Even before Covid-19 brought unprecedented stress to the healthcare system, the long-term care industry in America has faced a series of challenges and crises on a number of fronts. With calls for federal assistance still mostly unanswered, what can leaders do to best address the many challenges of long-term care facing them in 2023, and the years to follow?
The Biggest Challenges of Long-Term Care in 2023
Fewer Workers to Treat More, Higher-Acuity Patients
In an industry that’s always had a high turnover rate, the current workforce shortage has been devastating. A 2022 survey by the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) showed that an enormous 98% of nursing home providers are currently “experiencing difficulty hiring staff,” while 87% currently face “moderate to high staffing shortages.”
Of course, staffing has been one of the most persistent challenges of long-term organizations for decades. Workforce issues in general also account for a number of other issues facing the industry, including “unmet resident needs, quality problems, worker training and competency, and lack of integration with medical care,” as defined by the Kaiser Family Foundation in 2017.
All the same, as other facilities like hospitals and health centers have slowly leveraged economies of scale and other methods to overcome shortages after Covid-19, many long-term care facilities remain in dire need of staff. In some areas, there simply aren’t enough workers to cover patient care needs. As a result, some LTC providers have had to set limits on new admissions.
On top of that, many new residents referred to skilled nursing and other long-term care providers are higher acuity than before, the result of an ongoing trend to move post-acute care out of the hospital and into less expensive settings. Concurrent with this trend is the drive to further reduce expenses by shifting residents from skilled nursing facilities into home-based settings.
The result is new and different responsibilities and obligations for facilities that may already be stretched to the max — essentially, treating “two distinct populations,” as a pre-pandemic analysis by Wolters Kluwer describes it: “patients there for a few weeks as they recover from specific illnesses or injuries, and residents who live there because they require skilled nursing care to live.”
While it is true that some larger organizations have embraced the chance to expand their SNF service lines and resident capacity with new options for home care, many others have struggled to produce the additional workforce with the skills needed to do so.
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Government Funding & Public Awareness
Representatives of the LTC industry have called upon Congress to help solve these problems for decades, especially in the few years since Covid-19 struck. With some regulatory changes and federal dollars — as opposed to the patchwork collection of state rules and assistance — LTC organizations could work to correct its labor shortage with higher wages, programs for overseas workers, and other initiatives.
Indeed, chronic underfunding has long been one of the key challenges of long-term care in the United States. Even back in the 1980s, experts warned that “the current system as structured is being stressed to its limits and that its functioning is inadequate, with serious problems in cost and financing, and in access to and quality of, long-term care services.”
Today, political science professor Robert P. Saldin points out that one of the reasons why the LTC industry remains largely ignored by the federal government is lack of political will. Lawmakers haven’t made a priority of funding such an essential industry because many Americans don’t understand the nature of the problem in the first place, he argues.
“To the surprise of many, Medicare does not cover LTC expenses,” Saldin writes at National Affairs. “Financing LTC is especially difficult because the American public is generally ignorant about the issue and ill-prepared for the financial risk it poses … Those misperceptions severely limit reformers’ ability to rally political support for a new program to address the issue.”
Yet progress has still been made, though slowly. The version of the ‘Build Back Better’ bill that finally passed in 2022 included $150 billion in federal funding to help “provide the opportunity for higher wages and increased standard of living for the direct care workforce,” as the Partnership for Medicaid Home-Based Care (PMHC) said in a statement shared with Home Health Care News.
The funding was designed to “permanently increase by 6 percent the funding the federal government gives each state for in-home and community-based services, as long as the state creates a plan for strengthening and expanding services,” explained Rachel Roubein at the Washington Post.
“The economic package also boosts federal payments to states by 80 percent for the administrative costs of improving in-home and community-based services.”
How Can Leaders Meet the Challenges of Long-Term Care?
How can organizations that provide long-term care services get ahead of these challenges? While there’s no way to create new workers out of thin air, many facilities could benefit from access to a wider range of employees. A nationwide healthcare staffing and recruitment company can help fulfill that need, with thousands of workers available all across the United States.
Other workforce solutions can help organizations stretch their budgets by better managing and even automating certain administrative tasks. For instance, a healthcare managed services provider (MSP) or a vendor management service (VMS) can help streamline tasks related to hiring, billing and scheduling, helping healthcare employers accomplish much more with far fewer workers.
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Prepare for the Challenges of Long-Term Care with CareerStaff
As a leading provider of healthcare workforce solutions, CareerStaff Unlimited is here to guide you to the solutions that best meets your unique needs. How can we help your organization meet the challenges of long-term care? Contact us here to find out!