John O’Connor

What are the three biggest challenges facing long-term care?

To borrow a familiar punch line from the real estate sector, they are staffing, staffing and staffing.

For not only are labor challenges in this field as bad as ever, they could soon get worse. For that, we can thank two culprits (not counting staffing mandates, which CMS is seriously considering). The first is that a lot of nurses and other caregivers in this field will soon be retiring. But that leak in the staffing bucket is a small drip when compared to the other biggie: service demand is about to explode.

You see, the first of the aging baby boomers we’ve been hearing so much about are turning 78. From a resident-admissions perspective, that’s not quite the sweet spot. But it’s pretty close, and getting closer by the day. As weird as this might now sound, most skilled operators are less than seven years away from a demand windfall of epic proportions.

But services cannot be delivered without staff. We’re seeing this self-evident reality kick in already, as many facilities with open beds and billets are being forced to limit new admissions.

The industry is petitioning lawmakers to set aside more funds for job training and related facility payments. All things considered, those are certainly reasonable requests. But other changes will also be needed.

One of those needed changes, frankly, will be for operators to find new ways of managing working hours.

Which brings us to a new survey that revealed more than half of the nation’s employers are willing to give a four-day workweek a test drive.

In fact, the poll of 976 business leaders found that one-in-five (20%) have already made the switch. More than four-in-10 of the rest (41%) indicated they plan to give the shortened workweek a trial.

If those numbers are anywhere near accurate, a staffing revolution is well underway.

As for those who have made the switch, results so far are limited but promising.

One recent trial of the four-day workweek in Iceland turned out far better than expected. In fact, the results were so overwhelmingly favorable that 90% of the nation’s workers now enjoy reduced hours or other work-related modifications. A separate study in the United Kingdom also was largely successful.

Advocates of the four-day workweek claim that the shift reduces stress and raises energy levels. But could fewer days actually succeed in a long-term care setting?

At first glance, such a change might seem problematic. After all, if the work isn’t getting done in five days, how will it get done in four? It’s a fair question.

Here’s my response: maybe try a 3-day schedule. And no, I haven’t lost my mind.

Actually, many hospitals have already embraced this approach with their nursing staff. They do this by offering three 12-hour shifts per week.

And many nurses wouldn’t have it any other way. They are off four days each week. Another plus for many is that their commuting and child-care demands have been greatly reduced.

To be sure, there are possible downsides as well. Exhaustion, emotional damage and health risks are legitimate concerns.

But let’s face it: When it comes to staffing, things cannot continue the way they are. A three-day workweek may not be the only answer. But for many operators, it might prove to be well worth a try.

John O’Connor is editorial director for McKnight’s.

Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.