Page 25 - Modern Healthcare (January 2020)

TO CARE
Long-term care providers
scramble to hire and
retain personal care aides
crucial, though Loretto has a union workforce with com- Flat wages
petitive pay and perks. Wages for direct care workers changed very little
“We need to expand that workforce, and we need to be from 2008 to 2018, even as high rates of part-time
very innovative in how we approach talent development,” employment means median annual earnings were
said Loretto CEO Kim Townsend. With baby boomers ag- only $20,200 in 2017.
ing into retirement, “I’m concerned whether we’ll have
enough workers to do what needs to be done.” Median hourly wages 2008 2018
A severe shortage of high-quality caregivers could
crimp the ability of hospitals, physicians and health plans $13.38
to move patients out of higher-cost inpatient settings into $11.40 $11.77 $11.83 $12.07 $12.98
post-acute and home- and community-based care. That $10.33 $11.34
would hobble value-based care delivery.
Other long-term care providers also are urgently de-
veloping ambitious new strategies for recruiting and re-
taining these workers, who provide personal care such
as bathing, dressing, eating, toileting, housecleaning and Personal- Home Residential Nursing
care
homes
care
health
administering medications. Nearly 20 million adults in
the U.S. need assistance with daily tasks due to physical, Source: Source: PHI report: “Caring for the Future: The Power
cognitive, developmental or behavioral conditions. and Potential of America’s Direct Care Workforce”
Of the 4.5 million direct care workers in 2018, nearly 90%
were women, almost 60% were people of color, and about
1 in 4 was an immigrant, according to a new report from PHI, a long-term care research
group, based on data from the U.S. Bureau of Labor Statistics and the Census Bureau.
Turning away patients
The inability to hire and keep direct care workers has even forced some nursing
home and home-care operators to downsize or turn away patients. In Wisconsin, a
new survey of not-for-profit nursing home operators found that lack of staffing has
reduced bed capacity by 14 percentage points, to 77%, with the vacancy rate for staff-
ing at nearly 20%.
The shortage of direct care workers is expected to get worse over the next decade as
boomers age and the under-65 workforce shrinks as a percentage of the population.
It’s estimated there will be 8.2 million job openings in nursing homes, home care and
residential care through 2028, according to PHI. Meanwhile, first-year turnover can
exceed 80%.
That doesn’t bode well for hospitals and health systems that are relying on post-
acute care providers to help in reducing and preventing readmissions.
“We know workforce vacancies have caused providers to limit admissions both in
nursing homes and assisted living because they don’t have enough people to provide
the care,” said Jim Williams, who recently retired as director of member enrichment
for LeadingAge Wisconsin, which represents not-for-profit aging services providers.
The crunch will be even more dire if the U.S. continues policies to reduce immigra-
tion, providers and independent experts warn.
“Any policy restricting the entry of immigrants is going to harm long-term care and

January 27, 2020 | Modern Healthcare 23