The staffing issues and price increases at West Virginia hospitals are not getting any better. The West Virginia Hospital Association says the costs of medical supplies are up more than 20-percent in the last five years, and in that same time pharmaceutical costs have gone up by 40-percent. Many hospitals are also fighting a shortage of staff, with upwards of 20-percent of positions unfilled, as salaries pay 10-to-20 percent less than similar jobs in hospitals in neighboring states.