Workforce challenges, resident mental health and property insurance rates remain the top concerns for affordable senior housing providers, according to the results of a new LeadingAge survey.

Also, affordable senior housing providers are reporting lower COVID-19 rates among residents, but higher infection rates in staff members. They also report persistent challenges in hiring and retaining service coordinators and other staff members, according to a column by LeadingAge Director of Housing Operations and Policy Juliana Bilowich.

The quarterly informal survey of federally assisted senior housing provider members opened in late March and includes data going back to December. Providers were asked about the physical and mental well-being of residents, property finances and contract renewals, staffing challenges, and Department of Housing and Urban Development compliance and oversight.

Staffing levels top challenge

Staffing and other workforce issues overwhelmingly were listed at the top operational challenge in the next three months, followed by inspections, maintenance and resident mental health. 

Staffing levels are a top challenge, with 71% reporting that they had struggled with maintaining staffing levels in the past three months, up more than 20% from December. Participants also reported an increasing number of confirmed COVID-19 cases among staff members, low morale and personal circumstances affecting productivity. 

Filling service coordinator positions also is a top staffing-related challenge: 60% of respondents reported that it takes two to four months to fill an open service coordinator position, with more than 30% of respondents reporting that it takes longer than five months. 

HUD-approved budgets and low salaries were the top barriers to finding service coordinators, followed by a lack of qualified applicants. Providers reported that most service coordinators who left their jobs sought higher pay and more work-from-home flexibility. Vaccine requirements were cited by 15% of service coordinators as the reason they left their jobs.

Occupancy continues to be affected

Occupancy continues to be affected by the pandemic, with more than half of participating providers reporting higher vacancy rates compared to the December survey. Despite increased occupancy challenges, 84% of respondents reported vacancy rates below 4%, up from 75% in December. The majority of properties also show an estimated waitlist of one to five years, or more.

According to survey results, the rates of COVID-19 among affordable senior housing residents eased in the past quarter, with 41% or respondents reporting no known cases, up from 29% in December.

Providers are also reporting high rates of vaccine confidence, with more than 80% of residents and staff members being fully vaccinated and up to date on vaccines, including boosters. Almost two-thirds (62%) of affordable senior housing communities represented in the survey reported having either a vaccine mandate or a vaccination / regular testing requirement for staff members. Less than 2% of respondents said they are still undecided or are considering a vaccination and / or testing mandate.

Property financials remain flat, with 9% of respondents reporting severe cost burdens due to COVID-19 and 46% reporting general pandemic cost burdens. 

Almost 39% of respondents reported receiving HUD Coronavirus Aid, Relief, and Economic Security (CARES) Act funds in the fourth quarter of 2021 for COVID-19 operational expenses — about 14% said they received funds for capital expenses. Most (72%) said they used those dollars for cleaning, followed by personal protective equipment purchases and test access (69%), additional staffing (28%), and internet installation and technology (25% each). 

When asked whether they would seek additional funding from future HUD COVID-19 supplemental payments, 40% of respondents said they would ask for funding for operational expenses, 32% said they’d seek help for internet installation, and 12% each said they would seek additional dollars for back-up generation installation and other expenses. Twenty-eight percent said they would not seek additional pandemic funding.

Insurance rates a concern

Although LeadingAge said it has worked with HUD, affordable senior housing members and insurance brokers to bring down the cost of property liability insurance rates, 95% of survey respondents said they are concerned about rate increases and / or coverage loss.

Some respondents reported insurance rate increases of more than 30%, and almost 40% reported an increase between 10% and 30%.