Guest Commentary: Burdensome mandates won’t solve long-term care staffing crisis


Felisha E. Alderson is the CEO of the Kutz Senior Living Campus in Wilmington.

I am proud to be a nursing home caregiver in Delaware.

Our residents are some of our most fragile citizens, those with chronic health conditions and developmental or intellectual disabilities. We care for each of them with the utmost kindness and compassion because they’re not just our residents — they’re our family.

Over the last three years, I have become even more passionate about serving our seniors. Standing on the front lines of the COVID-19 pandemic gave me a renewed sense of purpose, and I’m thankful for the thousands of caregivers who helped save the lives of our most vulnerable.

Like so many across the country, Delaware’s long-term care facilities experienced a high level of turnover during the pandemic. Many of my fellow caregivers could not handle the stress anymore and burned out. Some decided to leave long-term care due to lack of available child care and for other health care opportunities, while others left for entirely different industries.

This has left us with a depleted workforce that we are still in the process of rebuilding. While we try to recoup our staffing losses, we are likely to see a new federal minimum staffing mandate from the Biden administration in the coming weeks. Imposing a minimum staffing mandate right now would create more burdens for staffing-challenged nursing homes like mine.

There are several factors that make Delaware uniquely impacted by nursing home staffing shortages. Delaware is a haven for seniors and retirees. We’re a tax-friendly state with no sales tax and low property taxes. The 65-plus population increased 55% between 2010-21 — the fastest-growing age group in the state. This boom in our senior population has put nursing homes and assisted living communities in high demand.

Because of our rapidly aging population, our hospitals are growing significantly. This gives more job options for health care professionals — particularly highly sought-after licensed practical nurses and certified nursing assistants. With more resources, hospitals tend to offer higher wages and better benefits than nursing homes do, so it’s hard for us to compete for these workers.

Delaware is also geographically small, so accessing surrounding states is easy for those who live in the northern part of the state. We are in direct competition with Pennsylvania, Maryland and New Jersey because workers can commute into those neighboring states for their jobs — another factor that chips away at our potential pool of job applicants.

This is why a federal minimum staffing mandate would hurt Delaware’s nursing homes. Staff availability levels are already low, and there is so much competition for existing workers. It will be nearly impossible to find enough caregivers to meet the requirements of this mandate without federal funding to help us hire. So far, what the Biden administration is expected to announce comes with no additional funding.

Unrealistic, unfunded mandates are not what we need. What we need is for our leaders in Washington, D.C., to support nursing homes with funding and policies we need to build a strong workforce.

Boosting our Medicaid reimbursement rate would significantly improve our financial outlook. We have not received an increase in our reimbursement rate since state fiscal year 2008. While we received aid during the pandemic, the funding was only temporary and was allocated solely for staffing stabilization and infection control. Adequate Medicaid funding would enable us to invest in training and hiring the next-generation workers, offer higher pay and competitive benefits, and make long-term care a more attractive field to work in.

Strengthening our workforce also means getting the next generation of caregivers trained, certified and ready to enter the workforce quickly. Modernizing health care training would help us do that. Online training has not been widely embraced in Delaware, and some schools were closed for many months during the pandemic. While some in-person clinical training is essential, allowing more training online will make it easier for students to complete their education and get a job.

Our caregivers selflessly serve every day, and they deserve our support. We are counting on policymakers to do the right thing. Let’s invest in long-term care instead of imposing burdensome regulations that will do nothing to solve our workforce crisis.

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