Urban and rural long-term care providers facing workforce challenges

Long-term care facilities statewide are struggling with a persistent workforce shortage, but LeadingAge President and CEO John Sauer says rural and urban areas face different challenges related to this issue.

“When you talk to our more urban members, they indicate there are significant workforce pressures,” he said.

In urban areas, nursing homes and other long-term care providers are competing with many other employers that can usually offer a more attractive starting wage. Entry-level manufacturing jobs can pay up to $20 per hour, and Sauer says urban care facilities simply can’t match that rate.

On the other hand, nursing homes in rural areas are often the largest employer in the area, so options are generally limited for people seeking work. But when these care providers struggle to pay an attractive wage, Sauer says that can lead to workers leaving the area entirely or simply retiring.

And he notes the average age for nurses in the state is around 55, so many are already nearing retirement.

“When a rural area loses a nurse, there’s often no other nurse in that immediate area they can hire to replace that nurse,” he said. “Where is the next person coming from? How long will people spend driving their car to work in a rural area? Those are the unique pressures some rural facilities are facing.”

Figures compiled by LeadingAge show one in five caregiver positions in the state are currently unfilled. Since 2016, 30 nursing facilities in the state have closed, and 11 of those have shut down since the beginning of this year.

Sauer says nursing facilities are struggling to pay a competitive wage because Wisconsin’s Medicaid reimbursement rate is relatively low compared to other U.S. states.

“Our payment standard is in the 25th percentile,” he said. “We talk at length about Medicaid underfunding; it’s hard not to, when two-thirds of all nursing home residents are paid for by the Medicaid program.”

He says only 25 percent of direct care nursing homes in the state are reimbursed for the cost of employing registered nurses, certified nursing assistants and licensed practical nurses. Increasing Medicaid reimbursement to these facilities would help them increase wages and retain more workers, according to Sauer.

LeadingAge Wisconsin is a nonprofit nursing home operator based in Madison. Sauer says a number of its members are considering downsizing their operations as a way to “control their Medicaid losses.” He says the state’s relatively low Medicaid reimbursement rate “threatens the viability of the entire nursing home operation.”

But he says raising reimbursement isn’t the only way to improve nursing home care and access in the state.

“We’re working on a variety of things,” Sauer said. “We have started a geriatric career development program that we’re piloting in inner-city high schools in Milwaukee, where we are attracting young people to consider a career in long-term care.”

Students who graduate from this pilot program will be certified as nursing assistants. Sauer says LeadingAge is working with the state Department of Workforce Development and other partners to stimulate interest through job fairs and other outreach.

“It’s a very rewarding career for people, and that’s the message that we’re trying to carry to people and communities,” Sauer said. “If we don’t start investing now, the demographics of our aging society is such that we’re going to be behind the 8-ball.”

Listen to a recent podcast with Sauer: http://www.wisbusiness.com/index.iml?Article=394097


–By Alex Moe