Long-term residential care facilities suffered immense staffing shortages throughout the global coronavirus pandemic, according to a new report by the Office of the Assistant Secretary for Planning and Evaluation (ASPE).
Between December 2020 and December 2021, though the overall employment in the health care industry increased, the U.S. lost around 145,000 employees from its long-term residential care workforce, resulting in limited admissions and facility closures across the country. Employment decreases impacted long-term residential care employment at a greater magnitude than that of hospital employment, which lost 32,900 employees in the same timeframe. Additionally, ASPE predicts the national nurse shortage will reach more than 500,000 employees by 2030.
“Since early 2020, COVID-19 has put increased demands on the health care workforce in terms of messaging, immunizations, testing, and inpatient and outpatient care while often limiting the supply of health care workers able to respond,” the report stated.
ASPE attributes the pandemic for heightening worker “burnout, exhaustion and trauma” issues. Health care workers also contracted COVID-19 at higher rates than non-hospital health care employees. This led to a precipitous rise in staff shortages and complaints across the industry.
In addition to challenges presented by the pandemic, ASPE said there continue to be a number of factors influencing the ongoing workforce shortage such as a decrease in the number of qualified incoming nurses, discrepancies in workforce diversity and nurses aging.
Some hospitals and facilities have resorted to moving staff from other departments to assist in emergency departments and intensive care units. Many have also increased the number of temporary travel nurses they have on staff. In certain cases, such as during the Omicron surge of December 2021, healthcare facilities reportedly shortened the quarantine and isolation period of staff infected with COVID-19 to alleviate a widening gap between the number of patients to nurses.
The nationwide shortage has been deeply felt in Washington, D.C., impacting the city’s poorest neighborhoods. Having exhausted all options, some facilities have resorted to closing their doors permanently. Due to continuous COVID-19 outbreaks affecting both staff and patients, United Medical Center (UMC) had to close its 120-bed nursing home early. Prior to the pandemic, the D.C. Council decided to close the hospital by 2023 in favor of constructing a new one. The replacement hospital, which will also be located in Ward 8, has not released plans to include a nursing facility.
“Like hospitals across the city and the nation, UMC is experiencing a staff shortage of nurses. We continue to host and participate in job fairs, we have introduced additional financial and other benefits to attract qualified nursing, and we have been utilizing contract nurses to fill the gaps,” said Toya Carmichael, the corporate secretary and vice president of public relations at UMC.
Many long-term care facilities have struggled financially as patient intake has declined over the course of the pandemic. According to the American Health Care Association (AHCA), the nursing care industry could lose up to $94 billion amid the pandemic. Medical organizations and institutions such as ASPE and the AHCA have called for the implementation of more policies such as the Care For Our Seniors Act to improve quality care as well as provide adequate funding to sustain long-term care facilities.
The Care for Our Seniors Act calls for policy to be reformed and prioritized in four areas: clinical– enhancing the quality of care and infection prevention, workforce– implementing and retaining a workforce strategy to attract qualified nurses, oversight — improving systems to be more resident focused, and structural — modernizing the care models to provide person-centered care.
In an overview of the Care for Our Seniors Act, the AHCA stated, “Long term care providers stand ready to make meaningful change that can help our residents, our staff and our country. But it won’t be possible without a commitment from policymakers to provide the necessary and consistent financial support for our elderly residents.”