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Long-term care CEOs: Pandemic pushing staff shortages to crisis levels

Leaders from several long-term care organizations in the state say care facilities are struggling to hire for some 23,000 open positions.

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Marvin Plakut, the CEO of Episcopal Homes of Minnesota, speaks during a press conference on a widespread staffing shortage in long-term care. Plakut says his company has 50 unfilled positions, which is about 10 percent of his workforce Peter Cox / MPR News
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Minnesota’s long-term care industry says it is facing its worst-ever workforce shortage.

Leaders from several long-term care organizations in the state say care facilities are struggling to hire for some 23,000 open positions now — about 20 percent of the full-strength workforce — but that resignations continue to outpace new hires, making the situation increasingly dire.

“We know our workforce crisis is a monumental problem to solve,” said Gayle Kvenvold, president and CEO of LeadingAge Minnesota. “And it's made worse by having fewer workers at a time when we will have more seniors in our state than in any period in our history.”

Those staffing shortages are leading to tighter admissions policies.

A survey from Care Providers of Minnesota and Leading Age Minnesota, groups that represent long-term care facilities in the state, say nearly 70 percent of nursing homes are restricting admissions in some way because of a lack of staffing ability.

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"We can't admit people if we don't have the staff to take care of them," said Patti Cullen, president and CEO of Care Providers of Minnesota. "It's not that we don't want to take care of the seniors and help the families and communities. We can not because we don't have the staff available to do that."

Staffing shortages had been a challenge in long-term care even before the pandemic, but the COVID-19 pandemic has worsened the problem.

During the height of the pandemic, the staffing issue was about people being out with COVID or out on quarantine. Those shortages, in extreme cases, led the state to send in National Guard members to help fill the need for caretaking staff at several facilities in the state.

But leaders say they're now facing a problem of burnout.

“After nearly two years of fighting the pandemic and protecting those who are most likely to be impacted by this virus, caregivers are exhausted,” said Mark Halpert, COO of Monarch Healthcare Management, based in Mankato, Minn. “They saw unprecedented suffering as they waited for equipment, treatment, and even waiting for the vaccines.”

There's also an issue of some people not wanting to comply with the upcoming federal vaccine mandate for workers in the field.

There’s concern that “if workers choose to leave their job rather than be vaccinated that we will have an emergency, a crisis situation develops around staffing,” said Kvenvold of LeadingAge Minnesota.

"We just can't close on Sunday or at noon when we don't have staff, and we cannot accept a lower quality of care for the residents that we are serving," said Erin Hilligan, vice president of operations for Ebenezer, Minnesota’s largest senior housing operator.

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"We're committed to providing safe quality care to everyone in our buildings, we'd be honored to care for everyone who chooses us,” she added. “We just don't have enough staff."

For a handful of homes across the state, Hilligan said, the shortage is unsustainable.

“Nursing homes, especially small nursing homes in rural Minnesota, are starting to close. This is already happening. I'm afraid it's going to get worse,” she said.

Industry leaders want the state to set up emergency staffing teams to help.

Pay remains one of the biggest obstacles in hiring and retaining staff, they say.

“The average wage for a direct care worker right now in Minnesota is between $16 and $17 an hour,” Kvenvold said. “And we know that we're going to need to be able to do better than that to compete in our rapidly evolving workforce.”

In order to raise pay, she said, Minnesota needs to make changes to its reimbursement system. The state sets Medicaid reimbursements rates and rates for those who pay privately.

“Our ability to increase wages is tied directly to state funding allocations,” Kvenvold said. “As wage pressure mounts, providers cannot simply raise their rates to increase the wages to attract new workers.”

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