Dr. El

The longstanding story of long-term care staffing is that organizations can’t afford to increase the salaries of their workers due to Medicaid reimbursement deficits, rising expenses, tight margins and other fiscal hurdles. 

As we’ve seen during the pandemic, however, low-paid direct-care staff often supported themselves by working at multiple facilities, leading to increased infection rates and disastrous results that took a financial and human toll.

More recently, severe staffing shortages related to COVID-19 have constrained the ability to take in new admissions and forced some companies to raise pay in an effort to retain and recruit staff. 

The investment in staffing will reap rewards in numerous areas, especially in a capitated model where prevention is key. The true LTC staffing tale is that we can’t afford not to give workers a livable wage. 

Here’s the real storyline, a long-term care riff on the children’s book “If You Give a Mouse a Cookie”:

If you give the staff a livable wage …

If you give the staff a livable wage, they’re probably going to stay at the job longer.

If they stay longer, they’ll get to know each other and work better as a team.

If they work better as a team, they’ll know whom to contact when they notice small problems,

Like a leak in the ceiling or a dissatisfied family member, before the leak is a flood and the dissatisfaction is a lawsuit.

If they notice growing problems, they might ask for training. 

If they get the training, they’ll undoubtedly be able to prevent more problems.

If they’re trained on how to work with people with dementia or with the growing population of residents with severe mental illness, they’ll probably create warm, supportive environments that reduce resident agitation, the use of medications, injuries and staff turnover.

If they’re trained on how to manage stress and their own mental health, chances are they’ll be happier individually, and as teams, units, departments and facilities.

If the facility is filled with happy workers, they’ll have more energy to get to know the residents.

If they engage with the residents, they might notice early changes in their physical or emotional condition so that they can be treated in-house rather than re-hospitalized. 

If they keep residents in-house, they’ll probably make them feel more comfortable.

If the residents feel more comfortable, families will feel more comfortable too.

If families are happier, they’ll be less likely to have angry conversations with the DON, the administrator and the social work director. 

If the DON, the administrator and the social work director aren’t fielding irate phone calls from family members, they’ll be able to focus on complying with regulations, managing their teams and making improvements in care quality.

If the facility is adhering to regulations, there’s less time spent on compliance troubles and less money spent on penalties.

If teams are being managed properly, there’s less frustration and turnover.

If there’s less turnover, care quality will improve.

If care quality improves, staff members feel better about the work they’re doing and the place in which they’re doing it.

If employees love their jobs, they’ll resist offers of higher pay in other fields because they’ll have “occupational attachment,” the priceless gift of loving their residents and loving their work. 

And if the staff is stable, the care is improved, rehospitalizations are averted, leaks are caught before floods, and penalties are avoided, organizations will have the funds to pay a livable wage.

Eleanor Feldman Barbera, Ph.D., author of The Savvy Resident’s Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is a Bronze Medalist for Best Blog in the American Society of Business Publication Editors national competition and a Gold Medalist in the Blog-How To/Tips/Service category in their Midwest Regional competition. To contact her for speaking engagements, visit her at EleanorFeldmanBarbera.com.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.