAfter First and Third Licensing Periods %11%0%6%14%14%16%12%9%6%198919931997% Not Renewing After First Licensing Period11%14%200120052009% Not Renewing After Third Licensing PeriodAn average of 11% of RN licenses issued are not renewed after the first licensing period. About30% of RN licenses are not being renewed after three licensing periods.Figure 5: Utah RN Licenses Issued by Year: % Living out of State, % Not RenewingAfter First License Period Living out of State 1989 to 2010.Percent of 18%20%20%10%0%3%3%5%1989 1991 1993% Living Out of State5%11%11%9%11%7%7%9%1995 1997 1999 2001 2003 2005 2007 2009 2010% Not Renewing After First Full Licensing Period- Living Out of State9 P a g e
An average of 23% of Utah RN licenses are issued to individuals with an out of state address. Anaverage of 7% of licenses issued each year are to individuals with out of state addresses who donot end up renewing after the first licensing period.Figure 6: Expired Utah RN Licenses by Age 1989 to 69%73%69%75%Under 55Over 55Since 2005, an average of 1,563 RN licenses have expired in each 2-year license cycle (781expirations per year). Given the average 1,881 new licenses issued per year, this results in a netgrowth of 1,100 licenses per year. An average of 31% (242) of expired licenses per year can beattributed to retirement (over age 55).Table 2: Utah RNs by Age at Issue Year and Age at ExpirationAgeCohort atIssue Year 2525-2930-3435-3940-4445-4950-5455-5960-6465 TotalAge at Expiration 13,72965 0164,5503,4062,4651,5348483687,588Through the age of 55, regardless of the age at which a license is issued, an average of 49% oflicenses have expired within 10 years of being issued. There could be a wide variety ofexplanations for this trend, from RN’s possibly leaving the state or moving in to an advancedpractice role. RN’s could be deciding to focus on raising a family with the intention of laterreturning to the workforce. There may also be the possibility of professional burnout within 10years.10 P a g e
Table 3: Utah RNs Working in Healthcare with Utah Wages Reportedby Age and County of Employment1County of Employment 55Years ofAge 55Years ofAgeMissing TotalBear River Multi County District(Box Elder, Cache, Rich)27390371734*CacheWeber River Multi-County District(Davis, Morgan, Weber)*Davis*WeberUintah Basin Multi-County District(Daggett, Duchesne, 29921,72836%64%22158342% Urban Share of District57 5Southwestern Utah Multi-County District(Beaver, Garfield, Iron, Kane, Washington)20192*Washington14683064280No Urban Counties1,12365686677%Southeastern Utah Multi-County District(Carbon, Emery, Grand, San Juan)17078 5249No Urban CountiesCentral Utah Multi-County District(Juab, Millard, Piute, Sanpete, Sevier, Wayne)12033105258No Urban CountiesGreat Salt Lake Multi-County District(Salt Lake, Tooele)8,4932,5803811,111*Salt LakeProvo River Multi-County District(Summit, Utah, Wasatch)Out of 6519%37 54,03620%29619,753100%N/A17,93691%* Census Designated Urban Counties† Out of State- Employer address out of state with wages reported in Utah Missing consists of DOPL license data where there was no date of birth available. In addition it includes RNswho work in the specified county as verified by IHC and the U of U.91% of RNs working in Utah in healthcare work in an Urban County20% of RNs working in healthcare are over age 55.1Adjusted for IHC and University of Utah Employees11 P a g e
Figure 7: Age Distribution of Utah RNs Working in Healthcare- Single vs. %41%30%35%28%20%24%10%0% 2525-3435-44Single Job45-5455-6465 Multiple JobsThe age of an RN is inversely correlated to whether or not they are working more than one jobin a health care work setting. The older an RN gets, the less common it is to have multiplehealthcare jobs.Figure 8: Utah RNs Working in Health Services by Healthcare Work Setting and 71%26%83%74%27%73%0Below 5538%33%48%23%35%27%62%67%52%77%65%73%Above 5512 P a g e
60% of Utah’s RN workforce works in a hospital. About 21% (2,496) of RNs working in hospitalsare above the age of 55. Notably, a larger percentage of RNs over 55 years old work inInsurance Activities and Government/Administration Support than in other healthcare workcategories.00 5 54229007733305952 5 5337232412912402317814733818503315 5 5 5 5 504902911992872198 592246867760187111,688949738506190 5018 50 554 52803833703912280000010077 5 5 5 545364845135321211200 51670029002010 5249175991002200 55 Total760OTHERTECHNICALSERVICESOFFICES OFHEALTH CAREPROVIDERSHOME HEALTHCARE LSERVICESADMIN/ GOVTSUPPORT2221County of EmploymentBear River Multi CountyDistrict(Box Elder,Cache, Rich)*CacheWeber River MultiCounty District (Davis,Morgan, Weber)*Davis*WeberUintah Basin MultiCounty District(Daggett, Duchesne,Uintah)Southwestern UtahMulti-County District(Beaver, Garfield, Iron,Kane, Washington)*WashingtonSoutheastern UtahMulti-County District(Carbon, Emery, Grand,San Juan)Central Utah MultiCounty District (Juab,Millard, Piute, Sanpete,Sevier, Wayne)Great Salt Lake MultiCounty District (SaltLake, Tooele)*Salt LakeProvo River MultiCounty District(Summit, Utah,Wasatch)*UtahOut of State*TotalPercent ofWorkforceRESIDENTIAL CAREFACILITIESTable 4: Utah RNs Working in Healthcare in Utah by County and Work Setting986313546351 5 28627 5 9410751,332866312346250 5 28027 5 86107 5 1,290106 50325802414 684932296829 270 2,406 11,881 158 294 1,601 307 69 639 1,117 183 19,7534% 1% 12%60%1% 1% 8%2% 0% 3% 6%1% 100%* Census Designated Urban Counties* Out of State- Employer address out of state with wages reported in Utah or Utah License with address out ofstate13 P a g e
