Staff Shortages at Long-Term Care Facilities Problematic - National Guard Helping in Some States

Labor shortages, due in part to the virus crisis, are causing staff shortages in many areas of the economy. However, at long-term health care facilities, the labor shortage is at a crisis level. 

A report published by the According to American Health Care Association and National Center for Assisted Living (AHCA/NCAL) shows that America's nursing homes have lost 220,000 jobs, and assisted living facilities have lost 38,000 jobs since the start of the virus crisis. 

Home care staffing was also down 1.2% during the same period. The AHCA/NCAL represents more than 14,000 nursing homes and assisted living communities across the country that provide care to approximately five million people each year.

Trying to find quality home care providers has always been a challenge but has become worse since the height of the pandemic, according to Kevin Outerbridge and Logan Outerbridge, who operate Amada Senior Care of Bergen and Passaic Counties in New Jersey. They say the problem is not going away.

"Now we offer a 401k plan, and we worked hard to find health insurance that is more affordable for our employees. In addition, we're focusing more on trying to convey the message to potential employees that coming to work for our agency isn't just a job change, it's a career move," they said.

COVID-19 and Underfunding of Facilities Part of the Problem

There are several challenges the long-term care industry is facing that are contributing to the staffing problem. Mark Parkinson, president and CEO of AHCA/NCAL, said that staff burn-out is one factor.

"As many caregivers are getting burned out by the pandemic, workers are leaving the field for jobs in other health care settings or other industries altogether. Chronic Medicaid underfunding, combined with the billions of dollars providers have spent to fight the pandemic, have left long-term care providers struggling to compete for qualified staff. We desperately need the help of policymakers to attract and retain more caregivers so that our nation's most vulnerable have access to the long-term care they need," Parkinson said.

National Guard Helping in New York and Minnesota

Long-term care facilities in several states including Minnesota, New Jersey, and New York are receiving additional help from National Guard to help provide care. The military has been used in Canada as well as the crisis has hit that nation as well. 

New York Governor Kathy Hochul announced the deployment of 120 national guard medical personnel to assist long-term care facilities throughout the state. 

Col. Richard Goldenberg, a spokesperson for the New York National Guard, says the guard is prepared to provide support as long as the state determines there is a need. 

"If it takes through the winter, we are prepared to do so," said Goldenberg.

Minnesota Governor Tim Walz has activated 400 guard members to provide services in facilities. 

"Our long-term care facilities are facing an all-hands-on-deck moment, and that's why we are taking unprecedented action to support skilled nursing workers, residents, and patients," said Walz.

Governor Murphy announced that the New Jersey National Guard is deployed to long-term care facilities throughout the state to assist with COVID-19 response efforts and to augment long-term care facility staffing.

“Time and time again, the New Jersey National Guard has stepped up to the plate throughout this pandemic,” said Governor Murphy. “This deployment will send members of our National Guard to long-term care facilities with staffing needs and will act to protect the health and safety of long-term-care residents while the Omicron variant surges throughout the nation. 

Virus Crisis Exacerbating Labor Shortages

The AARP says this is not a new problem but has become much larger since the start of the virus crisis.

"Labor shortages were a chronic issue in nursing homes because of relatively low pay, difficult working conditions, and limited benefits for staff. The pandemic has exacerbated staffing shortages," said Rhonda Richards, a senior legislative representative in government affairs at AARP.

More People Need Long-Term Health Care - Few Prepared

The need for long-term health care is increasing due to demographics and medical advances allowing for greater longevity. Most long-term health care is not paid for by health insurance or Medicare as they pay for a very limited number of days of skilled services. Medicaid is the primary payer across the nation for long-term health care services in the United States, but you must have little or no income and assets to qualify for those benefits. Plus, Medicaid reimbursements are low, placing financial pressure on facilities with Medicaid beds.

Long-Term Care Insurance will pay for both in-home and facility care, but you cannot purchase a policy when you need it; it must be purchased when a person still enjoys fairly good health. 

The AARP's 2021 Home and Community Preferences Survey says most people (77%) of adults ages 50 and older say they want to stay in their homes when they need care. However, few people think about long-term care until the crisis happens; thus, they don't consider purchasing Long-Term Care Insurance until it is too late.

Long-Term Health Care Costs Rising Rapidly

Long-term care costs are increasing rapidly, in part due to higher demand and labor shortages. The financial strain on families can be substantial as nursing home costs average over $100,000 a year, according to the LTC NEWS Cost of Care Calculator - Cost of Care Calculator - Choose Your State | LTC News.

The average costs of in-home care, adult day care centers, assisted living facilities, memory care facilities, and nursing homes vary depending on where you live. But one thing is in common nationwide, costs for all types of care are increasing, and many families are not prepared.

Family Caregivers Face Greater Challenges

Family caregivers face physical and emotional challenges. The care provided by these family caregivers is more intensive, complex, and lasts longer than in the past. Plus, in most cases that have not received adequate preparation for their role. There is a lot of evidence that suggests that many caregivers experience negative psychological effects.

The CDC says 30.7% of these family caregivers of older adults experience suicidal thoughts - Caregivers Facing Mental Health Issues | LTC News. With staff shortages and not enough families with LTC Insurance, more family members may see themselves thrust into a role that creates burden and anxiety for all involved.

An AARP study says more younger people are providing care services, with 23% of family caregivers being Millennials and 6% who are Gen Z. At those ages, the role interferes with education, careers, and relationships.