Why Skilled Nursing Operators Must Look Beyond Washington to Solve the Workforce Crisis

As the skilled nursing industry works to stem the workforce shortage tide, leaders in the sector should not expect to find the ultimate answers in Washington.

That’s according to Clif Porter, senior vice president of government relations at the American Health American Health Care Association/National Center for Assisted Living (AHCA/NCAL).

“We can’t fix this in D.C., this is not a D.C. easy button fix,” Porter said during the discussion, adding the solutions must be a combination of different things given the fact that every labor market is so different.

Every metropolitan statistical area (MSA) or micro market has its own unique challenges, Porter added, comparing finding solutions to the workforce crisis to a Gordian knot.

Porter discussed sector advocacy, among other changes facing SNFs over the next fiscal year, during a webinar alongside Marquis Limited President Norman Rokeach and Majestic Care CEO Bernie McGuinness. The event, hosted by eCapIntel, was moderated by Ambassadors Group Executive Director JJ Rabinowich.

Unraveling the workforce ‘Gordian knot’

While Porter believes immigration is one of, if not the most important solution to solving the workforce crisis, he also recognized the deep partisan divide that would have to be overcome to do so.

The nursing home employee count has ticked up modestly since the beginning of the year, but the number is still nowhere close to what the industry saw 10 years ago – about 21% of the sector’s workforce has not returned.

What can realistically be done, he said, are things like passing legislation to extend the temporary nurse aide (TNA) programs and making sure buildings have the ability to train certified nursing assistants (CNAs) in their own markets.

Operators also have to be innovative in showing employees that they are valued members of the workforce team, especially those on the frontlines.

“These folks have to have the tools that they need to feel good about their jobs when they go home. And if they don’t, they’re going to go work in an environment where they can. It’s just that simple. They have the option,” Porter said.

Rokeach said he’s recently met with three different governors in states where Marquis operates to see what can be done to invest in the nursing home workforce — whether that be college tuition reimbursement, loan forgiveness or fast tracking nursing school programs.

Marquis has also “adapted to today’s needs” by offering increased scheduling flexibility, among other things, as part of its larger retention strategy.

“I think the more capabilities we have of retaining our staff and wanting to make sure that even if our competition is going to be offering $1 more down the block — but they know coming to work that they’re coming to work with an environment that … cares about them and really makes it a great employee experience — that’s been a tremendous help from a retention standpoint,” Rokeach said during the webinar.

Majestic Care, in addition to its employee focused benefits program, has also worked with local and state officials to get more CNA programs in local high schools and attract students who may not be interested in attending a traditional four-year university.

But when it comes to eliminating the use of agency staff, McGuinness said the biggest key has been consistency and retention within the company’s executive directors and directors of nursing.

Majestic Care has seen an uptick in hiring over the last six months and has been able to eliminate agency staffing in 13 of its facilities through these tactics and others — including their own internal float pool which has grown to 80 employees.

Overall, Majestic Care has reduced agency spend by about 50% which amounts to almost $3 million.

“Our markets are very different. Urban, rural, this state, that state, big city, little city, but the common denominator was local leadership and retention of that leadership at the facility level,” he said.