'You get what you pay for' (part 3): Wages lead to staff shortages
According to a fact sheet highlighting the underfunding of Wisconsin’s facilities compiled by “Leading Age Wisconsin,” the state’s Medicaid nursing home payment is the worst in the nation. Without funding to cover operating costs in the facilities, the facilities cannot afford to pay their caregivers a competitive wage.
Plum City Care Center's Director of Nursing Dawn Davis said it was hard to keep caregivers around when they weren’t even offering them a “living wage.”
Davis and Spring Valley Healthcare and Rehab Center administrator Kevin Larson both pointed out that Kwik Trip offers a higher starting salary than they can offer their Certified Nursing Assistants.
The Leading Age Wisconsin Fact Sheet claimed that the average full-time employee at a Wal-Mart was comparative to the wage of nurses in Assisted Living facilities.
Wisconsin is at a competitive disadvantage paying its caregivers when compared to its neighbor across the river in Minnesota because Minnesota has invested in Medicaid reimbursements.
“Minnesota invested hundreds of millions of dollars into their long-term care workforce,” Executive Director of the Wisconsin Health Care Association John Vander Meer said. “Anecdotally, we’ve heard that facilities across the border in Minnesota offer caregiver wages about $2 per hour higher than facilities in Wisconsin. If Wisconsin fails to address our nation-worst Medicaid reimbursement system, our state will remain at a competitive disadvantage for recruitment and retention of caregivers.”
Added Larson: “Unfortunately, in our state, we are getting what we’ve paid for.”
Changes could be on the horizon
Janet Zander, Advocacy & Public Policy Coordinator for Greater Wisconsin Agency on Aging Resources, points out that this is an issue that impacts all people, which means legislators should be eager to come up with a plan that helps fix the dilemma.
“Optimism comes from everybody, including our legislators, who all seem to be understanding our caregiver issues,” Zander said. “Everyone is affected. We found that resonating with legislators regardless of affiliations.”
Wisconsin District 93 assemblyman Warren Petryk (R-Eleva), who is on the committee of Aging and Long-term Care, said that this “was one initiative that I’m looking at in this term.”
“Obviously there’s the same crisis in nursing and care staffing as there are in many other job sectors across Wisconsin, western Wisconsin and the United States,” Petryk said. “I’m working closely with the Certified Nursing Assistants Advocacy group down in Madison on possible legislation. Hopefully that will be part of a solution.”
Vander Meer said that a majority of Wisconsinites believe long-term care should be invested in.
“WHCA/WICAL recently conducted a scientific survey of Wisconsin voters, which found that 79 percent of respondents agreed that continuing to underfund state Medicaid for nursing homes is unacceptable,” Vander Meer said. “I would ask those who may prioritize other issues to consider the quality and availability of care they would like for themselves or for their loved ones should they need long-term care in the future.”
And it makes sense that Wisconsin voters would find this cause worthy of support.
“This service is a common good and it is an ethical value,” Larson said. “We need to do a better job with funding of long-term care to confront this crisis. We have good caregivers, but we’re losing them. We need people to take a logical look at this and help us out.”
Davis paraphrased a quote that is attributed to President Harry Truman, authors Margaret Fuller, and Pope John Paul II adding that how we approach this dilemma reflects upon us as a society.
“A nation's greatness is measured by how it treats its most vulnerable members,” is one of the many variations of the quote Davis cited.
In 2007, the Institute for the Future of Aging Services prepared a report for the National Commission for Quality Long-Term Care to explain the upcoming problem of caregivers retiring with their fellow Baby Boomers. Nurses are retiring faster than nurses are being trained to replace them. This is a problem the report explored and when combined with the wave of elderly that will be needing care in the coming years, those affected are feeling the heat of the challenges.
Almost 10 years after the report was released, effective strategies either haven’t yet been developed or they have yet to be executed. At Plum City, the median age of caregivers is a shade under 50-years old — a statistic that is reflected throughout the state.
In the meantime while dealing with these challenges, Vander Meer applauds the pride that caregivers have in what they do.
“For anyone who has spent time in a long-term care facility and seen the dedication of providers and the compassionate care our frontline caregivers provide their residents every day, it’s hard not to be optimistic,” Vander Meer said. “However, there are certainly challenges that face our profession and the residents we serve.”
Though Petryk is aware of the crisis concerning long-term care, he says it’s a difficult time to predict possible changes.
“We’re really in a holding pattern until we know for sure what is coming from the Federal Government. We haven’t had any indication of what might be happening there,” Petryk said. “I don’t want to anticipate changes or what they might look like until they come to us from Washington in the next several weeks. I would imagine by the end of the year we’ll know much more. Then we’ll need to dig into the specifics and evaluate that at that time.”
At Preferred Senior Living in Ellsworth, administrator Julie Chollett said she tries to create an environment in the facility that can slow the rate of turnover. She tries to hire young ambitious nurses that are eager to learn and complement them with experienced nurses who feed off of the energy.
To attempt to overcome the challenges of maintaining a full staff, Davis said they just take it in stride.
“When a slot is filled you have to start looking for other slots,” Davis said. “You can’t really blame them (for taking higher paying jobs) — we can’t pay them enough for them to live. People want to travel, spend time with their families. It’s hard to do that with our wages.”
Added Plum City Care Center administrator Carla Hutter: “Every night before I go to bed, I just hope that all of our nurses will show up the next day.”