InFront on the Workforce

Long-term and post-acute care publication

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Job Numbers Are Strong But Present Challenges for Healthcare

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There’s good news about the job market; but behind the positives there are some troubling realities.

April marked the 103rd straight month of job gains and resulted in a 50-year low unemployment rate of 3.6%. Specifically, a Bureau of Labor Statistics (BLS) report observed that notable job gains occurred in professional and business services, construction, healthcare, and social assistance. However, underlying this in post-acute and long-term care facilities, hospitals, and other healthcare settings, labor costs are increasing and operating margins are shrinking.

According to one report, labor costs in healthcare organizations represent about 60% of net revenues. At the same time, operating margins have gotten smaller as Medicare and Medicaid, instead of private insurance, have become primary payors for most patients. While technology has increased labor intensity, this hasn’t resulted in substantially fewer jobs or lower labor costs.

HHS Issues Final Rule on Conscience Provisions

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Healthcare employees will be able to refuse some procedures, services due to faith-based objections.

Last week, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced the issuance of a final rule on conscience provisions that enables healthcare employees to refuse certain medical procedures—including abortion, sterilization, and even advance directives–if they have faith-based objections. This rule replaces a 2011 regulation that, according to HHS, “has proven inadequate.”

The final rule clarifies what covered entities (including federal agencies and programs, as well as state and local governments receiving federal funds) need to do to comply with applicable conscience provisions and requires applicants for HHS federal financial assistance to provide assurances and certification of compliance. The rule also specifies compliance obligations for covered entities, including cooperation with OCR, maintenance of records, reporting, and non-retaliation requirements. The rule includes healthcare entities and employees, healthcare professionals, and individuals in an HHS-funded health service or research activity. It also applies to patients “who object to certain procedures, including screenings and mental health treatment of children or occupational illness testing, and in other specific instance….” HHS has also issued rules that exempt certain entities from the Affordable Care Act’s contraceptive mandate if they have objections based on religious or moral grounds.

Facilities Brace for Star-Rating Declines under CMS Changes

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Higher staffing level thresholds could cause star ratings to plummet despite quality care.

In March, the Centers for Medicare & Medicaid Services (CMS) announced that it was setting higher thresholds and evidence-based standards for nursing home staffing levels. Starting with April numbers, the agency will automatically give one-star staffing ratings to any facility that has four or more days each quarter with no registered nurse (RN) on site. This a significant drop from the previous standard of seven or more days. Now the real-world impact of this is starting to come to light, and it’s causing great concern. According to recent statistics, at least 550 providers could be affected, and it’s likely that the number ultimately will be higher.

Brand Gravity Draws Quality Candidates Like a Magnet

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Move beyond branding to gravity for perpetual popularity with job-seekers.

To consistently attract good workers, you don’t just need a solid brand; you need brand gravity. This is when your brand has the “emotional pull” that makes people remember you and your company over time in a positive light. It means that when people are in the job market, they come straight to your organization because they already know it’s a good place to work. So how do you create brand gravity?

Tick Tock: Let a High-Tech Time Clock Watch Workers’ Hours

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What features will maximize your ability to manage schedules, payroll?

About 78 million Americans punch a time clock, according to the U.S. Department of Labor, and businesses lose up to 5% of gross payroll to time clock fraud annually. However, maintaining accurate attendance is important to more than just your bottom line. If employees see co-workers get away with arriving late or leaving early, they may become frustrated and resentful. This can cause on-the-job conflicts and even result in turnover. So what’s the answer?

It’s the 21st century, so timesheets and a punch clock aren’t enough anymore. Time clock software that tracks employee attendance, schedules, and time off is the path to accuracy and effectiveness. When all of this information is captured and recorded in a database, it can be used to generate reports, track trends in real-time, and make payroll more efficient.

Are You Following ADA Guidance on Obesity?

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HR leaders needs to look at how they address the safety, other needs of overweight employees.