Table 5: Utah RN Income- DWS Occupational Report for RNs2Area NameBear RiverCentral UtahEastern UtahOgden-Clearfield MetroProvo-Orem MetroSalt Lake MetroSouthwest UtahSt.George MetroUtah StatewideAnnual Inexperienced Median 43,552 44,490 44,940 49,080 47,690 49,710 47,540 44,960 48,530Annual Median 54,516 56,660 56,610 59,290 58,610 60,830 58,670 57,240 59,420Figure 9: Utah RNs Average Annual Gross Compensationby Healthcare Work Setting- UMEC Analysis 3 See table 6 for complete detailAvg. Annual Wages in Thousands 60 50 53 46 45 41 40 35 29 25 30 20 41 19 17 33 34 26 23 31 19 32 23 38 36 32 24 17 10 10 0Primary EmployerSecondary Employer2Income for RNs is looked at in two different ways in this report. DWS publishes an Occupational Report for RNsthat provides annual inexperienced and experienced median income statistics for RNs statewide and by geographicarea. DWS provided the UMEC with data on average RN income by employer. Because UMEC analysis only looks ataverage RN income by RN employer the income by employer data that is included in the report is lower than theaverage income data that DWS provides in their Occupational Report for RNs. The UMEC analysis does howevershow differences across RN healthcare work categories in the state that the Occupational Report does not show.DWS Occupational Report for Registered Nurses in Utah published online .do?soccode 291141&oititle Registered%20Nurses*3While DWS does publish Utah RN income data averages by geographical area, income data across healthcarework categories is not published. The UMEC has analyzed the average (mean) RN wage by employer in order toshow differences across RN healthcare work categories in the state.14 P a g e
Table 6: Utah RNs Annual Gross Compensation, By Healthcare Work Setting- UMEC AnalysisPrimary EmployerRN Work SettingSecondary EmployerMean*Median†Std. Dev.**Mean*Median†Std. Dev.**ADMIN/GOVT SUPPORT 45,681 50,163 7,926 18,941 10,587 10,481AMBULATORY 41,374 40,406 34,765 17,135 9,775 10,384EDUCATIONAL SERVICES 35,334 34,105 7,113 16,504 12,265 15,053HOME HEALTH CARE SERVICES 29,289 24,902 11,081 25,381 24,582 17,378HOSPITALS 44,633 43,947 4,592 10,224 5,105 7,579HUMAN RESOURCES 25,500 17,802 6,681 22,765 17,790 9,293INSURANCE ACTIVITIES 53,241 57,704 9,240 32,688 31,790 14,404OFFICES OF HEALTH CARE PROVIDERS 33,581 29,875 18,399 19,087 17,255 9,889RESIDENTIAL CARE FACILITIES 31,195 28,083 10,793 23,490 16,209 6,522SOCIAL ASSISTANCE 32,137 31,980 20,554 41,058 39,446 8,330TECHNICAL SERVICES 38,047 31,716 29,891 31,842 31,893 17,039OTHER 36,356 29,664 25,610 23,987 19,187 10,900* Mean average of mean RN wages by employer† Mean average of median RN wages by employer**Standard deviation of meansIn addition to having a larger percentage of RNs within each workforce above the age of 55, RNsworking in Insurance Activities and Admin/Government Support also have the highest grosscompensation of RNs in any work setting.Table 7: Utah Organization of Nurse Leaders Survey ResultsTotal Applications ReceivedNumber of Qualified ApplicationsNumber of Students Accepted to a ProgramNumber of Students Graduated4,0193,5912,1721,669The Utah Organization of Nurse Leaders (UONL) gathers data on the states RN trainingprograms. For the 2010 -11 school year, RN training programs in the state received 4,019applications for admission. Of these, 89% (3,591) of applications were from qualified applicants.Out of these qualified applicants 60% (2,172) were admitted into an RN training program inUtah. Having 1,419 qualified applicants (40% of all qualified applicants) not able to get into aprogram shows a high demand and competition for training in the RN profession.RN training programs in Utah graduated a total of 1,669 students in the 2010-11 school year.This is equal to 77% of the number of students accepted. Utah’s RN training programs have anaverage pass rate of 85.4% on the National Council Licensure Examination (NCLEX). This meansthat approximately 1,425 graduates from Utah’s RN training programs passed the exam toreceive their RN license. This equates to 65.6% of all Utah RN program enrollees passing alicensure exam after completion of a degree.15 P a g e
To summarize, an average of 1,883 new RN licenses are issued annually in the state of Utah. If81% of these RNs are working in healthcare in Utah, then we will have 1,525 new RNs in ourworkforce each year. Our state training programs graduate about 1,425 NCLEX certified RNseach year. If all of these graduates are getting a Utah license, it is likely that Utah’s trainingprograms are within 100 RNs per year of Utah’s entire annual supply of RNs.Figure 10: Utah’s RN Workforce Supply and Employment Demand1,8831,525Average Number of New LicensesIssued per Year1,425Estimated Number of NewlyLicensed RNs Working inHealthcare in UtahEstimated Number of RNStudents Passing NCLEX in 201116 P a g e
Active Utah RN Licenses Working In Health Care in Utah 19,753 81% Active Utah RN Licenses Working Non-Healthcare Jobs 3,044 12.5% Active Utah RN Licenses Not Working in Utah 1,573 6.5% Total Active Utah RN Licenses 24,370 100% 81% of RNs with an active Utah l
