Albany Times Union, November 7, 2021


“Nursing homes set to fail”

Michael Balboni

The state of New York can mandate the COVID vaccination for any and all involved in health care. What it can’t do is mandate that new employees join this critical workforce.

The recent concerns about unvaccinated health care workers walking off the job en masse because of the governor’s mandate turned out to be unfounded. But this result could still become a ruinous reality when the new staffing ratios law for New York nursing homes takes effect in several months. The question now becomes: How will the nursing home industry meet these new requirements when it can barely attract sufficient numbers of staff now?

Without a comprehensive workforce development plan that has been established and supported by our leaders in Albany, New York nursing homes are being positioned to fail.

Although the pandemic exacerbated a staffing shortage, the struggle for nursing homes to find qualified employees began long before the COVID-19 pandemic. This is not just a New York problem either. Seventy-five percent of nursing homes in the United States have demonstrated they do not have enough staff to meet this recommendation. And that statistic was recorded in 2016 when the circumstances were far less dire.

Nearly every nursing home in the U.S. is struggling to find staffing today, with 99 percent facing a shortage according to a September poll conducted by the American Health Care Association. And as the pandemic has gone on, the staffing shortage has only intensified. According to an Associated Press review of federal data, 32 percent of nursing homes had worse staffing levels in June compared to the start of the pandemic, demonstrating that the exodus has gained momentum with time.

Simply put, recruiting and retaining nursing home staff is the urgent priority.

Look beneath the surface of the crisis and you will see that this situation has been developing for some time. Financially speaking, minimum wage levels make it difficult to justify working as a certified nurse assistant when it’s only a little more than one can make working in a service industry. Combine that with the pandemic’s devastating impact on nursing home residents and staff, which most Americans witnessed through months and months of harrowing images. Other impediments to recruiting staff include the challenges of in-person work, a heightened risk of COVID-19 exposure, and the mental and emotional toll of caring for those most vulnerable. As a result, there is little incentive to get tomorrow’s workers to see the long-term care industry as their future.

The problem is real and immediate. Without having sufficient staffing, 78 percent of nursing homes across the country are concerned that workforce shortages might force them to close. This has already started having implications on the next generation of nursing home residents, with 58 percent of long-term care facilities limiting new admissions due to staffing shortages.

In order to survive the challenges ahead, Albany must become a full partner with the state’s nursing home industry to develop and enact a comprehensive workforce development plan. As the Hochul administration seeks a clean slate on a broad range of issues, the governor should restore the financial resources that were eliminated under the Cuomo administration. At the peak of the pandemic — at a time when 23 other states and the District of Columbia all increased Medicaid funding to nursing homes — New York made the unconscionable decision to cut Medicaid funding by 1.5 percent.

Recognizing the slow motion crisis taking place before our eyes, the Hochul administration should work with the nursing home industry to create a compelling messaging campaign that inspires potential staffers to pursue meaningful careers in our long-term care facilities. As part of this campaign, the state and the industry should combine resources to offer incentives for those who are committed to entering the nursing field. Similar to the Peace Corps, those who are interested in nursing should be offered partial college tuition reimbursements in exchange for working in a long-term care facility.

COVID-19 has proved that a pandemic can dismantle our health care system if we are either incapable of identifying the threat or unable to respond quickly in confronting the crisis. It is imperative that we reimagine our health care system in a way that integrates the resources needed so that we are not caught unaware when the next pandemic arrives.

Which raises the most urgent question: What happens on January 1 when Albany’s staffing mandate is enforced? Will our leaders simply ignore the reality of fewer and fewer nursing home employees reporting for work? Or will we learn from lessons past and heed this critical warning while we still have time?

Michael Balboni, of East Williston, is a former state senator now executive director of the Greater New York Health Care Facilities Association, a trade association providing regulatory compliance and life-safety services to more than 80 nursing homes in the New York City metro area.

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