Study: Retirement homes hardest hit by employment decline since pandemic

Among health care employment sectors, nursing homes have been hardest hit by the decline in job growth since the pandemic – a rate more than three times that of hospitals or doctors’ offices , according to a researcher at the University of Michigan.

Employment in nursing homes is 10.5% below pre-pandemic levels, compared with 3.3% for hospitals and 1.6% for doctors’ offices, according to a study by Thuy Nguyen, professor associate professor of health management and policy at the UM School of Public Health, and colleagues.

The study, published Nov. 2 in JAMA, assessed health sector employment levels before and after the pandemic to identify subsectors hardest hit by job losses and recovery .

The shortage of nursing home workers – and healthcare workers in general – is not new, but the study may help inform policy change, including a federal proposal targeting staffing levels in skilled nursing facilities, or SNFs, said Nguyen, lead author. of the study.

The Biden administration’s proposed nursing home staffing standards aim to increase staffing in nursing homes by setting mandatory national minimum nurse staffing levels, which has the potential to positively impact decreasing SNF employment levels and ultimately improving the quality of outcomes for nursing home residents.

Thuy Nguyen, assistant professor of health management and policy at the UM School of Public Health

“Our research findings can help define the scale of the challenge facing policymakers. These declines in SNF employment levels are likely multifaceted in nature, and the Biden administration’s proposal alone is unlikely to fully address the myriad reasons for the decline in employment in this sub-sector. health care sector.

Nguyen and co-authors Christopher Whaley of Brown University, Kosali Simon of Indiana University and Jonathan Cantor of RAND Corp. used national labor statistics from the U.S. Census Bureau to assess employment recovery from an initial decline in employment following the March 2020 public health emergency through its end. of 2022.

“This data comes from a census of employment and wages that covers 95% of jobs in the United States. As the post-pandemic recovery continues, these same government databases will be important for monitoring future changes in employment in the health sector,” Simon said.

The study fills a gap in research by offering more recent data than is generally available to assess the entire health care workforce, says Nguyen, who addresses the workforce shortage ci below.

What is your opinion on the direction of the staff shortage? Will it get worse before it gets better?

Understanding the causes and consequences of divergent healthcare employment recovery patterns is beyond the scope of our study, but our findings highlight the potential for additional employment declines in certain fields such as care workers long term. These results are concerning because they suggest long-term consequences of the COVID-19 pandemic on declining health sector employment, such as long-term care workers’ decisions to leave the sector. I believe that without more focused efforts from policymakers and health care organization leaders, we may not see a brighter picture of long-term care employment in the near future.

Any surprise discoveries?

Surprisingly, health sector employment declined less rapidly than non-health sector employment in 2020, but recovered less quickly in 2022. Patterns of employment recovery varied considerably depending on the health sub-sector. For example, SNF staffing levels had already declined before the pandemic and declined further post-pandemic – 12% below the pre-pandemic level by the end of 2022, while physician office staffing levels reached levels before the pandemic.

What kinds of policy changes are needed or already underway?

Addressing the long-term care job shortage is an urgent public health issue in the United States. Among ongoing policy changes, the Biden administration’s new proposal to set mandatory national minimum nursing staffing levels could improve the situation to some extent.

However, it is unlikely that this proposal alone will fully address the decline in employment among long-term care employees, as many of these employees have faced a variety of challenges such as burnout, lack of of available childcare and modest salary levels. Leaders of health care organizations should consider raising wages and improving working conditions for long-term care workers to address the short-term job shortage while also focusing on retention long-term. The government should provide additional financial support and make it easier for individuals to access careers in care homes or other health care sectors.

How concerned should patients and health workers be about staff shortages?

The current staff shortage in nursing homes will likely continue to exacerbate burnout and high staff turnover. Higher levels of nursing staffing and greater skill diversity appear to be associated with better quality outcomes for nursing home residents. This raises concerns about the quality of care in nursing homes among patients, health care workers as well as leaders of health care organizations.