If you’re not having difficulty in filling open staff positions, your long-term care facility is among the very few that aren’t. Nationwide, these healthcare organizations are struggling with a protracted labor shortage that leaves many providers wondering how to meet critical care needs with too few workers.The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) surveyed 616 nursing homes and 122 assisted living communities in 2021 to better understand the workforce challenges these organizations are facing. The results show a dire problem that’s only getting worse.
In fact, 43% of respondents representing nursing homes and 25% of those affiliated with assisted living facilities reported that their overall workforce situation is much worse in 2021 than it was in 2020. Another 30% (nursing homes) and 34% (assisted living centers) said their situation had somewhat worsened between 2020 and 2021. In all, 81% of assisted living respondents and a whopping 94% of nursing homes indicated their organizations were dealing with staffing shortages. Over half reported a challenge in filling current needs for staff in positions that ranged from housekeeping and dietary staff to registered nurses, licensed practical nurses and certified nursing assistants.
Bureau of Labor data shows that just since the pandemic began nursing homes have lost over 15% of their total workforce, with 241,000 employees leaving the industry between February of 2020 and March of 2022. This dramatic loss leaves nursing homes and assisted living facilities (at 6.2%) the hardest hit by far among all healthcare sectors while the broader industry continues to struggle with staffing shortages, albeit to a lesser degree.
Potential action from government could help
What’s the solution to a problem so pervasive that shows no signs of abating any time soon? Mark Parkinson, president and CEO of AHCA/NCAL, hopes federal and state legislators will take action to ease the challenges these organizations are wrestling with.
“Our country must make significant investments to help address these shortfalls,” he says, referring to the workforce issues highlighted in the survey. “We have laid out proposals in our Care For Our Seniors Act that would enable our providers to address staffing shortages, but without help from Congress and state legislators, this will not be possible.” ACHA/NCAL also support the Building America’s Health Care Workforce Act introduced in May of 2022 as well as other proposed legislation designed to ease the strain on the healthcare industry.
With Congress gridlocked and little hope of quick action for meaningful legislative change, LTC leaders are doing the best they can to attract and retain urgently needed staff with available resources. Many are using temporary staff sourced through agencies, and most are asking or requiring existing staff to work longer hours, overtime and extra shifts as needed to cover critical gaps. Of course, this puts employees under further stress, and even with these strategies in place the crisis continues to intensify.
Plenty of barriers but few solutions
It’s hard to find much light at the end of the staffing tunnel right now. When hiring gets tough, employers typically respond by raising wages and offering enhanced benefits to attract and retain the team they need to support operations and deliver optimal organizational performance. LTC facilities are doing what they can toward that end but the financial realities make major wage and benefits increases a fiscal impossibility.
Medicare and insurance rates are fixed figures that don’t flex to meet this current crisis. That leaves LTC providers stuck between the proverbial rock and hard place as they try to provide quality care for patients and fulfill all regulatory obligations, while often lacking the requisite staff to perform even the basics. The upshot is that existing staff are overworked and at risk of burnout, and the healthcare organizations they represent are themselves at high risk of being forced to limit admissions — or in some cases, face the prospects of closing their doors entirely.
Long-term, systemic solutions that support the entire healthcare industry are clearly needed, and there’s no real way around that fact. However, innovative short-term strategies and careful management can allow nursing homes and assisted living centers to navigate some of the turmoil; expert guidance and industry insights can help leaders cope with staffing issues and other concerns. If your organization is struggling or has questions about the best way to meet today’s challenges, contact the experienced healthcare industry advisors at Mauldin & Jenkins.