Statistics suggest that at least a small percentage of your employees are overweight or obese. Some of these individuals may qualify for Americans with Disabilities Act (ADA) protections if their weight and related symptoms/problems “substantially limit a major life activity.” You need to know who qualifies for what protections and be prepared to provide these accordingly. Otherwise, you could leave your organization open to discrimination complaints.

If an employee is obese and has associated problems—such as joint pain, mobility difficulties, shortness of breath, and/or diabetes, you need to implement a process to determine what accommodations may be needed or possible. Note that the underlying problems may be considered disabilities in their own right, regardless of weight issues; and the ADA considers those workers “regarded as disabled,” even if they don’t meet other criteria.

Survey: Companies Offer Innovative Family-Friendly Benefits to Attract Workers

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In a growing trend, employers are thinking beyond parental leave to fertility treatments, child care, college savings accounts, more.

According to a new study, employers are increasingly offering family-friendly benefits to attract and retain good employees. These include more traditional efforts such as paid parental leave, as well as more novel benefits such as fertility treatments and medications, genetic testing, and egg harvesting/freezing. According to the numbers, there’s a good chance some of your competitors are offering these perks; so take the time to consider what more you can do.

According to the International Foundation of Employee Benefit Plans’ (IFEBP) annual Employee Benefits Survey, nearly a third (31%) of employers with 500 or more employees offer some sort of fertility benefit. At the same time, 23% cover in vitro fertilization (IVF) treatments, and 18% offer coverage for fertility medications. Among other offerings: 15% cover genetic testing to determine infertility issues, 13% cover non-IVF fertility treatments, and 7% provide for egg harvesting or freezing services. Even the smallest companies are starting to offer these benefits. Of those with 50 or fewer employees, 10% offer some sort of fertility benefits.

EEOC Acting Chair Offers New Insights on Pay Equity

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Know the laws and what you can do to avoid pay discrimination headaches…or worse.

Earlier this month, U.S. Equal Employment Opportunity Commission (EEOC) Acting Chair Victoria A. Lipnic published a message about equal pay and highlighted some significant recent legal cases. She started by observing, “What we know at the EEOC is that pay discrimination, the concept of ‘equal pay for equal work’ enshrined in the Equal Pay Act of 1963, is real. We see and bring the cases every year.” She noted that her agency garnered approximately $4.1 million in litigation for discrimination victims whose claims involved equal pay violations. Clearly, HR professionals need to stay on top of these issues so that they can attract and keep talent and avoid the expenses and headaches related to unfair wage claims.

Leaders with Soft Skills Make for Solid Employee Engagement

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Beef up your soft skills to retain employees, attract top candidates.

There is a lot of talk about the importance of “soft skills”—such as communication, time management, and creativity—for employees. But leaders also need these abilities so that they can engage workers, encourage retention, and promote a culture where everyone thrives. Take a minute to inventory your soft skills and think about how you use them.

Telehealth Moves on the Fast Track

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This technology is picking up speed with practitioners, payors; HR should partner with team leaders to get on board.

Telehealth, or telemedicine, is getting more attention than ever, as senior care providers—especially those in rural areas—seek ways to improve care and outcomes with limited resources and staffing. There is a growing recognition of telehealth’s value, including by the government and other payors; and by 2022 between 340,000 and 590,000 physicians expect to be using telehealth. Yet healthcare organizations are still struggling with how to implement and use this technology. HR can play a key role in helping their organization’s efforts to adopt telehealth.

Why the urgency? According to one survey, physician adoption of telehealth went up—from 5% to 22% between 2015 and 2018; and it continues to grow. Practitioners’ willingness to use this technology also increased during the same period—from 57% to 69%. This growing interest, according to respondents, has been driven by a desire to improve access and patient outcomes, attract and retain new patients, and be on the leading edge of medicine. They also see telehealth as a way to increase their work-life balance and reduce burnout.