Nursing homes struggle for staff during pandemic

Mar. 7—SELINSGROVE — The COVID-19 pandemic has amplified the direct care staff shortage in U.S. nursing homes, prompting Valley agencies to offer perks to attract and retain staff.

A report released this week by the health policy journal Health Affairs, based on data collected beginning in 2016, revealed that 15,645 federally licensed nursing homes across the country experienced an average 128 percent staff turnover rate.

"This turnover crisis is something we've been warning about for 10 years," said Zachary Shamberg, president and CEO at Pennsylvania Health Care Association who also cited a 2019 report, "Who Will Care for Mom and Dad?" issued by then-Auditor Eugene DePasquale that foreshadowed a dire future in senior care unless the employee shortage is addressed.

The pandemic has only served to augment the lack of available direct care workers — including licensed practical nurses, certified nursing assistants and personal care aides — has had on nursing homes, Shamberg said.

Brookdale Grayson View nursing home in Selinsgrove has been hard hit, with about 25 percent of the staff leaving in the past year due to health concerns associated with the coronavirus and another 25 percent falling ill with the disease despite mandating social distancing, masking and other safety guidelines, said Administrator Lennie Boop.

A nursing home relies on direct care workers, so Boop said the agency had to contract out some positions during the past year to make up for the loss.

That's a problem for facilities that "need to pride themselves on continuity of care," said Shamberg. "We need to see workers truly invested otherwise care suffers."

Nursing and Rehabilitation at the Mansion Administrator Mark Monohan said the long-serving staff at the 52-year-old Sunbury facility "are like family" which has helped it buck the national high staff turnover trend.

"We did a calculation a few years ago and found that our staff had an average of 10 years," he said. "They're committed and they stay."

The 70-bed facility employs 100 and has a 90 percent occupancy rate.

While there have been concerns due to the health crisis, Monohan said, the family atmosphere has helped maintain a low staff turnover.

But most long-term care facilities are struggling with a staffing shortage crisis that has been exacerbated in the last 12 months.

"The last 12 months have amplified problems, and none greater than the workforce shortage," said Shamberg.

PA Health Care Association advocates for nursing home direct care workers' salaries to be commensurate with health care workers and raise Medicaid reimbursements to nursing homes so they can pay staff higher wages.

The state association has also partnered with the national association to come up with creative ways to boost the recruitment of quality staff.

"We're considering all options, working with labor unions, chambers of commerce, to figure out ways to build a pipeline of workers," said Shamberg.

Temps, salary & shifts

The Temporary Nurse Aide program established last April to bring more people into nursing homes to assist with senior residents' activities and take the pressure of direct care employees has recruited 4,000 people in Pennsylvania in less than a year.

"It gets more people into homes and enables them to see if it is a career for them," said Shamberg. The response to the program "makes me very hopeful that there are folks who want to take that position."

Jennifer Mabus worked in administration in the home health care field for 10 years before going back to school and becoming a licensed practical nurse in August 2019.

"I just felt I needed to do a little more. Helping people is wonderful. ... I wish I had done it sooner," said Mabus, who joined the staff at Brookdale Grayson View as an LPN and health and wellness coordinator in February 2020.

Mabus said she knows she's an "exception" rather than the rule in the senior personal care business.

While higher pay and additional perks are recommended to attract more staff, Mabus said people who are considering a job as a direct care worker have to want to serve the population.

"You have to look at it not as a job, but a profession," she said. "You can be a shining light in someone's day."

It's imperative that more people are interested in working with the senior in their final years as the population grows, he said.

According to the 2019 state auditor's report, by 2040 nearly 25 percent of Pennsylvania's population of about 13 million will be 65 or older, compared with 15 percent in 2010.

"Pennsylvania is the third-oldest state and our fastest-growing demographic is 85 and older," said Shamberg. "If we can't keep Pennsylvanians in these jobs, unfortunately, we will not be able to care for our aging population and you'll see facilities close."

RiverWoods Senior Living Community in Lewisburg is taking steps to address the issue by boosting the salary of certified nursing assistants to $17.50 an hour. Officials are also installing bulletin boards in the area to advertise available jobs at the facility and will be sending out a mailing to 9,000 households within a 25-mile radius, said Interim Administrator Rocco Parro.

"Staffing challenges are really the Achilles' heel for a lot of organizations," he said.

When Parro began his career in the senior care field in 1984 "there was a bigger pool of service-minded people with empathy and compassion."

Today, he said, those jobs don't pay enough and "people need to make a living. Sometimes they're thankless jobs."

Another way the Lewisburg facility is hoping to retain employees is by moving some staff from an 8-hour to a 12-hour work schedule on April 1, said Parro.

Employees at Milton and Watsontown Nursing and Rehabilitation centers are being offered the choice of working an 8-hour or 12-hour shift, said Leah Callaway, director of marketing and communications at Bedrock Care.

"We're taking the initiative and giving scheduling options because many people's lives have changed," she said. "It's all about being flexible to retain those good employees."

Employee flexibility

Flexibility and options are important since Bedrock's facilities are experiencing an 80 percent decline in the applicant pool, said Callaway who attributes "apprehensiveness" due to the virus.

The 112-bed Watsontown facility employs 112 staff and has 82 residents and the 94-bed Milton facility employs 91 staff and has 87 residents.

In addition to offering work scheduling options, Bedrock is increasing the amount of the sign-on bonus and offering certified nursing assistants a career pathway to let them rise in ranks if they choose.

Brookdale Grayson is getting its staffing levels back to normal but still has a way to go. Currently, the 95-bed nursing home employs 51 staff serving about 50 residents.

"We're down about eight positions and are at about 54 percent occupancy," Boop said. Pre-pandemic, the facility was consistently filling most of the beds. "For years, we ran at 100 percent capacity."

The health pandemic is keeping many people from moving into the nursing home until the health crisis is over, he said, adding that he hopes as more people receive the vaccination the fear will taper off.

As of this week, 95 percent of Brookdale Grayson residents and 40 percent of staff have received the COVID-19 vaccine, Boop said.

The facility is also focused on bolstering its staff and maintaining morale so it has given out bonuses, initiated dress-down days and provides extra treats in the break room.

"We want people to know that even in a pandemic they can make a difference in the lives of a senior," said Boop.