Healthcare worker with resident

Staffing concerns are front and center for senior living and other aging services providers, according to a LeadingAge pulse survey, with operators continuing to struggle to attract qualified workers and shutting down some operations due to worker shortages.

The survey included assisted living and memory care communities, continuing care retirement / life plan communities and nursing homes, among other provider types. 

Most respondents indicated significant position vacancies, with several sharing that they need to hire at least 50% more workers to be fully staffed. At many sites, administrative and managerial employees are filling in to cover for staff vacancies, they said. Communities also reported turning to on-call workers or paying existing employees overtime.

Staff retention weighs heavily on participants, rising to one of the top operational challenges. The top reasons staff members leave, according to survey results, are better pay (75%), vaccine mandates (62%), a better schedule or hours (42%), and burnout, stress, fear of COVID-19, or to take a job outside of healthcare.

Some companies cited unemployment benefits as a competing interest for staff members. Many said they can’t take on retail and food service businesses due to the long-term care industry’s reliance on public programs and tying wages to reimbursement rates, although those are not factors for many senior living operators.

Recruiting new employees is a struggle, respondents said. Providers reported significant shortages for in-demand workers providing long-term services and supports for older adults: 52% reported that certified nurse assistants were the most difficult positions for which to recruit, 24% said they had difficulty attracting registered nurses and 9% said they had difficulty hiring licensed practical nurses.

The majority of LeadingAge members (57%) who took part in the survey said they relied more heavily than usual on temporary or agency staff during the pandemic. But several respondents said they were unable to use temporary or agency staff due to a lack of available workers or the inability to negotiate reasonable contract pricing. Providers also complained about agency staff not being dependable, saying attendance issues are more common among this group.

The result of those staffing challenges left 42% of respondents reporting they were unable to serve new residents or consumers, whereas 25% said that their challenges were so significant that they had to shut down units, buildings or neighborhoods.

The survey was conducted during the last week of September and included assisted living operators (49% of respondents), memory care providers (35%), nursing homes (70%), affordable senior housing operators (14%), home- and community-based services providers (14%), home health providers (13%) and hospice providers (9%).