When the COVID-19 pandemic hit and 13.7 million workers in roles comparable to direct care lost their jobs in early 2020, they did not turn to direct care jobs, a recent study found.
Of the 9.1 million who have now found a new job, "an immeasurably small number of workers" entered the direct care workforce, despite high demand for staff, a study by consulting firm PHI and the Health Workforce Research Center on Long-Term Care at the University of California San Francisco found.
"The fact that few workers who lost jobs during the pandemic moved into open direct care jobs highlights the need to improve direct care jobs so they attract well-skilled and dedicated people to care for people who need their services," Joanne Spetz, associate director for research at the Health Workforce Research Center on Long-Term Care at the University of California in San Francisco and an author of the report, said in a press release.
When starting the study, the authors had expected to be able to compare workers' new direct care jobs – positions like personal care aides, home health aides and nursing assistants – to their previous occupations, Stephen McCall, a data and policy analyst at PHI and one of the study's authors, told Modern Healthcare. But, instead, they found that "statistically zero" people who had lost other entry-level occupations like food preparation and serving and office and administrative support, analyzed were entering the direct care workforce, he said.
"I think the thing that surprised us the most is that no one was entering this workforce at a time when they're so needed," McCall said.
PHI's research estimated that long-term care employers will have a need for 7.4 million workers from 2019 to 2029, including 1.3 million new jobs. In September alone, the nursing home sector lost 37,600 jobs, continuing its downward spiral, according to the latest U.S. Bureau of Labor Statistics data.
The industry has long struggled to attract workers because direct care jobs often are low paying and undervalued positions with little room for career advancement, McCall said. And that has only been further complicated by the COVID-19 pandemic, which made working in congregate settings like nursing homes a risky endeavor, he said.
Of those who reentered the workforce, 22% found jobs in lower-paying jobs than they had when the pandemic started. But even those jobs paid more than direct care positions, the study found.
The authors recommended targeted recruitment efforts for others in entry-level positions, offering support for people of color and childcare assistance for parents and raising wages.
"I think it's always been true that, in order to bend the curve on turnover and vacancies, we're going to have to think about job quality holistically. For the most part, these are still dead-end jobs with limited possibilities for advancement," McCall said.
Other fields with similar pay, such as retail and fast food, are raising wages and offering benefits such as childcare and tuition assistance. McDonald's increased hourly pay an average of 10% in May and plans for average hourly wages to reach $15 by 2024 at company-owned restaurants. Target and Walmart both started fully covering college tuition for their employees.
"The overarching lesson from this report is our country's leaders will need to transform the direct care workforce to ensure that employers can fill these jobs—now and in the decade ahead," Kezia Scales, director of policy research at PHI and one of the report's authors, said in a press release.