As nursing homes continue to eye behavioral health services for residents, Forest Hills of DC CEO Tina Sandri believes those efforts need to be extended to staff as well — especially following the height of the COVID-19 pandemic.

“I had an activity staff person come up and tell me, ‘I just held the hand of somebody dying. I was trained to make people happy and do activities, I wasn’t trained to be here for the last breath,’ and yet who has it fallen on, the activities profession because the nurses have been too busy doing other things,” Sandri told Skilled Nursing News.

“These types of things don’t disappear. We’re going to see repercussions from this,” she added.

According to the 2021 Future of Work in Nursing Survey conducted by global management consulting company McKinsey & Company, about 400 frontline nurses noted that they are looking for more workforce health and well-being support from the organizations that employ them, as well as increased workforce flexibility.

Also, more than half of the aforementioned nurses reported insufficient staffing levels, intensity of the workload and emotional toll of the job as important factors in the decision to leave their current position, according to the analysis.

Similarly to the “bottleneck” that exists in recruiting nurses to the long-term care industry, Sandri said leaders need to simultaneously be building the bridge for behavioral health and use that “person-centered care” philosophy not just for residents but staff as well.

Forest Hills has a 130-year history providing senior care, which in addition to skilled nursing, includes assisted living and memory care.

Sandri said part of the mission at Forest Hills is to inspire and engage its seniors, and this message is one that she hopes can apply to staff as well when it comes to finding ways to recruit and retain workers.

Forest Hills is expected to receive grant funding for its CNA education program as part of a partnership with D.C.’s Department of Employment Services. Sandri said the program will build apprenticeship career ladders as well as providing leadership training for its participants.

In addition to this program, Sandri is looking for ways to attract staff who want to “job share” or work on a part-time basis, especially those who left the industry during the pandemic to be home with their children.

“Our industry is a pink industry and we’re going to have to realize that some of those women aren’t coming back for a number of years,’ Sandri said. “So maybe job share, getting more creative and figuring out how we can be attractive to those women in the workforce who decided that they are just going to commit more time to motherhood.”

‘We’re the anomaly’

Not unlike many other facilities throughout the skilled nursing industry, there were times in the last year when Forest Hills, particularly in its skilled care, had to limit new admissions due to staffing shortages.

Now, however, Sandri said Forest Hills has reached close to 100% occupancy — what she recognizes as “the anomaly.”

Skilled nursing occupancy, once at 84.7% pre-COVID, dropped to 68.4% at its lowest during the pandemic in January, according to research from professional services firm CliftonLarsonAllen. Occupancy continued to recover each month as COVID-19 vaccinations were more widely distributed, but that growth appears to have stagnated.

Sandri said part of the success in occupancy comes from having a strong, experienced team but also a director of nursing “who’s not afraid of high acuity.”

“During covid the acuity levels went up and they’re likely to stay up,” she said.

As skilled nursing facilities continue to see higher acuity patients come through their doors, Sandri believes skilled nursing facilities will always be needed to fill this particular need. She said she does not see how it would be feasible to provide the type of around-the-clock care SNFs do in a home care environment.

“There’s no comparison and look, we can’t even staff them up in a group environment, where are you going to get them to provide home care,” she noted. “So there’s the reality of we want to have all the ice cream we want but guess what, there’s a limit ice cream and there’s just not enough ice cream.”

“So we have to face the reality that if we don’t grow more of our workforce, we cannot fulfill these wishes for Americans,” she added.