Nursing homes have struggled to hire and retain staff for many years. The COVID-19 pandemic worsened the nursing shortage in healthcare, a problem that has plagued nursing homes for decades. Even before the pandemic, staff-to-patient ratios were dangerously low, and the situation has only worsened. Despite adopting various solutions, nursing homes need help hiring and retaining quality staff, making it challenging to keep their doors open.

The American Health Care Association (AHCA) released its 2024 State of the Sector Report based on a recent survey of 441 nursing home providers. The survey results show that despite ongoing investments, the nursing home sector is still struggling to rebuild its workforce and recover from the pandemic. Providers also worry that the new federal staffing mandate from the Centers for Medicare and Medicaid Services (CMS) will worsen the situation.

In this article, we will explore the findings of the AHCA report, discuss the factors contributing to the staffing crisis, and examine why current efforts to attract more staff are falling short.

Nursing Home Labor Crisis: Why Efforts to Attract More Staff Are Falling Short

The nursing home sector faces a critical workforce shortage, with numerous facilities needing help to attract and retain staff. This ongoing issue is impacting the quality of care and the ability of these homes to operate efficiently.

1. Widespread Job Openings in Nursing Homes

• Current Job Openings: Ninety-nine percent of nursing homes report having open positions.
• RN Positions in High Demand: 89 percent of these facilities are actively trying to hire registered nurses.

The near-universal presence of job openings highlights a critical workforce shortage in nursing homes. The high demand for registered nurses indicates a specific need for skilled medical professionals, which is crucial for maintaining the quality of care.

2. Staffing Levels Below Pre-Pandemic Norms

Reduced Workforce: Seventy-two percent of nursing homes have fewer staff members than before the pandemic. The pandemic has had a long-lasting impact on staffing levels in nursing homes. Many facilities need help to return to their pre-pandemic workforce numbers, affecting their capacity to provide adequate care and meet operational demands.

3. Stagnation or Decline in Workforce Situation

No Improvement: Over half of nursing homes report that their workforce situation has changed or deteriorated. Despite efforts to hire more staff, many nursing homes need to see improvements in their workforce situation. This stagnation or decline suggests systemic issues in recruitment and retention, further exacerbating the challenges in providing consistent and high-quality care.

Challenges and Strategies in Recruiting and Retaining Staff in Healthcare Facilities

Key among these challenges is the difficulty of finding qualified candidates who are interested in and capable of meeting the role’s demands. Despite these hurdles, healthcare facilities actively deploy strategies to attract and retain talent, ensuring continuity in care delivery and organizational stability. This section delves into the primary obstacles faced and examines the proactive measures taken to address these issues effectively.

1. Recruitment Challenges

• Ninety-four percent of healthcare facilities find it challenging to recruit new staff.
• Sixty-seven percent attribute this difficulty to a need for more interested or qualified candidates.

Healthcare facilities need help attracting new staff members due to a widespread perception of insufficient interest or qualifications among candidates. This issue poses a significant hurdle in maintaining adequate staffing levels across various healthcare settings.

2. Wage Increases

• Ninety percent of nursing homes have recently increased wages.
• This increase reflects ongoing efforts to remain competitive in the job market.

Most nursing homes have implemented wage increases as a proactive measure to enhance competitiveness and attract qualified candidates amidst challenging recruitment conditions.

3. Bonus Offerings

• Seventy-eight percent of facilities have offered bonuses, including sign-on bonuses.
• Bonuses serve as incentives to attract and retain staff members.

Offering bonuses, including sign-on incentives, is a prevalent strategy facilities adopt to incentivize potential candidates and retain existing staff. These financial incentives aim to mitigate recruitment difficulties and bolster staff retention rates.

4. Internal Promotions

• Seventy percent of facilities have promoted staff from within.
• Internal promotions are seen as a strategy to motivate and retain existing employees.

Many healthcare facilities prioritize internal promotions to recognize and reward talent within their workforce. This strategy fosters loyalty among current employees and cultivates a supportive and growth-oriented organizational culture.

5. Investment in Training

• Sixty-nine percent of facilities have invested in staff training and education.
• Training initiatives aim to enhance skills and job satisfaction among employees.

Healthcare facilities actively invest in training and education programs to equip their staff with the necessary skills and knowledge. By supporting professional development opportunities, facilities seek to empower employees and improve overall job satisfaction, promoting long-term retention.

