High costs and a lengthy hiring process are two factors separating the nursing home industry from what many operators say is the only "silver bullet" for staffing shortages plaguing the industry: immigrant workers.
Staffing agencies are taking the lead in bringing foreign workers to the US, but costs are skyrocketing and the pace is "glacial," said a report in Skilled Nursing News.
The US must compete with countries that have far shorter wait times for prospective nurses to gain entry—think Canada, which has welcomed immigrants for the past year as a remedy for labor shortages, the report said.
Indiana-based Majestic Care, an SNF operator, partnered with PSR Global to bring five immigrant nurses to its Goshen facility and is actively seeking nurses from Mexico, SNN reported. The recruiting of immigrant nurses represented an investment of about $28K SF per nurse, the company said.
Clearview Healthcare Management is investing about $15K per nurse, including immigration fees and expedited fees, working with Accelerated Consulting.
The Louisville-based nursing home operator has 35 facilities across Tennessee and Kentucky. The company is aiming to bring over 40 nurses—and $600K investment. Other agencies were asking for charges as high as $30K per nurse.
According to the Bureau of Labor Statistics, the nursing home industry has been down 240K caregivers since the start of the pandemic—a gap that can't be filled by a domestic workforce.
Nursing home operators who have been lining up in opposition to a Biden Administration proposal to establish minimum staffing levels for resident care in nursing homes—a proposal they say would add more than $11B a year to their operating costs and require an additional 191K nurses an nurse's aides—now are seeing nurses lining up to demand minimum staffing levels as a basic working condition.
Margins at skilled nursing facilities have been squeezed by rising costs and labor shortages as occupancy levels recovered last year. A nationwide shortage of nurses that pre-dated the pandemic was greatly exacerbated when overworked nurses joined the Great Resignation.
Now, the remaining nurses in the workforce are throwing down the gauntlet at hospitals and nursing homes over staffing levels they say are inducing burnout and causing more nurses to leave the profession.
The quick settlement in January of a three-day strike by nurses at two of NYC's largest hospitals, Montefiore and Mount Sinai, may turn out to be a template for what nurses increasingly say is their top demand—a higher priority to them than increased wages—establishing a ratio of patients to nurses.
The New York State Nurses Association (NYSNA), which represents an estimated 7,000 nurses who work at the two hospitals, announced a deal to establish set nurse-to-patient ratios for all in-patient and emergency units at both hospitals.
NYSNA said the deal will end conditions that have forced nurses to cover up to 20 patients at a time and guarantees there will "always be enough nurses at the bedside to provide safe patient care, not just on paper."
In November, the Biden Administration said it will propose a minimum staffing level for nursing homes based on a 2001 recommendation from the Centers for Medicare and Medicaid Services that nursing homes deliver at least 4.1 hours of nursing care to every resident every day, the equivalent of one nurse for every seven residents on day and evening shifts.
The American Health Care Association has estimated that the 4.1 hour per day care standard would add $11.3B annually to cost of operating the nation's 15,500 nursing homes—and require an additional 191,000 nurses and nurse aides.
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