(The Center Square) – The health care workforce shortage is well-trod ground for the House Aging and Older Adult Services Committee, as the legislature seeks out new ways to entice and incentivize new workers.
One area that has received less attention, however, is the ways in which the state and its processes deter individuals from pursuing essential career paths. Many in the field are saying the obstacles are too great to justify the difficult work of th ejob.
“Simply put, we are failing our aging population,” said Zach Shamberg of the Pennsylvania Health Care Association.
According to many who have tried to enter the field, one huge barrier to entry is the third-party vendor the state contracts with to provide required testing. Credentia, a Florida-based company which operates in several states, has been given a corrective action plan in Pennsylvania to remedy the many failures within its system.
Chief among them is that potential nurse aides have a difficult time scheduling testing. Especially for those in rural areas of the state, testing sites are located hours away, and many testers complained of uncommunicated day-of cancellations.
Credentia’s corporate office in Lake Mary, Fla. is permanently closed, its online presence receiving a deluge of negative reviews both from frustrated testers and from customers. Both sides were left in the dark and faced with frequent cancellations, miscommunications and other challenges.
The vendor is expected to remediate the issues by the end of June, according to the state agencies who oversee the nursing aide program in the commonwealth, which include the Department of Education, the Department of Human Services and the Department of Health.
The triplicate oversight of the program is another area where some say a change would be helpful.
“We would support any initiative that brings that process and that training program under one office in one department,” said Austin Cawley, legislative director at LeadingAge PA, an aging advocacy organization.
Wayne Reich, an RN and the CEO of the Pennsylvania State Nurses Association agreed that putting the training and credentialing process under the State Board of Nursing would be a logical and helpful step. He also underscored the importance of listening to those working in the field to understand what is driving them out of it.
Cesar Nieves has been a CNA for 23 years and sees it as his vocation. For the past four years, he has worked as a med tech, a higher position in the field. He says there’s a great deal of “emotional distress” in the field, which “creates problems with the atmosphere” leading to high turnover.
“It’s getting a little bit too overwhelming, and people are leaving the industry,” said Nieves.
For him, the need to be there to care for the elderly supersedes the difficulty of the job. He says he cares for patients who have outlived their families and patients who never married, patients for whom nurse aides are the closest people in their lives. That’s enough for him to work 16-hour shifts back to back, though he turned down a 12-hour shift to make it to the hearing.
According to Shamberg, 77% of facilities in the state say they’re unable to find enough qualified candidates. He recounted a scenario in which an LPN left a nursing home in the middle of the night to be with his wife who was in labor delivering their first child. During that time, the facility was cited for violations of the state’s staffing ratio laws.
The ratios, intended to help reduce the overwhelming load of medical staff, have created a problem of their own. Facilities are full of empty beds because they don’t have the staff required to meet them, yet when facilities operate without enough staff, it’s detrimental to quality of care.
Advocates are hopeful that updates to Medicaid reimbursement could lead to better margins for struggling facilities, who then might be better able to recruit new employees. In the meantime, they compete with far less stressful service industry jobs with fewer barriers to entry who pay more.
