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Assisted living communities and personal care homes could lose staff members to nursing homes if a minimum staffing requirement is implemented for nursing facilities by the federal government as expected, worry all of the owners of assisted living residences and personal care homes in Pennsylvania responding to a new survey.

The Pennsylvania Health Care Association conducted the survey digitally Feb. 6-17 to better understand the current state of long-term care. Respondents included 31 executive directors and eight owners of assisted living residences and personal care homes, representing 33% of PHCA’s members of those operator types.

“Our survey of Pennsylvania’s assisted living communities and personal care homes revealed ongoing workforce challenges, which have subsequently created access-to-care challenges for thousands of senior citizens across the state,” PHCA President and CEO Zach Shamberg told McKnight’s Senior Living. “And to make matters worse, a new federal nursing home staffing requirement could pull even more workers away from an already shallow labor pool, exacerbating both the workforce and access concerns our providers shared in our survey.”

PHCA is the state affiliate of the American Health Care Association, which advocates for nursing homes, and of AHCA’s sister organization, the National Center for Assisted Living. AHCA has said that a federal minimum staffing mandate “would be detrimental to the long-term care profession” because it would “exacerbate the workforce issue and ultimately affect the lives of our residents.”

As McKnight’s Senior Living sister media brand McKnight’s Long-Term Care News previously has reported, the Biden administration is widely expected to release details of what would be the first-ever federal nursing home staffing mandate sometime this month, raising anxieties among nursing facilities. But the potential ramifications extend to other provider types as well.

“No industry is exempt from a workforce crisis, but not all industries are impacted the same way,” Shamberg said. “What happens to the long-term care continuum when there aren’t enough workers to provide care for our elderly loved ones and neighbors? And where will that population go to seek care?”

Waiting lists for Pennsylvania assisted living communities and personal care homes already are longer than those for nursing homes, according to executive directors who responded to the survey, and PHCA attributes the wait in part to staffing challenges. On average, 3.5 people are waiting to move into a senior living setting, which statewide equals approximately 4,000 people. Nursing homes, on the other hand, have waiting lists that average three people per facility, or a total of approximately 2,000 people statewide, according to survey results.

Workforce recruitment and retention is the No. 1 challenge or concern facing Keystone State assisted living residence and personal care home owners in 2023, according to PHCA survey responses. (No. 2 on the list is census, followed by financial sustainability in third place, and regulations/surveys and liability/risk at No. 4.)

Overall, 97% of assisted living/personal care survey participants said they have open positions that need to be filled, with the greatest percentage, 29%, saying that they have six to 10 open positions that need to be filled.

“Long-term care has an abundance of rewarding careers that are mission-driven and full of purpose,” Shamberg said. “We must do a better job of sharing the value these careers bring to the lives of our parents, grandparents, relatives and friends, rather than merely recommending harmful regulations and unattainable mandates.”

Twenty-six percent of assisted living/personal care survey respondents said they are using contracted agency staff to fill their open positions. Of those using agency staffing, 63% said they are using agencies much more in 2022 than in 2021. Assisted living and personal care respondents, however, appear to be using agencies less than nursing facilities; in a separate PHCA survey of nursing facilities, 81% of respondents reported using agency staff. 

Still, the average labor cost increase from 2019-2022 was 19%, according to the owners of assisted living residents and personal care home buildings responding to the survey; they collectively operate 50 buildings in the state.

Pennsylvania has more than 1,100 assisted living residences and personal care homes, according to PHCA.

See Related Articles, below, for additional news about the PHCA survey.

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