How to Survive Critical LTC Staff Shortages



the hardest hit industry

The Great Resignation has left behind an inconceivable staffing shortage among its US businesses, but no industry has been hit harder than the healthcare industry, particularly long-term care facilities (LTC). Further, the trend of quitting in this industry was already a crisis before the pandemic hit. According to Ashvin Gandhi, a health economist at UCLA,” the median annual turnover rate for nearly all U.S. nursing homes in 2017 and 2018 was 94%. Post-pandemic, LTC facilities are struggling, and many are shutting the doors – permanently. What does this mean for the ever-growing LTC needs of the baby boomers? The outlook is frightening.


they are misunderstood and undervalued

As a previous Director of Accounting and Human Resource at a LTC facility, I have always said that the work of a LTC caregiver, is the hardest, most thankless, underpaid job in the U.S. The incredible thing is that these front-line workers can and do respond when management creates an employee experience where training, respect, support, supervision, communication, and clear, fair expectations are understood. When benefits, in the way of getting basic needs filled like child-care, transportation, and food are added, these direct care employees begin to tolerate more and give more.



“They’re misunderstood and undervalued … The reality is that this is complex work; these are professional caregivers with job responsibilities that demand a higher wage." Robyn Stone, Leading Age



it’s not just low wages – it’s low Medicaid rates

The bottom line is, our LTC facilities are in trouble, especially those facilities that take care of our underprivileged citizens – our LTC Medicaid folks. It is in these facilities that our caregivers and elderly suffer the most. For Medicaid LTC facilities to survive, the government must pay Medicaid reimbursement rates that actually pay the cost of LTC in addition to management creating a remarkable, effective employee experience for these care giving employees. In 2021, Medicaid reimbursement for LTC was $189 per day while the cost was $412 per day. Many states are trying to raise the minimum CNA pay to band-aid the problem but where will the money come from to pay them this most needed pay rate? As an accountant, it doesn’t take a genius to know that you can’t raise expenses without raising revenue.


are you ready to take care of your elderly?

According to Leading Age, projections show that by 2028, LTC will require 8.2 million employees. However, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) reports that 400+ LTC facilities are expected to close in 2022 and it is not looking any better for 2023. Currently, three out of five nursing homes (61%) have limited new admissions due to staffing shortages. The AHCA/NCAL survey found that 87% of nursing home providers are facing moderate to high staffing shortages, with nearly half (48%) struggling with a severe staffing shortage.


As baby boomers age, many of our elderly will simply not have the resources to cover long term care. Medicaid facilities will require way more funding than will be available from the government. What that means is that long term care will be available to higher end clients at top notch facilities who will need to implement a healthy employee experience strategy for caregivers who will be expected to provide outstanding care for these elite clients. Medicaid facility will no longer exist, and family will be having to take care of the underprivileged.


Workers say their exits are driven by dangerous working conditions, poor pay and benefits, limited opportunities for advancement, burnout, and the respect deficit for their profession. Those issues were intensified by the pandemic, but they’re long-standing and deep-seated across the industry”. – Emily Paulin, writer for AARP


what is the next step?

It is only a few short years before top performing LTC employees will be in high demand. Is your LTC facility getting your employee experience strategy up for the challenge to come? I invite you to schedule a call with me today to listen to your concerns and see if and how I can help.


“CNAs are the first line of defense. We are the eyes and the ears for the doctors ... When we are overwhelmed, a lot of things slip through the cracks.” - Tamara Blue, a Detroit CNA


Many years my friend, many years....



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