Employment in senior living today can best be described as one that is rich in demand and poor in supply. It’s simple supply side economics and no matter how one does the math, the answer is the same.
As of early 2017, there were at least 22,000 new jobs unfilled across all senior living sectors. And with the biggest wave of Baby Boomers in need of this kind of care just around the corner, it’s bound to get worse.
According to the Bureau of Labor Statistics, at least 2.5 million more workers will be needed by 2030 to care for the so-called “silver tsunami.” Argentum has projected that 1.2 million new workers – mostly CNAs and aides (460,000) and registered nurses (25,600) – will be needed in senior living through 2025. Assisted living will outpace skilled nursing in staffing demand over the next 10 years with a projected growth rate of more than 30%. Only home care will register the greatest projected increases (60%). Nursing home staffing demand is expected to grow by about 20%.
The senior care labor issue will soon be front and center in nearly every debate over wages and employment in America. It is a sector growing by a staggering 24% per year, nearly doubling in size during the first 14 years of this millennium alone. In just 2013, positions in assisted living and continuing care retirement communities grew by more than 3%, outpacing every other American industry by 1.5%.
By the early years of the coming decade, long-term care will be by far the biggest employer in America – surpassing foodservice, hospitality, manufacturing and every other sector in the country.
According to the New York Times, the Paraprofessional Healthcare Institute projects that the nation’s direct care work force will be “5 million strong [and] the largest occupation in the United States.”
An executive at one of the nation’s largest long-term care workforce management firms has described it as “the herculean sourcing, hiring, and training tasks all healthcare organizations will face in the coming decade.”
For most assisted living owner-operators, sourcing the needed labor pool in the next 10 years will likely be the biggest challenge – one that will increase exponentially as acuity levels continue rising in the non-skilled arena.
As workforce solutions and hiring software provider Vikus recently found when it surveyed owner-operators, recruitment and hiring are becoming more and more challenging as each year passes. One reason: assisted living is competing with hospitals and other higher-paying sectors inside and outside of healthcare for what is currently a limited well-trained applicant pool.
The situation has forced hiring managers to dive more deeply into what’s in this pool. And many are surprised by not only its diversity, but its attitudes toward work, loyalty and other things. Make no mistake: the composition of the long-term care workforce – from its multi-generational quality to the growing domination of millennials – is undergoing significant changes.
Here’s a look at some of the key challenges:
Retention challenges. As if recruitment isn’t a big enough challenge, keeping talent is even bigger. Few experts dispute this oft-quoted statistic: More than 50% of new hires in senior living leave within the first 90 days of employment. As one university training executive has bemoaned, “Most communities have enough workers, they just don’t keep them.” Owner-operators also are faced with finding ways to make long-term care careers more attractive. In its “Getting to 2025: A roadmap for the senior living industry” report, Argentum found that fewer than 10% of applicants under the age of 35 said they have a high level of trust in assisted living.
Turnover and attrition. Just a few years ago, a University of California study found that median turnover in skilled nursing facilities was at 44%; the worst turnover rates – 52% – were among certified nursing assistants, or CNAs. It’s even worse outside of skilled care, particularly in residential care communities. Complicating matters is the fact that the costs to replace a lost employee can be as high as 21% of the individual’s salary.
Compensation issues. According to PHI, about 20% of home care workers today actually live in poverty – double the amount among U.S. workers as a whole. More than half of nursing assistants quit each year because of poor pay, leaving roughly 50,000 positions unfilled as a result. Though the percentage of private pay residents is substantially higher in this sector, the wage pressures are very real. Assisted living owner-operators frequently cite the so-called “Walmart effect” as a leading culprit that impedes their ability to recruit, hire and retain staff. Many continue losing lower-level caregivers to big box retailers that are able to offer pay that is substantially above federal minimum wage.
Training and education. Some observers argue that assisted living is only just now waking up to the fact that staff retention hinges on improving competency and career paths. Argentum and OnShift, for example, are undertaking a three-year partnership aimed at tackling the industry’s most vexing workforce challenges ahead. Their work recently resulted in the formation of a nonprofit Senior Living Certification Commission to operate and maintain credentialing and certification processes, including certification tests for assisted living executive directors. The workforce management industry has also responded with a bevy of new opportunities in online learning, streaming educational courses and intuitive software programs that offer continuing education credits.
The vendor community has responded to the staffing crisis in innumerable ways. Nowhere is that more evident than in technological innovations designed to streamline caregiving, documentation and resident security, as well as creating new opportunities for caregivers to engage with their supervisors and peers, as well as their residents.
There are seismic changes afoot.
As one assisted living community executive remarks, “We’re in the middle of a large paradigm shift on how to use technology to attract, recruit and retain staff and the market for staff in healthcare is more competitive, so technology is increasing in importance as a tool to navigate this shift successfully.”
Several leading workforce management companies have developed innovative mobile tech solutions that allow caregivers to easily change schedules and document, providing a measure of flexibility and in turn, greater job satisfaction.
Other kinds of mobile tech allow staff to engage with residents in ways they never have before. The ability to communicate in new ways also provides for a more satisfying and fulfilling workday, experts say.
And resident elopement and fall detection technologies provide a kind of virtual second pair of hands and eyes to often over-stressed and extending caregivers, improving safety and minimizing stress.
At the end of the day, as one California university study found, communities rich in technological solutions like these tend to experience significantly lower turnover and injuries, something that provides a veritable “win-win” to staff and employers alike.
Staffing is one of the largest challenges for senior living communities. ValueMed offers technology and tools to support your staff and reduce their burden; while our training leads to more confident staff, which improves outcomes and reduces turnover. Contact us at info@PharMerica.com or 855-637-1755 to learn more.Download PDF