We have seen the pandemic sweep across U.S. industries and leave an indelible mark. Restaurants, bars, diners, coffee shops, arts and entertainment venues, and thousands upon thousands of small businesses have been forced to shut their doors because they just don’t have enough people to keep them running. Understaffing continues to be a critical issue driving the demise of a staggering percentage of our nation’s businesses.
But a nursing home isn’t like a bar or eatery that can simply close down when employees don’t show up to work. Institutions created to provide round-the-clock care for vulnerable individuals requiring 24/7 healthcare don’t have the luxury of putting up shutters when workers become scarce. Over two million older adults depend on nursing homes and assisted living facilities for their daily life needs.
2021 AARP data analysis determined that roughly one-third of nursing homes in the U.S. are suffering staff shortages. In some states, as many as 60% or even 80% of nursing homes are understaffed. These statistics shouldn’t be taken lightly. This means that as many as a million or more older health-compromised adults are living in facilities that don’t staff enough workers to meet demands. And the staff members who are on the premises to serve the needs of residents are overworked, overburdened, fatigued, underpaid, and at high risk of making an error due to exhaustion or distraction.
Nursing homes and long-term care facilities have suffered a vicious cycle of lowered staff levels and worsened patient outcomes, leading to higher incident rates of COVID-19 outbreaks, patient deaths, and employee exits. Decades of research has consistently shown an indisputable link between higher staffing standards and increased quality of life for nursing home residents. When nursing homes are understaffed, residents bear the consequences.
We know that the coronavirus pandemic has drastically altered the U.S. healthcare industry. How has COVID-19 caused nursing home shortages? To better understand how the long-term nursing care industry has been impacted in recent years, it’s necessary to more closely examine the factors and concerns that have led to staffing shortages in nursing homes.
Why Are Nursing Homes Suffering Staff Shortages in the COVID-19 Era?
Below are a few of the predominant factors leading to increased nursing home staff shortages since the start of the pandemic in the United States.
Infection Rates
The simple fact is that nursing home staff members are infected in high numbers, rendering them unable to perform their jobs duties. Remaining workers on staff are left to cover gaping holes in shift schedules and task responsibilities lists. In general, nursing home staff members have been vaccinated at lower rates than the residents themselves. And booster rates are even lower, with only 30% of care facility employees reporting having received a vaccine booster shot.
Physical Health Concerns
Across the country, nursing home staff members are admitting that they have been singlehandedly tasked with the care of 50 or more elderly residents. This profoundly disproportionate ratio of caregiver to high-needs adults is a recipe for injury, illness, and distress on both staff and resident. Resident-to-staff ratios vary by state, with some as low as 5 or 8 to 1 and others reaching a maximum of 20 to 1. It’s well-known that higher ratios lead to lower quality of care and staffing issues. Physically exhausted staff members are more prone to infection, disease, and other stress-related health complications, in addition to the ever-present concerns of COVID infection they must deal with daily.
Mental Health Concerns
The current understaffing crisis is fueling burnout to no small degree. Nursing home employees are reporting exhaustion and mental fatigue, but, perhaps even worse, guilt and moral distress. Nurses and staff members who serve as the primary caregiver for dozens of vulnerable adult residents simply aren’t able to give each individual the care they need. The intense psychological stress that accompanies working endless hours and still feeling like you’re not “doing enough” has become a great emotional burden for many care facility employees. When a resident falls and is injured on your watch, for example, the emotional toll can be unbearable.
Financial Concerns
Low wages have presented a significant recruiting hurdle for nursing homes in the United States. A Harvard T.H. Chan School of Public Health report identified low wages as a critical contributing factor to staffing issues, but not one that has arisen only since the beginning of the pandemic. Instead, the strains of COVID-19 on an already-flawed infrastructure have only served to highlight the issues underlying current staffing issues. Bureau of Labor Statistics data shows that nursing home employees are among the lowest paid in the healthcare industry. Wages average between $17.45 an hour for assisted living facility staff members and $21.19 an hour for skilled nursing facility employees. In times of an industry crisis, it is generally the lowest paid workers that leave in the highest numbers.
The Appeal of Other Jobs
Students entering the job market are looking for higher pay, greater flexibility, better job stability, and more remote working opportunities than nursing home employment can provide. Work-from-home and tech-based jobs have been in higher demand than ever before since the pandemic’s onset. In states like Kentucky, financial incentives and scholarships have been proposed to encourage graduating students to pursue opportunities in healthcare. Recent healthcare budget plan proposals in the state included a $6 million scholarship fund for Kentucky nurses.
Nursing Home Staff Shortages in Kentucky
The state of Kentucky has over 280 nursing homes. In 2020 and 2021, over one-third of these facilities reported a staff shortage at least once on a weekly CDC Long-Term Care Facility: Staff and Personnel Impact survey. Like much of the rest of the country, our state has declared the current nursing home staff shortage a public emergency.
Governor Andy Beshear made the emergency announcement in December 2021, and government entities like the Kentucky Cabinet for Health and Family Services have hastened to propose mitigation strategies and plans of action to address the staffing crisis. Like those published by the CDC, many of these proposals recommend higher rates of vaccination, better facilities for quarantining, adjusted staffing schedules, and greater concern for social factors that may impact a staff member’s ability to retain employment at the facility, such as transportation, housing, and family circumstances.
Based on data current as of June 2021, Kentucky nursing homes saw over 17,000 positive COVID-19 cases among residents and nearly 13,000 cases among staff members. Now in mid-January of 2022, we are seeing over 40,000 nursing home residents test positive each week at the national level. This number is nearly 10 times higher than it was in November of last year. With the rapid spread of the omicron variant in residential facilities, it’s clear the staffing shortage problem isn’t going to reverse its course overnight.
Prior to the onset of the COVID-19 pandemic, Kentucky already faced a staffing shortage. Our state has witnessed incredible pressure mounted upon an already weak foundation. Even when a long-term residential care facility is fully staffed, things can go wrong. One additional issue that has come to light in the midst of staffing shortages is the problem created by loosened hiring standards.
When facilities desperate to get names on a staff listing are willing to compromise their values for the sake of numbers, residents can pay an exorbitant price for the neglect or abuse perpetrated by underqualified caregivers. If your loved one suffered mistreatment in a nursing home, there are legal options. Contact Thomas Law Offices to speak with a skilled attorney who can help you take action after nursing home abuse, neglect, or exploitation.
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