Other staff were unwilling to cover this shift because the home is further away than most of the provider’s other homes. Also, the asleep shift was likely to be awake because the person was known for having challenging behaviors.  Further supporting staff’s unwillingness to cover this shift was that they would only receive $10/hour.

This RMS rate then affects the provider determining they could pay overnight staff $10/hour for asleep shifts.  

Another influence was the Minnesota State Legislature, who creates laws governing provider rates, enforcing a 7% decrease in reimbursement rates to providers in July of 2018.  This impacted the provider’s ability to give an annual raises to staff and in turn influenced the provider having a staff shortage.  