San Joaquin County’s public hospital is facing high vacancy rates for certain healthcare specialists, forcing it to turn to costly temporary staffing to fill gaps.
San Joaquin General Hospital has only three computed tomography, or CT, technicians; it’s authorized to have six full-time techs. The hospital also hasn’t been able to hire a magnetic resonance imaging, or MRI, operator.
There should be 28 full-time and 22 part-time respiratory therapists on staff, but there is currently a 40% vacancy rate among those positions. And the hospital is missing two of the three speech therapists it should have at full staff.
In a memo to the county Board of Supervisors, the 152-bed acute-care hospital reports that recruitment has been “challenging due to chronic supply shortages” when it comes to staffing for the operating rooms, radiology, social services, cardiology, the family maternity center, neonatal intensive care and emergency room.
Two factors have largely contributed to the shortages, hospital officials say. One is that, as San Joaquin County’s most prominent trauma center, the hospital has to staff certain positions around the clock; other facilities don’t have such a heavy personnel burden. The other issue is more competitive pay at private hospitals.
“These areas have struggled to successfully recruit due to the current rate that is paid by SJGH is significantly lower than the local market hospitals,” the memo states.
| Department | Vacancy rate | Allotted full-time staff | Allotted part-time staff |
| Magnetic resonance imaging (MRI) | 100% | 1 | 0 |
| Speech therapy | 67% | 2 | 1 |
| Computed tomography (CT) | 50% | 6 | 0 |
| Respiratory therapy | 40% | 28 | 22 |
| Environmental services | 22% | 51 | 46 |
| Radiology | 20% | 20 | 0 |
| Registered nurse | 19% | 448 | 454 |
| Physical therapy | 15% | 7 | 0 |
| Dietary | 10% | 33 | 23 |
To cope with the shortfalls, San Joaquin County awarded contracts totaling $9.4 million last week to nine staffing firms to cover critical healthcare positions at the hospital in French Camp.
Temporary staffing can be an expensive alternative. At one point, General Hospital had about 320 contracted registered nurses during the COVID-19 pandemic. They were “costing us a fortune,” at nearly $300 an hour compared to about $70 an hour for a staff nurse, hospital CEO Richard Castro told the Board of Supervisors. He said the number of contract nurses has now been substantially reduced.
Use of outside staffing services is common in the hospital industry. Patient volumes fluctuate over the year but can rise sharply if there are flu outbreaks or during cough-and-cold season. Vacations and employee absences also cause dips in staffing that require temporary workers.
But officials say San Joaquin General’s recruitment problems run deeper because the hospital doesn’t pay as much as other facilities.
Current job postings for physical therapists, one of the job classifications cited by Castro, show the disparity. The hourly rate at San Joaquin General ranges from $43.41 to $52.78. At St. Joseph Medical Center in Stockton, it’s $49.78 to $74.05.
At the board meeting, Supervisor Mario Gardea expressed concern about staffing levels. He said the county had made it clear that it wants to “get in front of” retention and recruitment issues.
Castro said there has been success in reducing the dependence on outside staffing firms for nurses.
About 20% of San Joaquin General’s 448 full-time and 454 part-time nursing positions remain unfilled. That number was reduced, in part, thanks to better pay for nurses under a labor contract the hospital reached with the California Nurses Association/National Nurses Union in March 2025. The new contract followed a strike.
“With this contract, San Joaquin County can be a competitive health care employer — meaning it can recruit and retain experienced nurses and avoid staffing crises,” Kelly Mertz, a registered nurse active with the union, said in a statement reported by Stocktonia at the time of the settlement.
Castro said that agreement has helped reduce the nursing shortage, saving the hospital millions of dollars a year.
He added that the hospital is doing all it can to retain worker. For instance, it encourages part-timers to go full time because there’s a better chance to retain them. The hospital also tries to make the emotional argument.
“We talk about the blessings of being able to serve the underserved at the same level that they would get anywhere else,” he said.