The need for semi-skilled workers in LTC

Elizabeth Newman
Elizabeth Newman

What do the meat and poultry industry and long-term care have in common, other than often dealing with turkeys?

It turns out both have challenges in hiring semi-skilled workers, which is addressed in a bill proposed last week by Sen. Jeff Flake (R-AZ).

Historically, my take on Flake is his positions and work as a senator are a resounding “meh.” But the bill makes sense in establishing a 10-year pilot guest-worker program for foreign workers who fall in the gap for visas between temporary seasonal workers and highly-skilled immigrants. What it would do for the meat industry is find and keep year-round warehouse workers legally, and what it would potentially do for healthcare is bring in foreign semi-skilled workers, such as registered nurses and LPNs.

Before you object to the classification of “semi-skilled,” it refers to how applicants need less than a bachelor's degree. E-Verify would be mandated. The employers also have to show they looked for a U.S. worker before taking a guest worker. The bill would have a flexible pay cap for registered positions ranging between $65,000 to $85,000.

While nurses or other healthcare workers may look at the program with suspicion, it's not a secret that long-term care isn't as highly desired as a field to work in, compared to the acute sector.

Long-term care needs four million new workers by 2050, says Clifton J. Porter II,  senior vice president of government relations for the American Health Care Association. LPNs and RNs are needed, and it's especially challenging to fill those positions in low unemployment areas, he notes.

“It's becoming an increasing challenge. In Louisiana, in particular, there's a big need for nursing assistants. There's competition from other industries, such as shrimp. It's a squeeze on operators and a real problem,” he told me this week.  

He also notes that while fears may exist over immigrants and the U.S. workforce, “I've never seen a good nurse in the system without a job.” Plus, there's more of an intellectual challenge than 20 years ago in a nurse overseeing a day-to-day caseload at a nursing home. Long-term care facilities are accepting increasingly complex patients, and the push to decrease rehospitalization rates means “we are going to need to have more skilled people,” Porter says.

Working with a geriatric population is not for everyone. It's often grueling work, especially for those doing direct clinical care. We should develop strategies for putting more semi-skilled U.S. millennials into the long-term care workforce pipeline, but we also need to spend time in reality. Many semi-skilled workers in other countries want a chance to immigrate in order to create better opportunities and to help their families. Those who look on immigrants with fear tend to forget their own origin story, how someone generations back made the decision to immigrate to the U.S. If we can seek out semi-skilled workers who find hope in our long-term care industry and fill much needed gaps, everyone wins.

Flake's bill has been referred to a committee, and while it will be on AHCA's Congressional Briefing agenda, most believe it's part of a long strategy around immigration policies that make sense. There's not a lot of optimism that much is happening on the legislative side in a big election year, but we can and should provoke dialogue about immigration reform that helps healthcare.

Follow Elizabeth Newman @TigerELN.




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McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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