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As workforce vacancies near 30% among Wisconsin long-term care operators, a new report from a coalition of provider organizations recommends funding sustainability, certification flexibility and compassion for professional caregivers to create a long-term, sustainable workforce.

“Creating this path will require collective action among stakeholders, policymakers and the governor to provide the necessary investments in the state’s long-term care system to ensure that providers have the continued resources needed to provide high-quality care to Wisconsin’s most vulnerable citizens,” LeadingAge Wisconsin President and CEO John Sauer said in a statement.

Other associations contributing to The Long-Term Care Workforce Crisis: A 2022 Report were the Wisconsin Assisted Living Association, the Wisconsin Health Care Association / Wisconsin Center for Assisted Living and the Disability Service Provider Network.

Caregiver vacancies increased from 23.8% in 2020 to 27.8% in 2022, according to the report, which the groups said is based on “unprecedented” data collected from providers statewide. This level compares to a 2018 report that found vacancies at 20%.

23,000+ job openings exist

The survey showed a caregiver vacancy rate of 33.2% in adult family homes, 31.2% in skilled nursing facilities, 27.1% in community-based residential facilities and 25.6% in residential care apartment complexes.

As many as 23,165 job openings exist in long-term care facilities across the state, compared with 20,655 in 2020 and 16,500 in 2018, according to the report. The level is “troubling” given that there are only 19,6000 job seekers in the state who are not currently in the labor force, the authors said.

Workforce issues are forcing some providers to either limit admissions or rely on current staff members to work double shifts or overtime, which can lead to burnout, the report noted. More than 18,000 people who sought long-term care or services were denied or delayed services due to staffing shortages, according to the authors.

“Providers are at a breaking point as the workforce crisis continues to worsen,” WALA President and CEO Mike Pochowski said in a statement. “This is extremely problematic as Wisconsin’s population continues to age yet providers struggle to find necessary staff. Further, facilities have closed all across the state mainly due to caregiver staffing shortages.”

Several challenges out there

Survey respondents reported that despite significantly increasing wages, they continue to be challenged by having no applicants for open positions, experiencing no-call no-shows to interviews and shifts, and not being able to compete with non-healthcare providers. And the median wage offered by those competing industries is almost 25% higher than the starting wage offered to certified nursing assistants, they said.

The associations give some credit to Gov. Tony Evers (D), whose 2021-2023 state budget included an additional $104 million toward caregivers. The state’s Family Care (Medicaid) program also received a 5% rate increase as part of the American Rescue Plan Act for 2022, as well as a $54 million rate increase in 2021.

A waiver program allowing for temporary and emergency nurse aide programs deemed a “lifeline” during the pandemic was withdrawn in June, however, meaning the additional 5,925 nurse aides in the program may be forced out of the profession, the authors said.

Solutions proposed

The associations said the report demonstrates that more must be done to address funding deficiencies.

Among the proposed solutions in the report are creating funding sustainability, reducing administrative burdens, having flexibility in certification, investing in technology and education, and displaying compassion for professional caregivers.

“The results of our workforce study, while very troubling, are not very surprising. But we cannot dwell on the past,” WHCA / WCAL CEO Rick Abrams said in a statement. “Instead, we must act with dispatch to ensure a stable long-term care labor infrastructure for all Wisconsinites for the future.”

The biennial survey of long-term care providers began in 2016, when the reported caregiver vacancy rate was 12.9%, according to the groups.