By Andy Blye

The Nathaniel Witherell, the short-term disability care facility owned and operated by the town, is short on nursing staff.

The need for staff at the facility, which has 202 beds, fluctuates as the number of patients changes, officials said during recent budget meetings. Witherell leadership relied heavily on part-time workers last year and some of them ended up working full-time hours for higher rates of pay.

One part-time licensed practical nurse, Marie Joseph, made $216,827 last year, according to records provided by the Greenwich Human Resources Department.

As a part-time employee, Joseph’s base pay was just $9,783, but she made $116,000 from overtime last year plus an additional $90,721 in other earnings (like stipends and out-of-class pay) from the town in 2023.

Joseph was the 28th highest paid employee in town last year, according to HR records, and she made more money than the chief of police, the chief of the fire department, the head of Greenwich libraries and several other town departments. She even made more money than John Mastronardi, the executive director of the Witherell, who earned $191,289 last year.

Brad Markowitz, chair of the board of the Nathaniel Witherell, said he would not speak about Joseph's pay in particular, but that the facility has been over reliant on overtime in the recent past.

"While all well run nursing homes utilize some level of overtime in their nursing department, along with part time staff and access to per diem and agency staff, the primary driver of overtime at Witherell has been open full time positions," he wrote in a statement.

Joseph was not alone among Witherell part-timers that earned major overtime dollars in 2023. Four other members of the nursing staff that had base salaries under $10,000 ended up making at least $100,000 last year thanks to overtime pay.

Ten Witherell employees made at least $150,000 last year and seven of them were nurses, most of whom were full time staff nurses.

"Coming out of the pandemic it has been particularly hard to recruit permanent full time nursing staff to fill all of the approved positions," Markowitz said in his statement. "The team at Witherell is working to devise creative solutions to this challenge, and will collaborate with the Town HR Department to improve our ability to have an optimal staffing mix."

The Witherell is implementing a newer staffing model in the wake of multimillion dollar accounting issues that came to light last year. The Witherell hired an accounting firm to help redo their financials and the firm recommended that the Witherell deploy a "staffing matrix," which is typical for nursing home facilities.

The Witherell is unique in Connecticut because it is owned and operated by a town, whereas most nursing homes are owned by private companies or nonprofit organizations.

Markowitz said the Witherell was previously basing its staffing on the town's organizational chart, which did not adapt to changing patient census at the facility. As part of the new staffing model, the Witherell now pulls in "agency" staff, who are outside contractors that come into the Witherell to supplement regular employees.

Markowitz said, in general, the facility uses a mix of labor options to staff each day. This mix includes full-time nurses, part-timers, some people working overtime and agency staff.

He recently told the Board of Estimate and Taxation that overtime can breed burnout which ultimately means inferior patient care.

“No question, that we have people who are doing a lot of overtime and that's not just a financial issue. It's a quality issue. And all that needs to be looked at, understood, managed," he said during the Feb. 14 BET human resources committee meeting. "It's an ongoing process. … This is not going to change overnight.”