How Supply Chain Management Affects Staffing at Long-Term Care Facilities

A recent survey by the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) revealed alarming statistics about the state of the workforce in assisted living communities and nursing homes. Survey participants—administrators from 616 nursing homes and 122 assisted living communities—reported that 75% of the nursing homes and 60% of the assisted living communities suffered from staffing shortages during the past year. When asked about the past month, 94% of the nursing homes and 81% of the assisted living communities indicated a staffing shortage. 

Over 50% of the AHCA/NCAL survey respondents had lost direct caregivers—mainly nursing assistants—who quit within the past year. Another national study of long-term care facility staffing, published in March 2021 by the Centers for Medicare and Medicaid Services (CMS), showed an average staff turnover rate of 128% per year.

Staffing shortages are so severe that some facilities are in danger of closing down—or being shut down by state regulators—because they don’t have enough staff to cover even basic care for their residents. In an industry that was already struggling before the pandemic to attract and keep labor, AHCA/NCAL warns that over 1600 nursing facilities are in danger of shutting their doors in 2021.  

Who is staffing nursing homes?

The staff providing daily care in nursing homes includes registered nurses (RNs), licensed practical nurses (LPNs) and certified nursing assistants (CNAs). CNAs do most of the direct patient care, so a shortage of CNAs in a long-term care facility has a direct effect on the quality of care residents receive. 

Long-term care facilities compete for labor with other industries that don’t require a college degree. Per Medicare and Medicaid requirements, nursing assistants must be certified. If not already certified, newly hired nursing assistants must receive specialized caregiving training and pass an exam within the first few months of being hired. 

Why is there a staffing shortage in nursing homes?

Wages for CNAs working in nursing homes are notoriously low. The U.S. Bureau of Labor Statistics reports that as of May 2020 the annual wage for nursing assistants in the U.S. ranges from around $22,750 to $42,110 with a median annual salary at $30,850.

Nursing home administrators are in a difficult position when trying to implement measures to fix the staffing shortage. Using staffing agencies and short-term contractors to fill vacant positions temporarily only perpetuates the problem of high turnover. And raising hourly rates for nursing home workers would be difficult for many facilities that rely heavily on Medicaid to cover the costs of resident care—Medicaid payments to nursing homes only cover 70-80% of the cost of care per resident. 

The COVID-19 pandemic is another hurdle that has recently compounded the staffing shortages in nursing homes. To address the pandemic, the Biden administration announced a new national policy that requires all employees of long-term care facilities to get vaccinated. As of August 2021, CMS reports a COVID-19 vaccination rate of about 62% among the staff of long-term care facilities nationwide. The vaccination mandate allows CMS to withdraw its funding from any long-term care facility that does not require its employees to get vaccinated. 

Since other segments of the healthcare industry are not subject to this national mandate, it remains to be seen how this COVID-19 vaccine requirement will affect employee retention and recruiting for nursing homes. The fear among facility administrators is that nursing homes will lose employees and potential hires to other healthcare providers or industries that don’t require a COVID-19 vaccination. 

How can supply chain management help with employee retention?

Nursing home administrators must do everything possible to keep current staff and also appeal to potential candidates. That requires building a reputation for prioritizing staff needs. Facilities that provide staff with the equipment they need to do their jobs safely and efficiently will reap the benefits of employee satisfaction and a solid reputation as a desirable place to work. 

CNAs and other nursing staff help residents with all the activities of daily living, including eating, bathing, dressing and toileting. This work is arduous—physically and emotionally. It includes lifting and turning of residents, which increases the risk of back injuries for staff. And because of the close contact between nurses and residents, the employees daily expose themselves to a variety of pathogens, in addition to the COVID-19 virus. 

Providing safety equipment and devices to help patients—such as transfer aids—and personal protection equipment for staff accomplishes two goals: 

  1. It increases the safety and quality of care for patients, leading to greater patient satisfaction. 
  2. It increases workplace safety for employees, leading to greater employee satisfaction. 

Finally, proper supply chain management enables efficiency. Facilities that are consistently well stocked with proper, high-quality supplies and equipment are more efficient—staff won’t waste time that should be spent with residents looking for supplies or trying to figure out how to do their job without the proper equipment. Efficiency makes it easier for staff to care for patients, which leads to employee satisfaction and retention.

Concordance Healthcare Solutions can help

Concordance has a long history of providing medical supplies and equipment to long-term care facilities, even in the face of recent challenges and supply shortages during the pandemic. Through our wide network of suppliers and extensive experience in stockpile management, we can deliver the supplies and equipment your staff needs where and when your employees need them. Our customizable, user-friendly solutions are designed to save time and money and Positively Impact Lives™. 

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