While Pennsylvania nursing homes and long-term care facilities already face major staffing challenges, federal vaccine mandates and a new state-proposed minimum staffing requirement could devastate the industry.
President Joe Biden’s 100 percent vaccine mandate for healthcare workers is expected to lay off thousands of workers, in an industry that has struggled to find workers over the past decade.
About 35 percent of Pennsylvania nursing home workers have not been vaccinated. Zach Schamberg, CEO of the Pennsylvania Health Care Association, told The Epoch Times in a phone interview that this equates to about 33,000 workers who will lose their jobs if they don’t get shots. It only counts nursing home workers. Add thousands more workers in assisted living communities, individual care homes, hospitals, and doctor’s offices.
“NS [Biden] The administration has said, if we don’t terminate the workforce, it will freeze state and federal funding,” Schamberg said. “It is 80 per cent of our funding. Nursing homes will be forced to close their doors. The industry has been put in an impossible position. This either terminates employees or runs the risk of losing money. It is difficult for the providers who have been at the center of this pandemic since March of 2020.”
The association, which advocates for nursing homes, assisted living communities and personal care homes, is working to clear up misinformation about vaccinations, but many workers have good reasons to be hesitant about getting the shot. Schamberg said an alternative, such as testing, is needed for hiring workers. The association is advocating for this with policymakers in Harrisburg and Washington.
Caregivers who have not been vaccinated continue to follow infection protocols, get tested twice a week, and wear PPE.
A 2019 report by the Pennsylvania Auditor General Eugene Depasquale predicted a senior citizen population explosion and examined the current shortage of healthcare workers.
The report says there could be more than 4,000 registered nurses in Pennsylvania by 2030 as some retire and new jobs are created. Difficulties in obtaining a license, emotionally demanding work, and low wages are barriers to attracting workers.
“We knew there was a real need for workers then,” Schamberg said. “Then when COVID started, we saw the workers go away in fear. Schools closed and some workers had to return home to care for their children. We are now seeing an escape from burn-out. We cannot afford to lose a worker. Losing 33,000 would be catastrophic. “
The average salary for a Certified Nursing Assistant (CNA) is $15 per hour. In years past, nursing homes mostly competed for workers with other healthcare providers. As wages become more competitive, they are competing with convenience stores, restaurants, and Walmart, which all pay the same or more.
CNAs are often asked to handle tasks such as bathing, dressing, feeding and changing diapers for residents.
“It is difficult to find workers. This job takes a very special person. It’s an obsession,” Shamberg said. “Without the first investment of the state government, nursing homes cannot invest in their staff. That means investing in the state’s Medicaid program.” The amount the government provides determines how many facilities can be provided to workers.
Over the past two years, the legislature and governor have stepped in to support nursing homes with funds from the Care Act and the American Rescue Plan. But this is one-time funding and can only be used for COVID-related expenses, Schamberg said.
Many Pennsylvania nursing homes are already so staffed that they are not able to take on more residents. Instead, they are putting people on waiting lists. Patients transitioning from hospital care to long-term care should wait and seek an opening.
“Some family members are being forced to travel for 30 minutes or an hour to get care. A year ago, this was unimaginable. The issue of care in Pennsylvania today has a real reach,” Schamberg said.
Quality Life Services is a family-run operation in western Pennsylvania with 10 long-term care campuses and a home health and hospice business. Combined, the company has about 1,300 beds, but 900 beds are occupied right now, Steve Tack, Quality Life Services CEO, told The Epoch Times in a phone interview.
Residents are few in number because some succumbed to the virus before a vaccine was available, and at that time, families were hesitant to put their loved ones in long-term care due to strict visitation rules and fear of the virus. Were.
Quality Life Services is trying to rebuild its population but does not have the staff. And because of that, the company declines 80 percent of patient referrals from hospitals.
Patients in hospitals who are ready to be discharged into a nursing home, waiting in the hospital, looking for a nursing home that will take them.
