“The top three issues in aging services are workforce, workforce, and workforce.”
The old trope is not funny. As a member nursing home provider told us on LeadingAge’s most recent workforce survey, “I’ve been doing this for 32+ years and this is the most dire time I have ever seen. The hours are insane … it is getting really scary in long-term care.”
As much of the country is moving beyond the pandemic, aging services providers are still struggling to staff up enough to serve older individuals and their families in need of care. Many providers aren’t able to support those coming out of hospitalization because nursing homes and home health providers don’t have the staff to serve them.
Almost all (92%) of nursing home provider members who completed the February/March 2023 LeadingAge Workforce Snap Poll reported a significant or severe workforce shortage; 70% of assisted living providers said the same. In fact, 64% of the respondents on the survey said their workforce situation has not improved in the past year, when the nation was grappling with the emergence of yet another COVID variation. We’d hoped the workforce shortages–especially for critical nursing positions (registered nurses, licensed practical nurses, and certified nurse aides)–would ease at the end of the pandemic, but we’ve seen little change.
What does the workforce crisis look like up close for aging service provider organizations?
At any time, it’s not uncommon for 20% of the positions in organizations to be open, with no applicants.
Providers are dipping deep into their reserves to cover the cost of staffing agency personnel–paying two, three, or more times as much per hour as for full-time employees.
Remaining staff are carrying much heavier loads to make up for shortages.
Some providers are unable to survive–with some closing units or buildings and others saying things like “staffing continues to get worse, so we anticipate additional measures…if it doesn’t turn around.”
Older people who need care and services expect, and we should, provide the high-quality care that comes from having a full and fairly compensated staff. LeadingAge members always look to hire and retain mission-focused professional caregivers who are motivated and committed to service. But they have to be reimbursed adequately to pay their workforce a living wage.
With 1.7 jobs open for every person looking for a job in the country, and the many struggles that aging services providers face to attract those potential workers—it is indeed really scary right now for long-term care.
But there are possible solutions. “Our biggest challenge is our own country,” a member shared. Policymakers must step up to the plate and strengthen domestic training programs for staff across the aging services continuum. They can offer internships, apprenticeships, and loan forgiveness programs. Members of Congress on both sides of the aisle can come together and do something meaningful to help trained, qualified people from other countries to legally enter the United States and work in aging services. It will take courage and political will to frame and fund these solutions, but it must be done.
The Administration can create pathways for refugees, many of whom will see the value of working in aging services. A LeadingAge member observed on the workforce snap poll that “there seems to be no urgency among government agencies involved in [helping foreign workers come to the U.S.]” and another noted they “have 100 caregivers petitioned and have been spending years to get them over.”
A robust high-quality, person-centered care system is essential to serve all of us as we age, and LeadingAge advocates for federal policy changes and reform to this end every day—often alongside state partners and members. We will continue to raise our united voices to ensure policymakers get out of the way of ensuring there are enough motivated, well-trained worked to fill the jobs and deliver the care to all Americans in need.