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There's a critical shortage of nursing home staff


COVID-19 has killed more than 200,000 residents and staff at nursing homes and other long-term care facilities. And now with omicron, those places are again struggling. While the death rate is a fraction of what it was before vaccines were available, more staff are out due to breakthrough infections, which is aggravating long-standing staffing shortages. NPR's Rhitu Chatterjee reports.

RHITU CHATTERJEE, BYLINE: Sherylon Hughes is a nurse's aide at North Cascades Health and Rehab Center in Bellingham, Wash. She's worked at the facility for over a decade and says that the recent staffing shortage is the worst she's ever seen.

SHERYLON HUGHES: There were times where there was either no one on the schedule, or the person who was supposed to be with me to take care of the residents decided not to come in for whatever reason.

CHATTERJEE: There have been days when she's had to care for as many as 25 residents alone.

HUGHES: There's a profound sense of disappointment at the beginning of the shift because you know that you're barely going to sit down and that you're going to be exhausted by the end of it and that you're not going to be able to give, you know, the best care possible.

PATRICIA JOHNSON: The stress is unbearable.

CHATTERJEE: Patricia Johnson is a nursing assistant at Ambassador Nursing Home in Chicago. She's lost family members and residents to COVID-19 and has kept working the whole time, often putting in extra hours, doing double shifts.

JOHNSON: Sometimes, I'll be one to take days off, but I know if I take days off, my co-workers are going to work short because we're just trying to work and keep everything together, basically.

CHATTERJEE: And the entire industry is feeling the pressure.

NATHAN SCHEMA: Quite frankly, it's been pretty brutal.

CHATTERJEE: Nathan Schema is the president and CEO of the Good Samaritan Society, one of the largest nonprofit providers of long-term care in the country. He says nearly 400 staff have recently tested positive despite being vaccinated.

SCHEMA: Some of our more rural communities where, you know, you're serving 30 to 40 residents, it doesn't take but, you know, one or two nurses to be out with COVID to really create a tough situation.

CHATTERJEE: Schema says the organization has had to hire more agency workers than ever before. Managers and other non-front-line staff have had to step in to give exhausted front-line workers a break. The organization has had to limit new admissions and even close some facilities.

SCHEMA: In November of 2021, just a few months ago, we announced closure of four of our communities in Nebraska and Kansas.

CHATTERJEE: These closures are happening across the industry, but the staffing shortages didn't start with the pandemic.

SUSAN REINHARD: It's a perennial problem. It's a chronic problem.

CHATTERJEE: Susan Reinhard is executive director of the Public Policy Institute at AARP.

REINHARD: We know that, even before the pandemic back in 2020, that there were already staff shortages in nursing homes, home care, assisted living, long-term care in general.

CHATTERJEE: She says a major cause of this problem is poor pay.

REINHARD: You know, their wages are not adequate. We know that. They often are searching for enough hours to work full time and have benefits.

TRICIA NEUMAN: This is difficult - very difficult work.

CHATTERJEE: Tricia Neuman is senior vice president of the Kaiser Family Foundation.

NEUMAN: Many people are not trained well for this kind of work, to work with patients with dementia. That's certainly not easy.

CHATTERJEE: She says the pandemic has only made things harder. Long-term care workers have put their own lives at risk. They've watched residents and colleagues die of COVID-19.

NEUMAN: So it's just been a lot tougher now.

CHATTERJEE: And exhausted and burnt out workers have quit in record numbers. Sherylon Hughes, the nurse's aide in Washington, says many of her co-workers have left, too.

HUGHES: There was a pretty significant mass exodus of nurse's aides, office workers, nurses.

CHATTERJEE: She says many have moved to other industries.

HUGHES: I know lots of people who say that the pay is way too low. And the environment is too stressful and sad, that they would rather get yelled at doing retail for about the same amount that they would be paid, you know, doing one of the hardest jobs.

CHATTERJEE: Hughes says her employers have given staff hazard pay. And last year, she and her fellow union members negotiated raises. For the first time in her career, she says, she's seeing the industry recognize the urgent need to raise wages. She and her colleagues are lobbying for more state funding for the industry and to make sure that the money goes directly to front-line staff.

HUGHES: There just isn't any other way to fix this problem. We have to be able to offer a better living wage to people that are going to be coming in and doing one of the most important jobs in health care.

CHATTERJEE: Rhitu Chatterjee, NPR News. Transcript provided by NPR, Copyright NPR.

Rhitu Chatterjee is a health correspondent with NPR, with a focus on mental health. In addition to writing about the latest developments in psychology and psychiatry, she reports on the prevalence of different mental illnesses and new developments in treatments.