Long-time operational challenges that have worsened — or have popped up for the first time — during the 2020 pandemic are the top worries for nursing homes heading into 2021, a new McKnight’s Long-Term Care News survey shows.
“Having enough staff” was the nearly unanimous top fear, with 88% of survey respondents picking it as one of their four biggest concerns for the coming year.
“Rebuilding or keeping enough census” (82%), “Having enough PPE” (44%) and “COVID-related legal/liability claims” (40%) were next in popularity among the 10-answer field.
The survey reflects responses from 313 nursing home owners, administrators and top nurse managers who answered an email solicitation last week (Dec. 7-12). Full findings of the “McKnight’s LTC News 2021 Outlook” Flash Survey are being released throughout this week.
Sufficient staffing was the top priority in the executives and nurse manager subgroups, while administrators cited census as their top issue (86% to 82% over staffing).
“Building higher census and staffing under normal circumstances are the two biggest issues,” acknowledged Bill McGinley, the president and CEO of the American College of Health Care Administrators. “That’s what’s keeping administrators awake at night. For those numbers to be that high doesn’t surprise me. It just reinforces the fact that [administrators] are so stressed out.”
PPE, which would not have been in anybody’s top 10 a year ago, was the No. 3-rated concern for all groups except owners. The top execs elevated legal/liability concerts into the third slot with a 58% voting rate, relegating PPE to its seventh-most popular pick (27%).
“It blows my mind that here we are 10 months into the pandemic and nursing homes in this country are still worried about PPE,” McGinley said, echoing the sentiments of numerous other long-term care leaders in recent months. “The American government hasn’t figured out how to get PPE into the hands of nursing homes.”
While McGinley conceded that various roadblocks to obtaining more PPE, such as international tariffs, have hindered the acquisition process, he said that operators nonetheless “are disappointed in [federal] leadership.”
Medicaid and ‘staying open’ worries
The nurse manager and administrators subgroupings were generally in sync throughout their relative rankings. The owners and C-suiters subgroup stood out in several ways.
The top executives made “insufficient Medicaid reimbursements” their fourth-highest pick (at 46%), considerably above the concerns of administrators (36% – tie for fifth) and nurse managers (28% – seventh).
Similarly, the top executives were the most concerned subgroup about “staying open” (29% – tied for fifth, along with “potentially problematic policies under a new president’s administration”).
The nurse group actually placed new potential new policy concerns as its fourth-most concerning issue (33%), just ahead of legal/liability worries (32.5%).
The issue of having enough COVID-19 testing materials was just the ninth pick for all of the respondent groups, except for nurses, who made it their sixth most pressing concern (31%).
Interestingly, placements were unanimous for all of the respondent groups (top executives, administrators, nurse managers, and all subgroups combined) for two answers. “Insufficient Medicare reimbursements” came in eighth place (ranging from 23% to 25%) and “Repaying COVID-related loans” was firmly in last, or 10th, place for all (6% to 8% of respondents).
Coming in Friday’s Daily Update: Survey results about staff vaccination plans and COVID-19 testing attitudes.