Addressing the Challenge of Low Staff-to-Patient Ratios in Nursing Homes

Nursing homes predominantly rely on Medicare and Medicaid funding, allocated through a bundled payment system that often limits resources for comprehensive patient care. This situation leads to competing priorities among different specialties, resulting in lower salaries for staff and insufficient funds to hire additional personnel. Consequently, patients may receive only some necessary care services or the duration of care needed.

Efforts to address these challenges have been ongoing for decades, with limited success despite bipartisan attempts to improve quality and cost-effectiveness. Potential solutions involve a mix of strategies from both staff and nursing home leadership, aiming to enhance staffing levels and improve working conditions.

Possible Solutions:

• Legislative Action: Consider legislation mandating a minimum of 4.1-4.85 hours of direct care per resident per day, although enforcement could pose challenges.
• State-Level Initiatives: Implement minimum staffing requirements, though fixed numbers may not meet the needs of patients requiring more intensive care.
• Staffing Practices: To mitigate shortages, utilize strategies such as mandatory or voluntary overtime, temporary agency staff, and promotions.
• Financial Incentives: Increase wages and bonuses and improve reimbursement rates to attract and retain qualified staff.
• Work Environment Improvement: Foster a supportive environment to reduce turnover and burnout among CNAs, LPNs, and RNs, which is crucial for maintaining patient safety and care quality.

Nursing Homes Confront Admissions Limits and Closure Risks Due to Labor Challenges

A significant 46% of these facilities have introduced limitations on new admissions, with 38% regularly unable to accommodate potential residents. Additionally, 7% of nursing homes need help with the challenging task of turning away admissions daily. This trend highlights the critical impact of labor shortages on nursing home operations. Furthermore, nearly 20% of facilities have had to close units, wings, or floors due to workforce challenges. Looking ahead, 66% of nursing homes express concerns that ongoing staffing issues could potentially force them to consider facility closures, exacerbating pressures on the healthcare system.

Job losses in nursing homes during the COVID-19 pandemic were more severe compared to other healthcare sectors. Even as the industry strives to recover, it remains short of more than 130,000 workers needed to return to pre-pandemic staffing levels. The proposed federal staffing mandate would require hiring an additional 100,000 caregivers, with an annual cost nearing $7 billion. Failure to meet these targets could have dire consequences: over 280,000 nursing home residents, nearly one-quarter of all residents, could face displacement as facilities are forced to downsize or close their doors. These challenges highlight the urgent need for sustainable solutions to support nursing homes in delivering essential care while navigating complex financial and staffing landscapes.

Optimizing Nursing Care Efficiency with Prime Source Expense Experts

At Prime Source, we specialize in transforming nursing care management through innovative solutions prioritizing quality and cost-effectiveness. Our comprehensive approach includes analyzing your current expenses, leveraging industry-leading contracts for savings, and optimizing operational efficiencies tailored to your facility’s needs.

By partnering with Prime Source, you can access a strategic partner dedicated to enhancing patient care while navigating financial challenges. We understand the complexities of healthcare purchasing and offer proven strategies to maximize your budget without compromising quality.

Contact us today to schedule a consultation and learn how Prime Source can empower your facility with sustainable solutions. We can elevate your nursing care standards and ensure a healthier, more efficient operation.

FAQs

Q1: What Are the Main Factors Contributing to the Staffing Crisis in Nursing Homes?

A1: The staffing crisis in nursing homes is exacerbated by longstanding challenges in recruitment and retention, worsened by the COVID-19 pandemic. Factors include low wages, high job demands, and burnout among care workers.

Q2: How Is Prime Source Expense Experts Helping Nursing Homes Improve Staffing and Operational Efficiency?

A2: Prime Source Expense Experts offers tailored solutions to optimize nursing care management. This includes analyzing current expenses, leveraging industry contracts for savings, and implementing strategies to enhance operational efficiencies.

Q3: What Effective Strategies Can Nursing Homes Use To Attract and Retain Qualified Staff?

A3: Effective strategies include offering competitive wages and bonuses, promoting from within, providing comprehensive training programs, and fostering a supportive work environment to reduce turnover and improve staff retention.

Q4: How Does the Federal Staffing Mandate Impact Nursing Homes?

A4: The federal staffing mandate from CMS requires nursing homes to hire additional caregivers to meet minimum staffing requirements. This mandate aims to improve patient care but poses financial and operational challenges for facilities already struggling with staffing shortages.

Q5: What Are the Consequences of Nursing Homes Facing Closure Due to Labor Challenges?

A5: Nursing homes at risk of closure due to labor shortages may displace residents and limit access to essential care services. This can strain healthcare resources and impact the well-being of vulnerable populations relying on long-term care facilities.