Long-term care workforce challenges remain at ‘crisis’ level

Federal jobs data show that long-term care workforce challenges remain at a ‘crisis’ level, according to the industry.

A 6.7% decline in the assisted living workforce reflects a loss of 31,200 caregivers — from 463,100 employees in February 2020 to 431,900 in January 2022, according to the American Health Care Association / National Center for Assisted Living, citing data from the January Bureau of Labor Statistics Employment Situation report.

Overall, long-term care workforce levels are at their lowest in 15 years, with 409,100 jobs lost between February 2020 and January 2022. The decline has been especially noticeable in skilled nursing, which experienced a 15% workforce decline during that time, according to BLS data. Home health saw a 1.7% decline.

“Unless Congress acts, nursing homes and assisted living communities will increasingly have to take drastic measures, further limiting access to care for vulnerable seniors,” AHCA / NCAL said in a statement. 

Workforce data ‘not a surprise’

The BLS data are not a surprise and only confirm what members are saying about their daily experiences, a LeadingAge spokesperson told McKnight’s Senior Living.

“The COVID-19 pandemic has exacerbated a longstanding challenge in the aging services sector: recruiting and retaining qualified workers who are capable of managing, supervising and providing high-quality services and supports for older adults,” the spokesperson said.

Direct care workers — nursing assistants, personal care aides and home health aides — are the “heart of aging services,” according to LeadingAge. Although the pandemic shed light on how valuable these professionals are, it also made clear that the nation does not have the long-term care workforce it needs, the association maintains.

In a January poll, LeadingAge members named recruitment of new staff members a top concern, followed by finding enough staffing due to vacancies, and covering for colleagues out sick. Leaders of all of the major associations advocating for the industry recently told McKnight’s Senior Living that long-term care workforce challenges are becoming more urgent.

“The U.S. needs a path toward the sustainable, reimagined workforce of professional caregivers to ensure better care for millions of older Americans,” the LeadingAge spokesperson said.

Potential solutions to challenges offered

LeadingAge sent a letter last month to President Biden asking for a $2,000 one-time relief payment to the nation’s 4.6 million direct care workers and 3,100 affordable housing service coordinators. The association also asked Congress to authorize and fund a permanent program to raise hourly wages for these workers by $5.

Argentum pointed to the introduction of the Safeguarding Elderly Needs for Infrastructure and Occupational Resources Act as part of the solution. The SENIOR Act proposes a $10 billion sustainability fund and workforce development programs for senior living providers.

“Senior living providers know all too well about the workforce crisis, which has been exacerbated by COVID, with over 100,000 fewer caregivers serving on the frontlines since the pandemic began,” an Argentum spokesman told McKnight’s Senior Living. “This legislation would grow our caregiving workforce by developing, attracting and retaining the geriatric care workforce that is critically needed now, and would take an enormous step towards meeting the nation’s rapidly growing senior caregiving needs.”

AHCA / NCAL said that as pandemic burnout worsens, skilled caregivers are looking elsewhere for work. 

“While many long-term care providers have dedicated extensive resources to honor frontline heroes’ extraordinary efforts, current government reimbursement rates limit their ability to make additional investments and compete against other employers for workers,” AHCA / NCAL stated. “Without action from policymakers, our nation’s most vulnerable seniors risk reduced access to care as facilities are forced to limit admissions or even close down altogether.”

Is pandemic policy faulty?

AHCA / NCAL said testimony at the U.S. Senate Subcommittee on Employment and Workplace Safety’s Thursday hearing to examine the pandemic-related workforce shortages in healthcare settings reinforced the need for lawmakers to take new action to ensure that long-term care providers have the resources and recruitment tools necessary to provide high-quality care.

In testimony before the Employment and Workplace Safety Subcommittee of the Health, Education, Labor and Pensions Committee, Rachel Greszler, a labor policy economist with the conservative think tank The Heritage Foundation, blamed the labor shortages on policies enacted in response to the pandemic, rather than the pandemic itself.

She said that $600 weekly bonus unemployment insurance benefits, expansion of healthcare subsidies, and eviction moratoriums and rental assistance policies and programs “made it easier for people to not work, and almost certainly continue to play a role in weak employment, particularly among lower- and middle-wage workers.”

Greszler said that states have the ultimate responsibility to control the entry gates to the healthcare workforce and that they need to eliminate licensing and scope-of-practice restrictions that are unnecessary. Federal policymakers, she said, should remove barriers to employment, including vaccine mandates and welfare-without-work programs. 

Greszler said she does not support additional federal spending bills, saying they would “artificially and unsustainably pump up the demand for workers.”

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*CREDIT: McKnight’s Senior Living

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