Two healthcare professionals in conversation
(Credit: Solskin / Getty Images)

Healthcare workforce shortages were front and center at Thursday’s Senate Health, Education, Labor and Pensions Committee hearing, and senior living industry advocates made their voices heard through submitted testimony or public statements.

Committee Chair Bernie Sanders (I-VT) promised “a lot more future discussions. But talk and hearings are not good enough. The American people want this committee to produce some serious legislation that address these crises, and that is exactly what we must do.”

Although the hearing focused primarily on physician, nurse, dental and mental healthcare workforce shortages, in prepared remarks, Sanders said: “Our committee must also grapple with broader healthcare workforce challenges. Pharmacies across the country are having trouble hiring pharmacists. We don’t have enough home healthcare workers. We don’t have enough nursing home staff, etc., etc.”

Maggie Elehwany, Argentum senior vice president of public affairs, said that Argentum will submit comments about how the shortages in the long-term care industry will “eclipse” those in all other healthcare sectors.

Elehwany said there is a shortage of 400,000 caregivers for older adults and that the number will continue to increase. By 2040, the sector will need more than 20 million workers to care for the nation’s older adults, she said. Today, 96% of senior living communities are facing staffing shortages, and 61% are concerned that those shortages may force closures, Elehwany said.

“In the long-term care sector, shortages in the senior care workforce are objectively the most acute,” Elehwany said, adding that the senior living industry lost more than 100,000 workers between February 2020 and November 2021. “While the hospital and home healthcare sectors are closer to returning to pre-pandemic employment, the senior living workforce is presently at its lowest levels since 2015.”

The challenge isn’t just finding enough caregivers to meet current needs but to meet the anticipated demand for care in the future, she said, adding that every day, 10,000 people turn 65, with estimates that 70% of those individuals will need some form of care in the future.

Elehwany called Thursday’s hearing an “important first step.”

“It is my hope that the committee will hold additional hearings to specifically examine the senior living workforce shortages and policies to expand and retain our caregivers,” she said. “The senior living workforce is at a crisis level now, but if policymakers fail to act, by 2040 it will become a catastrophic crisis that eclipses all other healthcare provider shortages.”

‘Inaction is no longer an option’

Mark Parkinson, president and CEO of the American Health Care Association / National Center for Assisted Living, said in a statement issued before the hearing that “the pandemic has taken a physical and emotional toll on our healthcare workers, especially our nation’s long-term caregivers.” Nursing homes, he said, have experienced the worst job loss of any healthcare sector.

“For years, we have called on our nation’s leaders to help us address long-term care’s workforce challenges,” Parkinson added. “As historic labor shortages continue to limit seniors’ access to care, inaction is no longer an option.”

LeadingAge submitted a statement for the record indicating that the shortage of aging services professionals at all levels in long-term care is at crisis levels and is punctuated by the rapidly aging population.

“Aging services providers across the country need immediate support to expand and enhance the workforce,” the statement reads in part. “By 2034, the United States will need 3.5 million caregivers working in the field of long-term services and supports to keep up with the growing needs of our rapidly aging population.”

All-of-government approach needed, association says

LeadingAge called for an “all-of-government approach” to help fund and build training programs, change policy to build a workforce pipeline and increase reimbursement, where applicable, to improve wages.

Referencing the results of a member poll in June 2022, the association said that many long-term care providers reported “significant” staff vacancies and said that staff members were leaving the industry for higher pay or were “simply burned out.” According to the survey, 96% of assisted living communities are facing staffing shortages. In addition, 57% of respondents said they were filling positions with temporary or agency staff. 

Certified nurse assistants were the most difficult positions to fill, followed by registered nurses and licensed practical nurses. Members also indicated that staffing challenges affected the ability to admit residents. 

LeadingAge turned to its 2023 workforce policy platform to suggest policies that allow providers to increase pay to direct care staff to at least a living wage, offer incentives and federal grants to expand training and advancement opportunities, mitigate temporary nurse staffing agency price gouging, and enact “meaningful, equitable” long-term care financing.

The association also said that the industry needs policies that establish and retain a pipeline of foreign aging services workers, support a temporary guest worker program for providers, and improve the process for allowing RNs to permanently enter the country.

Immigration reform part of solution

Jeanne McGlynn Delgado, vice president of government affairs for the American Seniors Housing Association, told McKnight’s Senior Living that she was encouraged that immigration reform was highlighted at the hearing as being a necessary part of the solution — a position she said ASHA will continue to press with Congress and the Biden administration.

ASHA, she added, will submit a statement to the committee that will urge Congress to pay attention to shortages in the long-term care industry, specifically frontline caregivers, dining staff, medical technicians, housekeepers and others who are “critical to the operation of the communities that are serving our most vulnerable citizens.”