The American Health Care Association (AHCA) and the National Center for Assisted Living (NCAL) on September 22, 2021, released results of a survey of nursing home and assisted living providers across the U.S. AHCA/NCAL stated that the results of the survey highlight an urgent need for Congress to address the labor shortage facing the long term care industry.
Over 1,100 nursing homes and assisted living providers participated in the survey. Key findings of the results of the survey include:
- 86 percent of these nursing homes and 77 percent of the participating assisted living providers said their workforce situation has gotten worse over the last three months.
- Nearly every nursing home (99 percent) and assisted living facility (96 percent) in the U.S. is facing a staffing shortage. Additionally, 59 percent of nursing homes and nearly one-third of assisted living providers are experiencing a high level of staffing shortages.
- More than 7 out of 10 nursing homes and assisted living communities said a lack of qualified candidates and the unemployment benefits being paid to those who are not working have been the biggest obstacles in hiring new staff.
- Due to these shortages, nearly every nursing home and assisted living community is asking staff to work overtime or extra shifts. Nearly 70 percent of nursing homes are having to hire expensive agency staff, and 58 percent of nursing homes are limiting new admissions as a result.
- An alarming finding is that 78 percent of nursing homes and 61 percent of assisted living facilities are concerned that workforce challenges might force them to close. More than one-third of nursing homes are very concerned about having to shut down their facility(ies).
President and CEO of AHCA/NCAL Mark Parkinson stated, “Lawmakers across the country must prioritize long term care, and that begins with providing resources to address workforce challenges. When facilities have the means to offer competitive wages and training programs, workers will follow. We have laid out key proposals in our Care for Ours Seniors Act, which will allow us to boost our workforce, but without the help from Congress and state legislators, this will not be possible.”
The Care for Our Seniors Act is being advocated by AHCA and LeadingAge. It has prioritized four principles for nursing homes that can be applied to support better pandemic management, help prevent such devastation from happening again, and strengthen nursing home care. The policy proposals may be considered by Congress and other policymakers either as a complete legislative package or individual policy proposals may be incorporated into other relevant legislation, as long as the necessary resources for each proposal are tied together.
The reforms fall into four categories:
- Clinical improvements to enhance quality of care
- Workforce improvements to strengthen and support our frontline caregivers
- Oversight reforms to make systems more resident-driven
- Structural modernizations focused on resident dignity and safety
Mark Parkinson concluded his remarks by stating, “Congress has the opportunity right now, through budget reconciliation, to include meaningful investments in long term care, which will help address key staffing challenges. Our caregivers are the backbone of long term care, and they deserve the full support of our lawmakers. We cannot allow facilities to close because of these challenges, which will directly impact residents and their families, especially when lawmakers have the means to help solve this dire situation.”
The full results of AHCA/NCAL survey results can be accessed at: PowerPoint Presentation (ahcancal.org).
Issue:
As the pandemic lingers on, it has become a challenge to recruit and retain nurse staffing for most facilities across the country; therefore, leadership should discuss innovative ways to recruit and retain staff. Adequate, competent nursing staff are vital to delivery of high quality care that all residents should receive. The facility’s emergency preparedness plan should also be reviewed to determine what steps may need to be taken if staffing levels become critically low. Insufficient nursing staff or nurses who are not fully competent in delivering safe patient care may result in a violation of F725 Sufficient Nursing Staff and F726 Competent Nursing Staff, and that could lead to citations and fines for noncompliance. Detailed information is available in the Med-Net Corporate Compliance and Ethics Manual, Chapter 1, Compliance and Ethics Program.
Discussion Points:
- Review your new employee orientation process and determine if changes should be made to help retain employees. Discuss with Human Resources the current tactics that are being used to recruit new employees. In addition, review nursing policies and procedures to ensure that they are comprehensive and competency-based. Update as needed.
- Train the appropriate staff on the importance of new employee orientation. Also train all nursing staff on your policies and procedures for nursing skills, and ensure that each nurse demonstrates competency in providing care. Ensure that nurses have access to the nursing policies and procedures for easy reference. Ask staff if there are areas within their responsibilities where they would like to receive additional training, and provide the requested instruction. Document that these trainings occurred and file in each employee’s education file.
- Periodically audit to make certain that new staff orientation is complete to ensure competency of the employees filling each role. In addition, periodically conduct audits to ensure that each employee’s competency is evaluated upon hire and at least annually thereafter per your facility’s policy.
