Loretto Health & Rehabilitation in Syracuse, N.Y., was struggling with a nearly 65% turnover among certified nursing assistants, home health aides and licensed practical nurses, many of whom faced difficult challenges with transportation, child care and other issues.
That’s a chronic and growing problem for nursing homes, home-care agencies and hospital systems, which rely on these staffers to provide the bulk of hands-on, nonclinical care for patients. Good post-acute and home care are key factors in achieving quality outcomes in value-based care, but research shows that high turnover hurts quality.
And turnover is expensive, with estimates that it costs at least $2,500 to replace a direct care worker.
Over the last three years, Loretto, a comprehensive post-acute provider with 2,600 employees, has launched a bevy of programs to enlarge the pool of potential caregivers, including recruiting intensively from Syracuse’s large refugee population.
A major goal is to help new hires better manage their financial and life issues and stay on the job. Improving pay and benefits also is considered crucial, though Loretto has a union workforce with competitive pay and perks.
“We need to expand that workforce, and we need to be very innovative in how we approach talent development,” said Loretto CEO Kim Townsend. With baby boomers aging into retirement, “I’m concerned whether we’ll have enough workers to do what needs to be done.”
A severe shortage of high-quality caregivers could crimp the ability of hospitals, physicians and health plans to move patients out of higher-cost inpatient settings into post-acute and home- and community-based care. That would hobble value-based care delivery.
Other long-term care providers also are urgently developing ambitious new strategies for recruiting and retaining these workers, who provide personal care such as bathing, dressing, eating, toileting, housecleaning and administering medications. Nearly 20 million adults in the U.S. need assistance with daily tasks due to physical, cognitive, developmental or behavioral conditions.
Of the 4.5 million direct care workers in 2018, nearly 90% were women, almost 60% were people of color, and about 1 in 4 was an immigrant, according to a new report from PHI, a long-term care research group, based on data from the U.S. Bureau of Labor Statistics and the Census Bureau.