“We have over 200 positions open for which we are recruiting,” Tack said. “A month ago it was 250. We have been aggressive with recruitment.” Of these, more than 150 jobs are in direct care nursing positions and others are assistant positions.
“More than 50 percent of our employees have been vaccinated,” Tack said. “There are a large number who have told us they will resign before vaccination.”
Quality of Life Services increased testing for illiterate workers and took precautions to keep everyone safe. Tack said the company is very concerned about how they will handle staffing after Biden is vaccinated.
“We’ve been told to expect regulation in mid-October or late,” Tack said. “We do not know when it will come into force. We spend a lot of our time talking with unvaccinated staff and encouraging everyone to get vaccinated. We tell them, don’t give up on us until we know for sure. Maybe there will be a test. “
“As I watch the news, I see people coming to this country who want to work,” Tack said. “We have to provide a way for them to come and help meet the need.”
New State Staffing Regulation
The Pennsylvania Department of Health added a layer of complexity to nursing home staffing by proposing a new minimum staffing requirement.
Facilities must currently provide 2.7 hours of direct care per day for each resident. At the peak of the pandemic, the department wrote a new rule, increasing the need for direct care to 4.1 hours per resident. Before it can go into effect, the new rule must be approved by the independent regulatory review commission, but this week the commission sent it back to the health department for rewriting, saying the regulation allowed the commission to determine Not enough information is offered to give. Regulation is in the public interest.
The Department of Health considers three job titles as Direct Care Staff: Registered Nurse, Licensed Practical Nurse, and CNA. But the Centers for Medicaid and Medicare Services considers those titles as well, including wound care nurses, social workers, physical therapists and assistants, speech therapists, dietitians, activities workers, and more. They will not count the hours of direct care workers in Pennsylvania.
“If enacted tomorrow, 7,000 new care workers would be hired at a cost of more than $400 million in new annual salaries,” Schamberg said. “Where do we get workers? It just doesn’t work. There is not a single provider that does not want to increase its workforce. This climate is not the time to do that. We will continue to oppose any proposal that would block access to care or force good providers out of the state. “
The Pennsylvania Health Care Association recently surveyed its members about the current state of long-term care. The responses are a sample of the entire region in the state.
Schamberg said a total of 18 owners/operators participated in the survey, which is expected to be released in full next week.
As an owner, they may operate one or more long-term care facilities in Pennsylvania, which include nursing homes, individual care homes, and assisted living communities.
Seven owners/operators said they could not afford to provide care more than 12 months from now. Three owners/operators said they currently plan to close or sell the facilities, and four preferred not to answer questions.
Asked how his organization plans to respond to the Biden vaccine mandate, 10 said they are still not sure and are planning to terminate three already unaffiliated employees.
The survey also received responses from 64 facilities across the state.
When asked how many employees were on the payroll in February 2020 and September 2021, the answers showed that on average, facilities have lost 18 percent of their workforce since the start of the pandemic; 43 percent of nursing homes have 21 or more job positions open.
In the survey, nursing homes responded that the top four reasons workers were leaving were burnout (70 percent); wages (66 percent); COVID-19 safety concerns (48 percent), and reluctance to comply with the COVID-19 vaccine mandate (34 percent).
Additionally, 96 percent of nursing home respondents said they would not be able to meet the direct care staffing requirement of 4.1 hours per day if implemented today; 85 percent of nursing home respondents have limited or withheld new admissions due to staffing shortages, and 50 percent of nursing home respondents currently have a waiting list for new admissions.
The Pennsylvania Department of Health did not respond to emails with questions about the minimum staffing requirement.
New York has said it will ask the National Guard to fill vacant health care jobs.
The Pennsylvania Department of Health also did not respond to questions about how it plans to fill any worker gaps in nursing homes and hospitals created by the vaccine mandate.
This News Originally From – The Epoch Times