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More than 12,000 positions in Minnesota assisted living communities are unfilled, with almost a third of assisted living providers reporting that they are limiting census due to staffing levels.

That’s according to the recently released results of a survey conducted Sept. 7 to 13 by the Long-Term Care Imperative. The group is a collaboration of LeadingAge Minnesota, which is the state partner of the national LeadingAge association and also of Argentum, and Care Providers of Minnesota, which is the state affiliate of the American Health Care Association / National Center for Assisted Living. Responses came from 193 assisted living communities and 124 skilled nursing facilities.

“This is a deeper and broader workforce shortage than we have ever experienced,” Gayle Kvenvold, president and CEO of LeadingAge Minnesota, told the Minneapolis Star Tribune.

“We have had chronic workforce shortages, but we’ve never had crisis-level shortages, and that’s where we’re at,” Patti Cullen, president and CEO of Care Providers of Minnesota, told CBS Minnesota.

The survey found that long-term care workforce issues are not limited to one part of the state or one type of setting. And the senior living and care industry is losing ground, having experienced 1.5 resignations per hire in August.

“We are losing more people than we can recruit,” Kvenkold told the media outlet.

Overall, around the Gopher State, 23,000 positions in assisted living and skilled nursing remain unfilled, up from 8,000 open positions reported in a survey conducted in June. Across both long-term care settings in the state, 25% of all licensed practical positions and 20% of registered nurse, home health aide, nursing assistant, dietary, laundry and housekeeping positions remain unfilled, according to the Long-Term Care Imperative.

10,000 nursing assistants / unlicensed professional positions open

Of the 23,000 open positions, more than 10,000 of them are positions for nursing assistants / unlicensed professionals working in assisted living, and more than 4,000 are such positions in nursing facilities. In assisted living, the next largest group of unfilled positions is in the dietary, housekeeping and laundry areas, where, combined, more than 2,000 positions are open. The remainder of the positions covered in the survey are licensed practical nurses and registered nurses; fewer than 1,000 positions in each category remain unfilled in assisted living.

To address the challenge, assisted living respondents said they are using more overtime and double shifts in 2021 than in 2020 (69.4%) or using the same amount of overtime and double shifts (20.2%) this year compared with last year; 7.8% of assisted living providers said they have not used overtime or double shifts in either year, and 2.6% of assisted living respondents said they are using less overtime or double shifts in 2021 than they did in 2020.

“Those who are in our buildings are burned out that are coming into work. We have folks working 100-hour workweeks, lots of doubles, so they’re tired,” Cullen said.

Fourteen percent of assisted living participants said they use agency staff and would use more if it were available, but most assisted living respondents (74.1%) said they are not using agency staff; 6.7% of assisted living respondents said they are not using agency staff but would if it were available, and 5.2% said they use agency staff and have sufficient staffing.

Census limited for almost a third

Almost 30% (28.5%) of assisted living providers participating in the poll said they are limiting census due to staffing levels.

“Seniors all across the state are either staying in a hospital longer than they need to or they are having to seek care in communities that are far from where they live,” Kvenvold told the Star Tribune.

The survey found that 52.3% of assisted living respondents are maintaining waiting lists, 11.9% are turning away more hospital admissions compared with before the pandemic, 9.3% have put a hold on new admissions, and 5.2% said they are not admitting from hospitals but are admitted from the community.

“We can’t admit people if we don’t have the staff to take care of them,” Cullen told the Pioneer Press.

The associations are calling on lawmakers to create “a more responsive and better funded system of reimbursement to pay caregivers the wages they deserve,” appropriate upfront money to enhance caregiver wages to bolster retention and recruitment efforts in long-term care in a special legislative session this year, and, in the 2022 legislative session, modify the state’s Medicaid reimbursement system to help providers raise wages and better respond to evolving labor market demands and the ongoing threat of COVID-19. Additionally, the groups are asking the state administration to use unspent American Rescue Plan money to pay for strike teams to fill emergency staffing needs and provide respite for existing caregivers.

Watch an Oct. 7 Long-Term Care Imperative press conference here.