Staffing challenges in long-term care are only expected to get worse, according to a report released Monday by the Pennsylvania Joint State Government Commission
The body was created in 1937 as the primary and central nonpartisan, bicameral research and policy development agency for the General Assembly of Pennsylvania. The current report, “Use of Contracted Workers at Medicaid Funded Long-Term Care Facilities in The Commonwealth,” is the result of a 2021 directive from the General Assembly.
Skilled nursing facilities in the Keystone State had 8,672 fewer workers in 2022 than in 2018, according to the report, which noted that that year, SNF residents received approximately nine fewer minutes per day with direct care staff than in 2018.
Staffing agencies charge a markup of about 45% to 75% for providing contracted workers, the authors noted. The rate “may be typical of their industry, however, they are not costs the Pennsylvania long-term care system can sustain,” according to the report, which recommended that the use of contract employees should be kept to a “necessary minimum.”
Pennsylvania Health Care Association CEO Zach Shamberg told the McKnight’s Business Daily that the group previously has “sounded the alarm regarding workforce limitations, access to care crises, and the opportunistic tactics of certain staffing agencies.”
“To overcome these issues, PHCA has advanced legislative priorities to support long-term care providers, including House Bill 2293, which was signed into law last November and will regulate staffing agencies in Pennsylvania’s long-term care continuum,” he added.
The law requires staffing agencies that provide temporary employment in assisted living communities and nursing homes to register with the state, validate the healthcare credentials of contracted employees and carry medical malpractice insurance. It also bans noncompete clauses in agency contracts and requires agencies to pay workers’ compensation coverage for all employees.
“With a lack of funds and increased staffing requirements, Pennsylvania will continue to lose access to more beds in nursing facilities,” Shamberg said. “The commission’s report found that there are 4.7% less beds available in 2022 than in 2013. And with the negative trend already facing Pennsylvania, we are bracing for an additional 13.6% reduction in beds by 2030, according to the report.”
Among its recommendations, the commission said that the state legislature should consider increasing Medicaid reimbursement rates to fully cover the cost of SNF residents, raising wages for direct care workers and providing training opportunities and access to career advancement opportunities.
“In short, there needs to be robust financial support, collaboration between commonwealth agencies and providers, and provider-based improvements at the direct-care level,” Glenn J. Pasewicz, executive director of the commission, wrote in the introduction to the report.
