Many nursing home operators in the past year have been in rebuilding mode, bolstering staff and reworking systems to fit better in a post-pandemic world.

Principle LTC has been doing much the same in developing programs offered to help employees in crisis or those who want to further their education. But, it’s going to take more than in-house initiatives to get the workforce to the level needed, especially given that the clinical employee pipeline is not regenerating at an adequate pace. Universities are having to turn away prospective nursing students due to a lack of professors.

Lynn M. Hood, CEO of Principle LTC, said the holdup in universities is a significant part of the staffing shortage not often talked about, and is something the industry should be taking note of with immigration an open and shut case right now. 

“I think what has probably been said, but maybe not as clear, is that we don’t know where to find registered nurses,” said Hood. “Unless the nursing schools become more talented at attracting professors, unless immigration policies change, we’re going to be hitting a very significant wall.”

Hood sat down with Skilled Nursing News to discuss efforts underway at Principle LTC to stabilize its workforce.

The following interview has been edited for length and clarity.

What has Principle LTC been working on in the last year or so?

Principle LTC has been focused on stabilizing our team post-pandemic. Like many operators, our agency costs were significant during the height of the pandemic, but we have successfully reduced them by 75%. Focusing on people and systems has been our priority.

Any staffing-specific initiatives you want to mention?

We’ve been really focusing on employee programs like Principle Cares, which allows employees to apply for financial assistance during a crisis. It’s a not-for-profit organization set up for employees dealing with unexpected catastrophic events such as natural disasters or severe economic hardship, provided they meet certain criteria.

Principle Cares started in 2017 when an employee had a house fire and lost a child during the fire. Although we all chipped in, including the facility staff, we knew it was time to do more during these types of situations.

We are also working on Principle Educates. Right now, this program provides money for formal education like nursing school or finance programs. The new program will allow for non-collegiate programs across all departments and positions to enhance learning.

We’ve heard that turnover among administrators has been a particular challenge for nursing homes. How is Principle working to rebuild this role?

The pandemic really caused a level of exhaustion that I’ve never seen before. To address this, we have partnered with universities in North Carolina, including East Carolina University (ECU). We are currently working with ECU to engage their new MPH students to do their internships in our facilities. By exposing these students to long-term care leadership, we’ve found that their interest in this field increases. We have three paid administrators in training (AITs) at any given time through this program, and we’re looking to expand it next year.

Any other big picture aspects of the staffing shortage you feel aren’t discussed enough?

We must fix the nursing education crisis. I have many friends and colleagues who are nursing professors. They are overworked and underpaid in my opinion. Good nurses require strong educational programs. We cannot impact the shortage that is upon us by stressing out the educators’ work volume and student counts.

And then you look at the effect of nurses retiring; a third of nurses today will be retiring in the next five years. I think what has probably been said, but maybe not as clear, is that we don’t know where to find registered nurses. Unless the nursing schools become more talented at attracting professors, and unless immigration policies change, we’re going to hit a very significant wall.

So how can the industry meet this workforce challenge?

First, we need to understand the situation within nursing schools. With a 68% National Council Licensure Examination (NCLEX) pass rate—significantly below average—and 75,000 students turned away annually due to a shortage of professors, it’s crucial to assess what changes are necessary within these programs. Our aging population needs to be assured that nursing homes will be available when needed and that we are focusing on stronger care outcomes and systems. To achieve these objectives, we must find effective solutions to the nursing shortage.