If you’ve tried to fill a vacant position in long-term care in the last few months (OK, years), you don’t need me to tell you it’s tough out there.
Even as skilled nursing providers compete against each other — for workers, referrals, maybe sheer survival — they know this crisis is larger than any individual challenge. That’s why so many are willing to share strategies that move the needle, if only the slightest bit.
Over the last few weeks, I’ve talked with several facility leaders who’ve gone to desperate measures to find decent job candidates and then tried to lure them in with over-the-top incentives. Others are doing anything they can to keep current workers, given that hospitals and agencies continue to offer outlandish hazard pay.
Sometimes, it hasn’t been enough, as Mark Fritz, president of Bridgemoor Transitional Care, knows all too well. He established units capable of treating COVID-19-positive patients in conjunction with a major hospital partner. But at the pandemic’s peak, he sometimes had to deny them entry because he simply couldn’t get enough workers to care for them.
How do you hire a CNA, even at an above-average rate, when they could go to an agency and make $50,000 in 10 weeks? Fritz asked me.
I had imagined the challenge, but hearing hard numbers from Tim Fields, CEO of Ignite Medical Resorts, gave me an even deeper understanding. Led by hospital infection preventionists, Ignite followed stringent infection control standards and set up an Ignite-only supply “bunker,” which allowed leaders to quickly get PPE like gloves and gowns to workers who needed them.
And still, at one point last spring, a building in Oklahoma was down 40 of 120 workers because of COVID-19 exposure.
Until this month, when the Centers for Disease Control and Prevention updated its guidance, even fully vaccinated workers who had been exposed had to stay home from work.
What company do you know in any industry that could operate for 10 to 14 days without a third of its staff?
Fields and his employees were fortunate in that he could absorb the costs of patching the holes during those absences and work to ensure they would want to come back when well.
Ignite staff earned full wages when required to quarantine. The company emphasized flexible scheduling and education opportunities. Fields also started a hardship fund to support those who struggled financially during COVID-19.
While the outbreak scenarios are dwindling, the underlying problem remains.
The consulting group Altarum last week reported nursing homes lost 182,000 jobs or 11.5% of its workforce between February 2020 and February 2021.
That’s more than three times worse than the overall healthcare industry, and other residential care facilities are actually adding back jobs now to cut into their pandemic losses.
And yet skilled nursing providers have been left adrift by federal and state regulators, who have offered no real assistance beyond short-term strike teams and spotty provisions for alternative CNA pathways.
Last week, the Government Accountability Office issued a report criticizing the Department of Health and Human Services for not implementing more recommendations from the Nursing Home Commission. The GAO reported that one in five nursing homes continues to report frontline staffing shortages through December and current staff “are exhausted.”
While operators wait for someone, somewhere to act on the staffing crisis — and provide funding that makes higher staffing ratios plausible — those who can are basically waiving cash in the air and still getting little to no response.
Yet, they’re not abandoning the resourcefulness that got them through the pandemic.
Marquis Companies, for example, is offering sign-on bonuses of up to $2,500 for nurses with $500 for full-time CNAs. They’re also going after displaced hospitality and restaurant workers to fill non-clinical jobs.
“They’re hard-working, multitasking, team players familiar with working in a fast-paced environment and with many different types of people,” said Katy Zahrte, Marquis’ vice president of talent management. “In addition, they tend to have strong communication skills and a customer service-based approach to problem solving.”
Too bad hard work and multitasking alone can’t solve all staffing problems. If they could, skilled nursing surely would have a lock on the market.