Long-term care has faced staffing challenges for years, and the pandemic has only made it worse.
March 2022 – The Journal of Healthcare Contracting
By Pete Mercer
In the last couple of years, we have seen the coronavirus pandemic stretch and exhaust the healthcare industry past any semblance of what it used to look like. The ramifications of the current state of the healthcare system will likely be felt for many years to come, especially in the long-term care sector. Long-term care is currently going through what experts are calling a dangerous staffing crisis that could put the future of this sector of the healthcare industry in jeopardy.
The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represents over 14,000 nursing homes and assisted living communities across the country that provide care to approximately 5 million people each year. The AHCA/NCAL recently released a report showing that long-term facilities are suffering from the worst labor crisis and job loss of any other health care sector, with an employment level drop by 14% (about 221,000 jobs) since the start of the pandemic.
Staffing levels in other healthcare sectors have fluctuated in the past couple of years, but nursing homes and assisted living facilities are still experiencing substantial job losses. According to a study conducted by the AHCA/NCAL in 2021, 86% of nursing homes and 77% of assisted living providers have said that their workforce situation has gotten worse in recent months, while 58% of nursing homes are even limiting new admissions. This is not only an unsustainable situation for these long-term facilities, but it’s also dangerous and detrimental to a vulnerable part of the population that depends on this industry.
In a media release, Mark Parkinson, president and CEO of AHCA/NCAL, said, “As many caregivers are getting burned out by the pandemic, workers are leaving the field for jobs in other healthcare settings or other industries altogether. Chronic Medicaid underfunding, combined with the billions
of dollars providers have spent to fight the pandemic, have left long-term care providers struggling to compete for qualified staff.
Parkinson said, “We desperately need the help of policymakers to attract and retain more caregivers so that our nation’s most vulnerable have access to the long-term care they need.”
“We desperately need the help of policymakers to attract and retain more caregivers so that our nation’s most vulnerable have access to the long-term care they need.”
Why workers are leaving
To put it simply, long-term care providers are exhausted. As we have seen over the last two years, when a workforce is understaffed, it creates a trickle-down effect throughout the whole industry. Long-term care facilities have trouble with staffing workers, which creates an unnecessary strain on those who are working, which further perpetuates this cyclical nightmare of exhaustion that so many are experiencing right now.
Cristina Crawford, Senior Manager, Public Affairs for the American Health Care Association, said, “This pandemic has taken an enormous toll on our staff and residents. Not only have many experienced tremendous losses, but it has also been exhausting – physically and emotionally – battling this virus day in and day out.”
Essential workers are dropping left and right. Additionally, Crawford described long-term care providers as “chronically underfunded,” which limits any sort of competitive edge they would need to hire new people. Crawford said they “cannot compete with other healthcare settings, like hospitals, that can offer better pay and benefits.”
This isn’t a new issue. Long-term care has faced staffing challenges for years, and the pandemic has only made it worse. Crawford said, “Workforce recruitment and retention has been an ongoing challenge prior to the pandemic, and we have been calling for help for years. Now, the pandemic has exacerbated our workforce challenges, and we are in a full-blown crisis.”
The effects on the residents
When healthcare workers suffer, the patients suffer. Without a stable option in place, residents and families are often left to find care alternatives that are less than optimal. Losing these workers is a dangerous prospect for the residents and patients of long-term care providers.
“The workforce crisis threatens access to care for vulnerable seniors,” Crawford said. “More than half of nursing homes are limiting new admissions because of staffing shortages.” Not only are the families put in a difficult position regarding the safety and care of their loved ones, but hospitals are unable to discharge patients if there are no long-term care options available. This also perpetuates the vicious cycle with COVID surges.
It’s also important to remember that this isn’t a problem that’s going to resolve itself. There will always be an elderly population that will need to be cared for, whether there are places to provide that care or not. “If policymakers do not act, the consequences will be devastating and could result in nursing home closures, which will ultimately affect access to care that our nation’s seniors need and deserve,” Crawford said.
The path forward
For long-term care providers to begin the road to recovery, Crawford said they would need immediate assistance from federal and state public health officials to support the frontlines and prioritize resources for long-term care providers. Crawford also argued for a long-term solution to “help recruit and retain the next generation of caregivers and to prepare for a growing elderly population.”
“Policy makers must act and support the multi-tiered workforce proposals we have put forth in our reform agenda, the Care for Our Seniors Act,” Crawford said. “These proposals include assistance programs for caregivers like affordable housing and childcare, tax credits, loan forgiveness, and incentives for higher learning institutions to train the next generation of healthcare heroes.”
State and federal policy makers also need to do things like fully fund Medicaid, which would allow long-term care providers to invest in their workforce and have a competitive hiring edge. “The strategies laid out in the Care for Our Seniors Act offer a comprehensive approach to recruit more health care heroes to help solve this workforce crisis,” Crawford said.