Literature Review

Demand for nurses continues to eclipse supply—reportMcKnight’s Senior LivingDecember 14, 2023Almost three years after the start of the pandemic, a shortage of registered nurses continues to eclipse the supply of qualified professionals. “The US shortage of registered nurses has been called a crisis. Burnout, staff turnover, a growing and aging baby-boomer population, and a lack of educators have contributed to high demand and undersupply, a longstanding problem aggravated by the COVID-19 pandemic,” according to a new report from ADP Research Institute. 

Repositioning Nursing Homes For Acuity, More Closures, Less Deal Making Expected in 2024Skilled Nursing NewsDecember 12, 2023As the skilled nursing industry heads toward a new year with continued labor shortages and reimbursement gaps, service repositioning and closures among operators are expected trends for the space. And although there are signs of positivity in the form of increased Medicaid reimbursement in some states, extensive rural closures are creating “nursing home deserts” and up to 450,000 nursing home residents are still at risk of displacement without a sufficient workforce.  

Assaults on healthcare workers now carry enhanced criminal finesMcKnight’s Senior LivingDecember 12, 2023Michigan is the latest state to codify protections for healthcare workers assaulted on the job, which one senior living association said will positively impact the state’s workforce shortage problem. Gov. Gretchen Whitmer (D-MI) recently signed into law two bills that create enhanced criminal fines for assaults, aggravated assaults and assaults with a deadly weapon against health professionals or volunteers while on the job. ... In signing the bills, Whitmer said healthcare workers face “rising rates of bullying, viciousness and violence.” 

Sunset Hospice Cottage faces staffing shortage, temporary closureThe Globe (Worthington, MN)December 12, 2023Worthington, MN—The Sunset Hospice Cottage has announced a temporary closure due to acute staffing shortages, an unfortunate side effect of the broader healthcare staffing crisis impacting rural America. Sunset Hospice Cottage has provided comfortable living for Worthington residents nearing the end of life since 2003, but now, due to an unprecedented shortage of healthcare workers, the cottage is forced to close its doors for the first time in 20 years. 

Nurses at University Medical Center vote to unionize, a Louisiana firstTimes-Picayune (New Orleans, LA)December 10, 2023LCMC Health’s University Medical Center nurses voted to join National Nurses United, the largest U.S. union for registered nurses, after a three-day vote that ended Saturday night. The union will be Louisiana’s first among health care workers. It is also one of the state’s largest, with 598 eligible members. More than 90% of eligible nurses voted in the election. Of those who voted, 82% voted in favor of the union, according to National Nurses United. ... Officials at UMC acknowledged the union and said they would “continue to work with the National Labor Relations Board and operate consistently with the processes established by the National Labor Relations Act.” ... Next, the union will be certified by the National Labor Relations Board. Negotiations and bargaining on a contract come after that. ... The union includes registered nurses who are full-time, part-time and per diem, along with clinic nurses and nurse practitioners.

Aging population requires ‘bold leadership’ to protect human dignity—LeadingAge to House SpeakerMcKnight’s Senior LivingDecember 11, 2023The growing population of older adults requires “bold leadership” to ensure aging with dignity, as well as access to care and support, according to an open letter from LeadingAge to Speaker of the House Mike Johnson (R-LA). The changing demographics and need to support older adults where they live and receive services presents a unique opportunity for Johnson to demonstrate leadership and commitment to “protecting human dignity,” according to the letter from LeadingAge President and CEO Katie Smith Sloan. ... “The US healthcare system is navigating a new and unfamiliar landscape in the wake of the COVID-19 public health emergency,” Sloan wrote. “Three years of sustained stress and increasing workloads have caused a dramatic shift in staffing patterns and an alarming rise in burnout across health professions.”

Mass. lawmakers approve measure allowing more home health care workers to unionizeWBUR-FM (Boston, MA)December 7, 2023Thousands of home health care workers in Massachusetts are newly eligible to organize and join a union under legislation passed by the state legislature this week. Union officials estimate the change will allow some 4,000 home health care workers to unionize. About 58,000 personal care attendants paid by MassHealth are already unionized and represented by SEIU 1199. 

Nursing home palliative, hospice care provide CNAs new opportunitiesMcKnight’s Long Term Care NewsDecember 7, 2023A lack of end-of-life training may leave certified nurse assistants unprepared to work with patients receiving palliative or hospice care, but nursing homes must do more to cross-train and build their confidence. That was the message this week from Karl Steinberg, MD, CEO of Stone Mountain Medical Associates, and certified nurse aide Telisa Green, who addressed barriers to quality, end-of-life care during a webinar hosted by the National Association of Health Care Assistants. The speakers recognized that education in this care area can be hard to come by for CNAs, who are broadly trained in vitals and other care-taking tasks. “Almost all of the palliative care skills that CNAs learn are on-the-job training,” Steinberg acknowledged. “I absolutely will advocate for increasing the availability of palliative care training for nursing assistants.” ... Both presenters emphasized the importance of prioritizing a patient and their family’s comfort over too much devotion to a formalized care plan, as well as being an advocate for the patient’s well-being—especially in end-of-life and hospice settings.

Insights on Exposing, Resolving Chronic Underfunding of Nursing HomesSkilled Nursing NewsDecember 5, 2023As nursing homes grapple with a tough economic and labor environment—which has forced closures and created access issues—patient and nursing home advocates underscored the emotional toll of care, calling upon the federal and state governments to do more to address new and emerging generational challenges to care. 

Labor challenges slowing nonprofit hospital recovery—FitchModern HealthcareDecember 5, 2023Nonprofit hospitals and health systems are recovering financially but more slowly than expected, according to a report Fitch Ratings published Tuesday. Much of the sector has broken even in operations on a month-to-month basis in 2023, but it happened later in the year and to a lesser extent than analysts anticipated, the credit ratings agency reported. Labor costs, although softening, remain the top pressure point. Fitch is keeping the nonprofit hospital sector in the “deteriorating” category. Downgrades have outpaced upgrades by about 3-to-1 so far in 2023. Negative rating outlooks grew from 8.9% in 2022 to 10.7% this year. ... In 2024, operational success will largely hinge on how well hospitals recruit and retain employees, Fitch concluded.

Hospice Clinician Wages Rising at Slower Rate; Turnover FallingHospice NewsDecember 1, 2023Wages for hospice clinicians continue to go up amid widespread staff shortages, but they grew at a slower rate in 2023 compared to the prior year. The national average hourly rate for Hospice registered nurses rose 4.58% in 2023, down from a 5.95% increase in 2022, according to a new report by the Hospital & Healthcare Compensation Service in cooperation with the National Association for Home Care & Hospice. Meanwhile, turnover rates declined in 2023, representing the first drop in several years, the report indicated.

Hospice Providers Developing New Strategies for Recruitment, Retention