Mood of the Market

Even though long-term care has been at the center of the storm for the nation’s worst public health crisis in a century, the field’s incredibly dangerous and often deadly conditions have not broken the devotion of top managers.

In fact, overall attitudes displayed have been nothing short of “astonishing,” said one expert examining results of the 2020 McKnight’s Mood of the Market Survey.

Slightly more than one-fifth (21%) of respondents said the coronavirus pandemic has “definitely” made them more likely to leave the profession, with another 8% saying “probably.” On the other end of the spectrum, however, 28% answered “no way” to the same question, while the most popular answer was “probably not” (29%).

“That means 57% of the people are liking this profession and feeling really tied to it. It really shows people like being in the long-term care industry,” observed Matt Leach, principal and senior consultant for Total Compensation Solutions of Armonk, NY. “They like helping the elderly — it’s why they’re there.”

Nearly 14% said they were “considering it, but not sure” when asked  if the pandemic made them more likely to leave the profession. 

“That means 70% might think about it but probably are staying,” Leach noted. “You have to figure these numbers are only going to come down when things come back to more normal conditions. They’ll probably never be higher than now. If they’re not leaving during a pandemic, they are going to be in this industry until they retire.”

The 2020 Mood of the Market Survey gathered attitudes of 381 long-term care administrators and nurse managers. They answered survey questions sent digitally over a week’s span, ending in early August. A similar survey was administered in 2019.

Like last year, respondents overwhelmingly found their work “very” (82%) or “somewhat” (16%) meaningful. It was the key to other sometimes surprisingly optimistic results, experts said.

Nursing homes have been the most common setting linked to deaths due to COVID-19, with some 40% of nearly 180,000 U.S. deaths (including many workers) attributed to such settings. That’s according to federal figures at press time, which were almost universally acknowledged as low due to confusion reporting deaths and infection rates.

Intent to stay or flee

When asked, “In the last three months, have you seriously considered quitting your job?” more than 44% of respondents said “yes” this year. That marked a seven percentage point (or 19% net) rise over 2019 results.

Yet job satisfaction levels, while slipping slightly from a year ago, remained remarkably high, observers pointed out. Nearly nine in 10 (87%) said they were either “very satisfied” (47%) or “somewhat satisfied” (41%) with their current job. That’s only slightly down from 91% recorded in the pre-pandemic Mood of the Market survey. This year, nurse managers (91%) registered slightly higher overall satisfaction levels than administrator (88%) respondents.

“I’m just astonished, quite honestly,” said compensation and benefits expert Mark Heston of Heston & Associates. “When you look at how satisfied they are after everything they’ve been through the last four to five months, we’re talking about chaotic, uncharted times and they’ve been at the forefront of it. It’s a true testament to the type of people in the industry. It speaks to selflessness and commitment. They’re focused on hunkering down and caring for residents.”

Leach agreed that environment is critical.

“What’s going on is how much these individuals like where they work and like the residents,” Leach said. “The fact that it’s only down that much tells us that it’s the culture that makes people do that, and that’s why they’re there.”

Heston cautioned, however, that such qualities shouldn’t be taken for granted.

“I know the workload has gone up significantly for all of these folks, which speaks volumes to the people they are,” he said. “But my concern is burnout. How long can they sustain that type of effort?”

Satisfaction with pay levels, perhaps not surprisingly, slipped markedly between the 2019 and 2020 surveys. Some 56% said they were “very well paid (21%) or “somewhat well paid” (35%), which was much lower compared to the 66% mark a year ago. Once again, nurses polled higher than administrators on this question (63% to 58%).

“They probably would say the pay has not kept up with the extra effort,” Heston noted. 

Here, too, is a danger, Leach noted.

“I can tell you from other downturns [in the economy] that the organization that has taken advantage of employees during downturns, those employees, once the market turns around, are not going to be very loyal soldiers,” he explained. “There’s a universal feeling if your company takes care of you but doesn’t take advantage of you during downturns, you’ll be a much happier employee and much more likely to stay during the good times.”

Leach also explained that long-term care managers may have more options to move than before. Several decades ago, they might have felt less inclined to bolt to other settings, but places such as hospitals, with more competitive pay and work schedules, could draw away talent.

Working too much?

One new question on this year’s survey slightly surprised the experts. Respondents were almost evenly split on whether they were asked to do too much work, though nurses  tilted much higher than the administrators on the feelings of burden.

Overall, 13% of respondents said “very much so, yes;” 36% said “generally yes;” 42% checked “generally no;” and 8% said “No, I don’t think that at all” about the “too much work” question.

“I would have thought it would have been higher (toward too much work),” Heston said. “Part of it might be the type of people and professionals you have here. They work hard and take the opinion, ‘We’re going to get done what has to get done.’ They’re used to this.”

Respondents reported feeling slightly less appreciated for the contributions at work this year. Overall, 81% said they felt their work was valued “a great deal” (45%) or “a moderate amount” (36%). In 2019, the overall level was noticeably higher at 88%.

The outlook for opportunities for advancement held steady from last year at about 60% positive overall, and were once again looked upon more favorably by nurses (61%) than administrators (57%).

“What is the one change that would most improve your job satisfaction?” showed that better salary and more staff (a new option in this year’s survey) led at 23.1% and 22.6% for the entire group. Better insurance or benefits (another new category) was next at 10.5% and was followed by more paid time off (9.7%) and training (8.1%). Last year, the top overall responses were more training (21%), higher salary (17%) and more paid time off (13%).

Broken down by vocational area in 2020, nurses’ top five changes that would lead to more job happiness were: higher salary and more staff (both 24%), better benefits and more training (both 9%) and more paid time off (7%). Administrators led with salary (23%), staff (22%), paid time off (12%), benefits (11%) and more flexible scheduling (8%).

Another notable survey finding: respondents’ confidence in their supervisor possibly helping them advance their career dropped from 74% in the more optimistic choice ranges in the 2019 survey to 68% in this year’s survey.