Staffing shortages force long-term care facilities to limit admissions, hire agency workers

Rampant staffing shortages across the nursing home and assisted living industries have forced most facilities to reduce new admissions and rely on overtime shifts and pricey agency hires to maintain operations, according to a new industry survey.

Across a sample of 1,183 long-term care providers polled by the American Health Care Association and the National Center for Assisted Living (AHCA/NCAL), 99% of nursing homes and 96% of assisted living communities said they are facing some degree of staffing shortages. Fifty-nine percent of nursing homes and 30% of assisted living communities characterized their staffing situation as “severe.”

Most long-term care providers indicated that the issue does not seem to be improving. Since June, 86% of nursing homes and 77% of assisted living providers said their workforce situation has somewhat or greatly worsened.

“The survey demonstrates the severe workforce challenges long-term care providers are facing due to the COVID-19 pandemic,” said Mark Parkinson, president and CEO of AHCA/NCAL, in a statement. “Too many facilities are struggling to hire and retain staff that are needed to serve millions of vulnerable residents.”

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About two-thirds of respondents from each long-term care setting said they are having a “very difficult” time trying to hire new staff to fill the gaps.

They frequently pointed to the shortage of interested or qualified candidates (nursing homes: 76%; assisted living: 71%) and unemployment benefits (71%, 72%) as the leading obstacles affecting their hiring efforts. Financial inability to offer competitive wages (40%, 34%) and vaccination requirements (45%, 40%) have also served as barriers, they said.

Just about every long-term care facility polled in the survey said it has been asking their existing staff to work overtime or cover extra shifts to offset the shortage.

Sixty-nine percent of nursing homes and 38% of assisted living providers said they have turned to hiring temporary agency staff, while a respective 58% and 28% said they have been forced to limit new admissions to their facilities.

Still, 78% of nursing homes and 71% of assisted living communities said they were at least somewhat worried that workforce issues could force them to shut down entirely. Thirty-five percent and 19% signaled even stronger concerns of a closure.

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Parkinson said these responses make the case for additional funding support from state and federal government. Long-term care facilities need to be able to offer competitive wages and training programs if they are to boost their workforces and avoid closure, he said.

“Congress has the opportunity right now, through budget reconciliation, to include meaningful investments in long-term care, which will help address key staffing challenges,” he said. “Our caregivers are the backbone of long-term care, and they deserve the full support of our lawmakers. We cannot allow facilities to close because of these challenges, which will directly impact residents and their families, especially when lawmakers have the means to help solve this dire situation.”

COVID-era staffing shortages are not unique to the long-term care sector.

National groups have called on the Department of Health and Human Services to declare a national nurse staffing crisis and prioritize policies that support workforce well-being, retention and long-term stability. In the meantime, many hospitals say they have ramped up their hiring efforts and benefits offerings to prevent understaffing.