Staffing Concerns in Skilled Nursing Facilities

The COVID- 19 pandemic has had an unprecedented impact on the long-term care industry. On Wednesday, March 17^th, the Senate Finance Committee held a hearing to hear first-hand accounts of the impact coronavirus has had on nursing homes staff.

The problems discussed were nationwide and similar across all states. Almost all nursing homes across the country have been affected by the pandemic. One significant problem that all nursing homes have battled is low staffing rates. Staffing rates were of concern before the pandemic hit. After the pandemic they became a crisis. The Journal Health Affairs published a study that discussed the issue of low staffing rates in U.S. nursing homes and stated that the median staff turnover rate was at 94%. Staffing issues are predominantly prevalent in the nursing departments affecting both registered nurses and certified nursing aides.

During the testimony, Dr. R. Tamara Konetzka stated that higher levels of staffing did not reduce the spread of infection rates. However, there were fewer deaths and cases when there was more staff available to attend to the residents. Dr. Konetzka claimed that short term methods to address staffing issues have included formation of strike teams to help fill the gaps of low staff. In the American Rescue Plan recently passed by President Biden, $250 million has been allotted for strike teams.

Dr. David Gifford, chief medical officer of the nursing home trade group American Health Care Association (AHCA) and Quiteka Moten, state long term care ombudsman in Tennessee, both believe more staff needs to be recruited in the long run. Dr. Gifford expressed interest in initiating programs to help increase worker retention at long-term care facilities. Programs for loan forgiveness and tax credits should be considered by skilled nursing facilities to help retain staff.

The biggest challenge nursing homes face when recruiting more staff is scarcity of financial resources. Dr. Konetzka claims that the long term care industry is “grossly underfunded” and there needs to be more transparency for the flow of money. Expert groups have also called for more financial transparency on “how nursing homes spend Medicare and Medicaid payments.” A financial reform will allow for a staffing reform.

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