Nurses in the skilled nursing sector say their situation has not improved after two-and-a-half years into the pandemic – more than half have seen an increase in medical mistakes as a result of lower staffing.
This is the “new normal” for the sector, according to a study released by IntelyCare on Wednesday. The Massachusetts-based health care workforce management platform uses AI float pool management and per-diem matching technology for staffing needs.
While 51% of respondents said the situation has not improved more than two years after the onset of the pandemic, about two-thirds, or 70%, have not seen staffing improve since ratios were brought low this year.
The lowest staff count for the sector came in at 1,342,700 in March 2022, according to the Bureau of Labor Statistics.
“It’s going to be a painful couple of years,” Rebecca Love, chief clinical officer for IntelyCare, told Skilled Nursing News. “We have to be getting smarter at looking at our workforce not as an endless commodity … we have a finite supply.”
IntelyCare surveyed 450 post-acute care nurses across the country, including registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs).
Operators have to look at their culture and benefits and look to be partners with public and private entities that may have solutions – technology or otherwise – to navigate the ongoing workforce crisis.
“[Nurses] keep calling out for help. They keep asking for people to really hear what they’re trying to say and nobody is hearing the nurses. Nobody is listening to what they’re actually saying or what they’re needing,” said Love. “There are a whole bunch of people out there – not nurses – making decisions about long-term care, about nursing care, but there are very few nurses involved in that conversation; that needs to change.”
Nursing homes should find new ways to improve conditions for residents and staff, Love said, as the country moves further away from the acute phase of the pandemic.
Meanwhile, patients received poor care as a result of low staff numbers, according to 45% of nurses that participated in the study.
Ultimately, Covid made both caregivers and patients less safe – government data shows a “significant increase” in all-cause mortality among residents within the first year of the pandemic; this is especially true in states with high community spread.
As Covid spread, according to surveyed nurses, safeguards were ignored. Almost half of respondents say safety conditions within the nursing home have not improved.
The study comes at a time when the Centers for Medicare & Medicaid Services (CMS) is intensely focused on staffing levels and how it links to quality of care, and Congress works to bolster the workforce pipeline.
The agency added staff hours per resident per day on weekends, annual RN and administrator turnover to the five-star rating system.
CMS is also in the middle of conducting a study to determine the right staff to patient ratio in the nursing home, with results expected to be announced next year. The study and proposal to follow are part of the Biden administration’s push for nursing home reform.
Congress, meanwhile, has introduced a number of bills to improve staffing, including the Building America’s Healthcare Workforce Act, or House Resolution 7744 and the Ensuring Seniors’ Access to Quality Care Act, Senate Bill 2993.
Legislative efforts are seeing some traction – S.B. 2993 recently got a companion bill introduced in the House as H.R. 8805 on Wednesday. The bills, supported by aging services organizations like LeadingAge, would repeal a two-year training “lockout” for CNA training programs if an operator was hit with a civil monetary penalty.
Congress sent a letter to CMS just one day prior, urging the agency to support H.R. 7744, which would extend temporary nurse aide (TNA) waiver flexibilities for 24 months after the Covid-19 public health emergency (PHE) ends.
“This is going to take a lot of effort by a lot of really smart people, to come together to solve this in a meaningful capacity. This is not the end of a difficult problem, this is just the beginning,” said Love. “We’re really going to have to work together. I think there is a willingness across the industry, all the partners in long-term care, to try to convene and move this forward in a positive direction.”
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