ICYMI: Report: Nursing Homes Increasingly Forced To Use Costly Staffing Agencies To Fill Vacancies

New Report Underscores Need To Build Strong Workforce Through Supportive Policies, Not A Blanket Mandate That Limits Access To Care

Workforce; Advocacy; Research and Data
In case you missed it, a new report in Health Affairs reveals nursing homes have been forced to use costly staffing agencies to fill critical vacancies amid chronic staffing shortages. The report, “Nursing Homes Increasingly Rely On Staffing Agencies For Direct Care Nursing,” finds:

“By 2022, almost half of all nursing homes used agency staff, accounting for 11 percent of all direct care nursing staff hours. Agency staff were increasingly used to address chronic staffing shortages, with 13.8 percent of nursing homes having agency staff present every day. Agency staff were 50–60 percent more expensive per hour than directly employed nursing staff, and nursing homes that used agency staff often had lower five-star ratings. Policy makers need to consider postpandemic changes to the nursing home workforce as part of nursing home reform, as increased reliance on agency staff may reduce the financial resources available to increase nursing staff levels and improve the quality of care.”

The findings underscore that while nursing homes continue to do everything they can to hire more workers, resorting to staffing agencies is often their only choice to ensure residents can continue to receive 24/7 care. Nursing homes must have enough caregivers for their residents, but due to the sheer lack of qualified and available caregivers in the labor force, they continue to struggle to recruit full-time employees. Agency staff are more frequently used to fill in the gaps.

As the report indicates, staffing agencies are considerably more costly than directly employed staff. With chronic Medicaid underfunding, the use of staffing agencies puts even more strain on nursing home budgets and leaves less resources to put toward hiring full-time staff. The Biden Administration’s federal staffing mandate would accelerate this practice, which in the long run is not in the best interest of residents.

The one-size-fits-all rule fails to address the underlying causes of workforce shortages and demands nursing homes meet an arbitrary staffing minimum without any substantial funding to help aid in hiring. As it stands, the proposed mandate would cost nursing homes nearly seven billion dollars annually. As the rule is currently written, 94 percent of facilities do not meet at least one or more of the three proposed requirements. If finalized, more than 280,000 nursing home residents could be displaced.

Rather than a one-size-fits-all approach that will exacerbate workforce shortages and limit access to care, seniors deserve comprehensive policies and programs that support nursing homes and help build a strong pipeline of caregivers. As the researchers of the Health Affairs’ report state:

“Without significant investment in the nursing home workforce and ensuring that nursing homes have adequate revenue to hire workers, nursing home residents may be at risk.”

Read the full Health Affairs report HERE.

Read CLA’s (CliftonLarsonAllen) analysis of the federal staffing mandate HERE.

Find out what Members of Congress, policy experts and long term care advocates are saying in opposition to the federal staffing mandate HERE.