With margins tightening and contract labor utilization climbing, the skilled nursing operators that can find a way to grow their workforce organically will have the most stable staffing levels moving forward.
That’s how Pearl Healthcare sees it – and it’s why the Illinois operator has looked to partner with certified nursing assistant (CNA) schools at its newest buildings.
“I don’t think that there’s anyone that hasn’t been impacted in some shape or form by the staffing challenges out there,” Pearl Healthcare CEO Eitan Zeffren told Skilled Nursing News. “We’ve really focused on retention as a first step.”
The newer player in the skilled nursing space, formed in 2018, now has six facilities in the Chicagoland area after adding former Symphony Care Network facilities Salud Wellness in Joliet and Symphony Orchard Valley in Aurora to its network.
Both facilities will offer a CNA school allowing students to get trained in the facilities, complete their clinical work and eventually get hired by Pearl Healthcare.
“It’s essentially a program that really allows anybody who wants to get into the health care space to do it from start to finish within our facility,” Zeffren said. “We find that the majority of the students that come to particular locations want to stay within that area.”
Pearl Healthcare has found success navigating the workforce crisis by “promoting from within” as well as internal training.
For operators, Zeffren said the best way to stabilize staffing is to make sure they’re keeping the staff they have within the organization by keeping them “engaged, motivated and feeling appreciated.”
“This was a natural progression for us,” he said of the CNA program. “We find that the first place to look for new leaders in the organization is internally, and we’ve had a lot of success with that.”
Over the course of the pandemic, Zeffren saw a lot of people that were outside the health care space at the time coming “out of the woodwork” and getting involved, he noted.
“It was difficult to turn some of those folks away because those are the types of people that you want working in the facilities, the ones that are really passionate about helping but just need the tools to be able to do so,” he said.
Zeffren is confident that the program also will bring new people into the workforce, providing them with the resources they need to join Pearl Healthcare.
“We’ve seen volume continue to increase in terms of applicants and hiring which has been extremely exciting to see some of that rebound,” he said.
A big question mark for SNF operators at the moment is determining what impact the end of the temporary nurse aide waiver will have on staffing. While states like Michigan have looked to keep some of the flexibilities the waiver offered, some operators are looking to push as many TNAs through certification and testing before the deadline hits.
That hasn’t been as much of a concern for Pearl Healthcare, as it is focused on retention.
“This program is going to be for full certification,” Zeffren said. “The removal of the waiver will have no impact on the students being brought in and we have the ability to hire them while they are doing their coursework.”
Another shadow looming over the skilled nursing space is the proposed Medicare cut the U.S. Centers for Medicare & Medicaid Services (CMS) announced earlier this year to make the Patient Driven Payment Model (PDPM) budget-neutral, which will reduce overall payments to SNFs by $320 million.
Zeffren admitted to having some lingering concerns about the proposed Medicare cut on the table at a time when the industry is “just starting” to see a return of normalcy in the space.
“The timing of it is definitely going to pose a challenge,” he said. “However, we feel confident. This is not the first time that we’ve seen these changes come across and it won’t be the last.”
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