Workforce shortage worsening for long-term care providers

Nursing homes and assisted living centers in Wisconsin are experiencing a worsening workforce shortage, according to a recent report from a group of provider organizations.

“Long-term care providers are all too aware of this crisis, because they live it each and every day,” said Lincoln Burr, CEO of the Disability Service Provider Network. “We find ourselves caught in a staffing vortex with dramatically increasing need and a rapidly constricting workforce.”

Groups involved in creating this report include: Wisconsin Health Care Association/Wisconsin Center for Assisted Living, LeadingAge Wisconsin, the Wisconsin Assisted Living Association, and the Disability Service Provider Network.

The report is based on a survey taken by nearly 800 providers. It shows fewer caregivers entering the workforce as more and more people are seeking long-term and residential care.

“This ever-growing workforce crisis is pushing more providers to decrease their admissions, making it more difficult for residents to have choice in where they live,” said Sarah Bass, operations and communications director of the Wisconsin Assisted Living Association.

Report authors say issues like this come from many factors: growing demand for caregivers; gaps in the starting wage for entry-level caregivers and non-healthcare workers; the state’s low unemployment rate; and Wisconsin’s Medicaid reimbursement system failing to cover the cost of care incurred by LTC providers.

These providers are struggling to offer competitive wages, report authors say, due to long-term care residents’ reliance on Medicaid and Medicaid-waiver funding to pay their bills.

About two-thirds of nursing home residents in the state are Medicaid recipients. And the average Wisconsin facility loses $63.04 per day for each of the state’s approximately 21,100 Medicaid recipients in nursing homes, report authors said in a release.

“Long-term care residents’ heavy reliance on Medicaid, paired with an insufficient Medicaid reimbursement system, severely limits a nursing home’s ability to compete in a tight labor market,” they said.

And one in three providers estimate at least 10 of their staff use BadgerCare Plus, the state’s Medicaid health insurance program for low-income people.

Burr says rates would be going up in an “efficient and balanced” marketplace, but “instead provider rates have decreased in terms of both inflation adjusted and real dollars.”

Report authors note that state leaders have taken action to address this problem, as the 2017-19 budget included a 2 percent increase in skilled nursing Medicaid reimbursement for each year of the biennium.

The report shows over 90,400 state residents live in LTC facilities, a 23 percent increase in the past 15 years. And over 82,000 caregivers work in these facilities, an 11.8 percent increase from 2016.

The report found 25 percent of respondents are unable to admit new residents or tenants due to jobs going unfilled — up from 18 percent in the 2016 survey.

This leads to current caregivers being called on to work double shifts or overtime. This can contribute to burnout, Bass says.

The report also found one in five direct caregiver positions in the state’s nursing homes and assisted living facilities are currently vacant. By comparison, the 2016 report found one in seven long-term care positions were unfilled.

Statewide, it shows 16,500 job openings in LTC positions, up from 11,500 openings in the 2016 survey.

The caregiver vacancy rate is also up from 2016, going from 14.5 percent to 19 percent. Thirty percent of providers face a caregiver vacancy rate of over 25 percent, and one in five providers face a caregiver vacancy rate of 30 percent or higher.

Fifty percent of providers say felt they were unable to compete with other employers — up from only 30 percent in 2016.

Eighty-three percent said there were no qualified applicants for caregiver openings, and a full 54 percent had no applicants for caregiver openings at all.

The state Department of Health Services will unveil the WisCaregiver Career Program this week. It provides free Certified Nursing Assistant certification as well as workplace incentives. The program’s goal is to attract 3,000 new CNAs to work in long-term care.

But, report authors say, this report proves that more action is needed to address deficiencies in funding.

“With the need for LTC services expected to continue to rise, providers are eager to work with state leaders to be a part of the solution to Wisconsin’s long-term care workforce crisis,” said John Vander Meer, executive director of the Wisconsin Health Care Association.

–By Alex Moe