New debate over proposed staffing agency legislation in Kansas shows how the issue can pit nurse advocates and nursing home leaders against each other as they work to address staffing concerns.
Last year, nursing homes nationwide saw an 83% increase in their median contract labor use compared to 2020, according to a report issued last week by accounting firm CliftonLarsonAllen. Leaders in several states have worked to curtail agency pricing through legislative channels.
While Kansas nursing homes are seeking more transparency into the practices of agencies, especially those based out of state, the Kansas State Nursing Association worries that a proposed rate cap will turn people off from choosing nursing jobs.
LeadingAge Kansas first proposed an agency reform bill in January 2020 and “it had a sparsely attended legislative hearing and no one gave it a second look,” Rachel Monger with LeadingAge Kansas told McKnight’s Long-Term Care News Monday.
“Compare that to now, when just the suggestion of bringing that bill back to the Kansas legislature has sparked statewide and national news coverage,” she said. “Agency spending in nursing homes went up another $13 million last year, and the state of Kansas itself shoveled tens of millions in taxpayer dollars this year to staffing agencies for state hospitals and veterans’ homes.
“The question has now been forced – do we start funding our system to offer competitive pay to Kansas workers and repair a tattered safety net for seniors, or do we waste even more public funds to pay a bunch of unregulated, out-of-state staffing companies who continue to profit from an industry and a state in crisis?”
Monger said there is no lack of ideas to ameliorate the agency staffing and staffing shortage issues. The issue is urgency.
“We are not balancing long-term systemic fixes with the short-term sustainability that our providers need during this time,” she said. “We strongly support widespread investment in workforce development, rebalancing and innovative care delivery models.
“But none of it matters if our providers cannot survive to see it. That is especially true in rural areas who rely on nonprofit missions to serve their elders and know that once a service is lost in their community it is rarely regained.”
Monger said the lack of resilience in an already fragile industry shouldn’t surprise anyone. Nursing home staffing hasn’t rebounded as quickly as other healthcare sectors because they are “over-regulated, under-resourced, and hit hardest by the pandemic,” she said.
Nursing home staff wants what everyone else in the world wants, Monger said – high pay, flexibility, respect, and support.
”Four things often missing in senior care before and after the pandemic,” she said. “If we want to regain lost workforce and attract newcomers to the field, we must show that we can offer all of those things on top of the personal reward of helping others. With enough commitment, strategic partnerships and investment from state and federal governments, we can reverse the workforce trends that hit us long before 2020.”
Monger noted that many of her members are stand-alone organizations.
“Before the pandemic many of our members struggled with serious, but ultimately solvable, challenges to the future of senior care,” she said. “Post-pandemic, many of our members feel like they’re careening over a cliff Thelma-and-Louise style. We need help right now. Better reimbursement and more staffing agency oversight will allow us to survive long enough to work on the systemic issues plaguing our field while continuing to supply badly needed services in our communities.”
