Kansas is spending tens of millions of dollars a year on traveling nurses because it can’t find full-time staff to fill positions at two state psychiatric hospitals.
But paying for temporary help is more expensive than hiring full-time employees.
Takeaways
- Kansas is spending millions more on a temporary solution to its nursing shortage at two state hospitals.
- The extra spending comes as state lawmakers are trying to reign in spending, but cutting contract nursing isn’t an option.
- Not enough people are applying for jobs at the state hospitals.
In 2025, the Larned and Osawatomie state hospitals spent $61.4 million on traveling nurses. Yet it would cost $47 million a year to replace all those contract nurses with full-time employees, said Scott Brunner, deputy secretary of hospitals and facilities with the Kansas Department for Aging and Disability Services.
KDADS doesn’t foresee a decline in contract nurses in the near future.
The debate over contract nurse spending comes as Kansas needs to cut its budget to prevent future shortfalls. The Trump administration’s recent budget bill is projected to cost the state $150 million.
The state also can’t cut contract nursing entirely.
Brunner said cutting nursing positions reduces the number of beds that patients could be using. Those people could end up in emergency rooms or jails.
“They’re going to be left with literally no other place to go for services,” he said.
Kansas’ problem is it needs to reduce expenses, and contract nursing costs have only grown. But the state can’t address its current nursing shortage without spending more to fix it.
Finding qualified staff now is tricky because multiple issues led to this staffing shortage. In August, both hospitals had job vacancy rates around 33%.
The COVID-19 pandemic devastated the health care workforce. The two state hospitals only spent $6 million combined on contract nursing in 2019, less than 10% of what they now spend. Today, the state doesn’t have the workforce to fill these positions. Not enough people apply for current openings. And Kansas needs to do more to increase the workforce.
Turning traveling nurses to state employees
Last year, the Larned State Hospital, the largest psychiatric hospital in Kansas, averaged 232 contract nurses a month. Osawatomie averaged 105.
Osawatomie’s is smaller, but its vacancy rate surpassed Larned in summer. The hospital has 44.62% vacant positions while Larned was at 44.23%.
Brunner said the state did convince about 20 traveling nurses to become state employees in the past year. But the hospitals are more than 230 employees short of being fully staffed and it isn’t likely the state can address its shortages this way, he said.
Contract nursing lets nurses travel across the country at a higher hourly rate than they could get in a full-time position.
A 2023 survey of traveling nurses found that 76% of contract nurses like their job. Only 51% of those nurses said they liked their last staff position.
The survey listed the top five reasons nurses take their first contract job:
- 84% said they do it for the money.
- 71% cited freedom and flexibility.
- 39% noted the sense of adventure.
- 28% appreciated the work-life balance.
- And 22% said ignoring hospital politics was a factor.
People surveyed were also asked to rank the importance of contract benefits. Health care plans and retirement contributions were the sixth and seventh most important perks, the survey said.
Contract nurses at Kansas state hospitals make about $65 an hour while state employees average $47 an hour with benefits. Besides reduced pay, rural settings like Larned and Osawatomie don’t offer the adventure that comes with traveling across the country.
“We are a little constrained on what we can offer people,” Brunner said. “(Some people) like that ability to go work for a fixed amount of time … and take a month off or take two months off and then move to another location.”
Finding full-time employees
Trying to find full-time employees through the contract nursing pool is no guarantee, but neither is opening up a position.
Brunner said Larned has 61 vacant nursing positions and the hospital won’t get 61 applicants to fill them. He said a really good month brings in 10 to 15 applicants.
The number of registered nurses in Kansas dropped 9.6% from 2019 to July 2025, said Barbara MacArthur, director of the Kansas Nursing Workforce Center at the University of Kansas Medical Center. The number of licensed practical nurses dropped 12.7% in that same time period.
A 2025 study of 2,600 nurses by Florida Atlantic University found that 65% of nurses are burned out and stressed. Only 60% said they would choose to become a nurse again.
Sixty-seven percent of nursing students are already worried about future workloads, and there is a decrease in the number of students at nursing schools.
An October 2025 article from the Hechinger Report said nursing schools are struggling to keep up. The article said there aren’t enough professors to teach classes and not enough hands-on training at medical facilities. Nursing schools nationwide turned away more than 65,000 qualified applications because schools lacked faculty, classroom space and budget flexibility, among other issues.
This comes as the nursing population is aging.
MacArthur said 25% of RNs and 23.4% of LPNs plan on retiring or leaving the field in the next five years.
Addressing workforce issues
Addressing workforce issues makes the state healthier, MacArthur said. Having an adequate number of nurses to Kansans means better health outcomes.
MacArthur is optimistic the state can address the shortage, despite the current negative trends.
She said her group is working to educate students about a career in nursing, hoping to convince more young Kansans to apply to become a nurse.
In Kansas, 84.5% of licensed nurses are working, and MacArthur and KU are asking the other 15.5% why they aren’t working. They are then turning those responses over to hospitals to see what benefits would get people back in the field — whether that be child care or help with aging family members.
At the state hospitals, Brunner also said there’s optimism. Larned had more state employees in 2025 than they’ve had in the past five years. That’s thanks in part to new bonuses designed to retain nursing staff.
He’s hoping the state can build on that momentum because the solution will require some work.
“In terms of an immediate kind of magic bullet,” Brunner said, “I don’t see what that is.”
