Nursing homes continue to lose workers

Nursing homes and residential care centers employed three million people in July, down 380,000 from February 2020, according to the Bureau of Labor Statistics. Industry employment has fallen every month, except one, since the World Health Organization declared Covid-19 a global pandemic in March 2020. By contrast, job losses in the healthcare industry leisure and hospitality, another sector hard hit, began to invest in May last year and the industry has regained almost 80% of the jobs lost in the first months of the pandemic .

“I’ve been working in the industry for 40 years and I’ve never seen it so bad,” said Terry Robertson, executive director of Josephine Caring Community, a long-term care center in Stanwood, Washington.

He said turnover has been double that before the pandemic. “Last month we turned down 138 hospital admissions because we didn’t have staff to open another unit,” he said.

Administrators and workers say nursing home staff have left — and stayed away — because of Covid-19’s salary, exhaustion, and fear. They say improved unemployment benefit and competent job opportunities have also played an important role.

Sheena Bumpas, a nursing assistant in a dementia unit at a long-term care center in Duncan, Oklahoma, said staff shortages create a cycle that wears out workers entering or remaining in the field.

“When you lack people, you have to work harder because someone has to be there to take care of the residents. You work and work and after a while you just get burned, “said Ms. Bumpas, who has been working for 19 years and is vice president of the National Association of Health Care Assistants, a non-profit professional association work.

Industry experts are concerned that worker deficiencies are causing a deterioration in care.

“We see staff shortages as a safety hazard and a quality issue,” said Ari Houser, a statistician who manages the AARP Institute of Public Policy nursing home data board. .

Research shows that when homes are understaffed, residents ’attention may suffer from waiting longer to feed, take to the bathrooms, or receive answers to their calls for assistance. A study last year found that facilities with higher levels of nursing staff tended to have fewer Covid-19 outbreaks and related deaths.

The shortage of workers is a difficult situation in the long run for the industry. Wage dissatisfaction, combined with the fact that certified nursing assistants tend to receive little training and therefore develop few specific skills that link them to the field, means that workers frequently change jobs or leave the industry for complete features that pay a little more or offer better hours or benefits. The average salary of nursing assistants was $ 14.82 per hour in 2020, according to the Bureau of Labor Statistics.

Thousands of nurses and caregivers have become ill over the past 18 months and many reported fearing bringing the virus home to their families, according to federal data and academic research. Those who remained at work faced heavier workloads, new protocols related to personal protective equipment and bewildered families and residents who were separated during Covid-19 closures.

While the healthcare sector as a whole is facing a severe shortage of nurses and other workers, the industry has regained more than half of the jobs it lost in the spring of 2020.

Hospitals and other facilities also pay better than nursing homes and can attract nurses and assistants with the promise of higher salaries, better benefits and career opportunities, administrators and experts say.

Most nursing homes have few levers to increase pay or improve the attractiveness of work, said David Grabowski, a professor of health policy at Harvard Medical School. Between 80 percent and 85 percent of your income comes from Medicaid and Medicare, so your income depends largely on the reimbursement rates set by those programs, Grabowksi said. Medicare usually covers limited-period stays for beneficiaries, while Medicaid is the source of funding for many long-term residents. Hospitals, on the other hand, receive a large portion of their revenue from commercial insurance, Grabowski said.

At Josephine Caring Community, Mr. Robertson offers signs of bonuses of up to $ 7,000 to nurses and $ 3,000 to nursing assistants, along with bonuses for current employees referring to new contracts and has accumulated hourly pay. all places. You can afford to offer incentives and increase your salary because the nonprofit paid your mortgage and has investments that make money, he said. But Medicaid reimbursement rates limit the facility’s ability to compete for workers and therefore to make beds available for patients in need of residential care, he added.

Barbara Aldaz, facility staff coordinator, works a second shift as a nursing assistant once or twice a week or enters on weekends to fill or schedule schedules for the following days. “I’m basically working seven days a week,” he said, adding that this pace has been the new normal since late spring.

Covid-19 vaccines have brought relief to nursing homes as residents and staff infections have decreased. But they have also created another staffing challenge for concerned managers: workers will leave if asked to receive the shot. According to government data, about 61% of long-term care center staff are vaccinated and 83% of residents. According to federal data, Covid-19 cases are on the rise again, caused by infections among staff members.

Last week, President Biden said his administration would require nursing homes to vaccinate their staff against Covid-19 or risk losing Medicare and Medicaid funding.

The threat essentially forces nursing homes to comply, as much of their funding comes from these two programs, but “it will lead to a considerable outflow of [certified nursing assistants], which will make scarcity worse, “said Lori Porter, co-founder and executive director of the National Association of Health Care Assistants.” The fear is real, the outcome is unknown, but until everyone is vaccinated ( vendors, families and visitors), ”Ms Porter said,“ residents of nursing homes will not be truly protected ”.

Write to Lauren Weber to [email protected]