4 ways operators can overcome workforce challenges
The new longevity economy includes a robust range of environments and services meant to attract residents well before skilled nursing care is needed. But are long-term and post-acute care (LTPAC) providers paying equally diligent attention to acquiring and cultivating the workforce needed to successfully operate those new models and do more than merely survive as businesses?
Consumers empowered by online research tools, greater transparency in government reporting, and plenty of local units to choose from are honing their decision-making skills—and making providers live up to their quality promises. Simultaneously, massive regulatory changes over the past four years have forced providers to sink or swim under the new risk-sharing models, including service bundling and the shift to quality-based reimbursement.
Building and keeping a dedicated, skilled workforce will become more difficult for operators in the next five years, analysts predict, thanks to a widening gap between the number of workers needed (especially in the home care sector) and the number of qualified workers available.
Four factors are simultaneously impacting LTPAC operators’ ability to recruit and cultivate high-quality teams:
For most LTPAC providers, employee turnover is the biggest challenge by far. Wages are a special concern for the LTPAC sector, which utilizes significant numbers of direct-care workers. The direct-care workforce is overwhelmingly female and receives the lowest hourly wages in the senior care service continuum with a national average hovering around $12 an hour, notes PHI, a national organization that tracks the healthcare paraprofessional workforce.
Yet, attractive wages may not be enough to woo and retain quality care staff as shortages create heightened competition for quality workers. Employees who feel respected, who are encouraged to serve on teams and are regularly asked to provide feedback tend to be less of a turnover risk, notes the 2018 Senior Living Trends report by CliftonLarsenAllen (CLA).
2. Aligning Workforce with the Consumer-driven World
As the senior living market continues to reinvent itself in a consumer-centric era, employees will need evolved skills and mindsets to succeed in the new models for aging in place and assisted living. “Senior living organizations will need to adjust to meet the Boomers’ desire to experience retirement on their own terms, including heightened focus on purpose, engagement, and health,” the CLA report notes. For many operators, that means employee training, addressing everything from preserving resident dignity and power of choice to cultural sensitivity training and ways to avoid ageist language.
3. Maintaining Leadership at the Top
The LTPAC market also faces an aging administrative sector: A whopping 40 percent of post-acute care multisite CEOs will reach retirement age in the next five years, according to the 2017 LeadingAge-CEMO Leadership Compensation Survey. Having a clear succession plan for key leadership positions can assure consumers and employees that the organization’s mission and culture are secure, increasing confidence and trust.
The trend “adds urgency to plans for replacing aging leadership and long-tenured caregivers,” the CLA report notes, adding that HR departments may need to break out of the traditional views of executive hiring and consider more multicultural and younger candidates.
4. Workforce Skills Mix
Providers seeking to grow in quality instead of merely toeing the regulatory line are reaching for a more sophisticated staff skills mix. The focus on skill sets in addition to staff ratios began when the Centers for Medicare and Medicaid Services (CMS) leveled the various state laws and required a minimum of eight RN hours per day. Later, CMS announced new requirements for infection prevention programs, requiring larger organizations to employ a certified infection preventionist on staff.
As the LTPAC sector moves from a medical focus to a consumer focus, operators are striving to provide staff expertise in specialty services, including healthy memory programs, active wellness programs, educational engagement, and lifestyle/social programming. “Assisted living operators are embracing the combination of lifestyle with higher acuity care to realize strong growth of specialty programs,” the CLA report notes.
New attention to specialty certifications and post-hiring education and training can help operators provide the services and programs consumers want while maximizing the value of each employee.
How LTPAC operators handle the growing workforce pressures will depend partly on a shift in mindset, the CLA report concludes. Navigating the challenges will require innovative recruitment strategies, a corporate culture that respects and engages all employees, and equitable pay rates, at the very least.