Elder health services adjust to enhanced requirements
It is said that work in health services for the elderly is a calling. Now that COVID-19 has turned the world upside down, facilities that hire these workers are trying to tap into that commitment to ensure that enough people are available.
Concordia Lutheran Ministries in Cabot, Butler County, is advertising for health care aides on its marquee sign and has announced an appreciation bonus of $25 a day for every day
their staff members work — more than $1 million across the Concordia system. The bonus will apply to workers who make less than $75,000, spokesman Frank Skrip said.
“We haven’t lost a lot of people; we just need to bring in people to help right now,” he said. “There is a nursing and aide shortage everywhere. We’re looking for about 60 nurses in our system just to keep up with regular demand, let alone what we’re going through now.”
In this region, Concordia serves about 1,000 independent residents, about 1,000 in assisted living or personal care and about 1,000 in skilled nursing facilities, which provide around-theclock care.
Across the region, representatives of care facilities acknowledge that in the best of times it is hard to recruit skilled nurses, nurse’s assistants, personal care workers and home health workers.
Now, senior care services are challenged to broaden the pool of potential staff so that when someone calls off or has a high temperature or exhaustion and is screened away from their shift that day, replacements will be available.
But these are extraordinary times, and officials report seeing some extra effort, fewer call-offs and increased hours.
“We do have some people who were typically part time who now have gone full time to pick up extra work,” said Brian Llewellyn, director of human resources at Concordia, which has 12 facilities in Western Pennsylvania.
Because some staffs have spouses now at home to tend their children, health aides and nurses can add hours to this effort.
“There is bound to be a chance that a number of staff will be ill,” said Brian Hortert, Concordia chief operating officer. “We have very few call-offs and better attendance through this pandemic than ever. But we continue to recruit. We have a fair number of applicants.”
He said that staffers who serve clients in their own homes go in after being screened daily, and, depending on the client, wearing surgical gloves, a gown, a mask and protective goggles.
While some facilities provide in-home care to clients, the majority of in-home care is contracted by the Allegheny County Department of Human Services’ Area Agency on Aging. That agency contracts with 17 personal care and home support providers in Allegheny County, and each provider maintains its own staff.
The county agency’s focus is solely on residents in their own homes who are 60 and older and have some incapacity or frailty for which they need help with meals, cleaning, hygiene and therapy.
Elaine Plunkett, spokeswoman for the county’s Department of Human Services, said that at any given time about 2,000 people receive these services.
She said direct-care worker recruitment is always a challenge because of low pay, scheduling and, currently, loss of child care, but that the county’s contracted providers of care have not reported an incidence of directcare workers quitting because of fear of COVID-19.
In fact, the COVID-19 crisis has caused some clients to call off services.
“A significant number of participants have canceled or placed holds on services,” Ms. Plunkett said. “Concerns can range from the participant wanting to limit the number of people in their home to being concerned that they might be a carrier and not wishing to spread the virus. We understand these challenges and are thankful that our participants are conscientious and proactive.”
At the seven retirement communities and eight personal care or assisted living facilities of Presbyterian SeniorCare Network, the situation is “so far so good,” said Lisa Fischetti, spokeswoman for Presbyterian SeniorCare Network, which serves 6,500 patients and clients in Western Pennsylvania.
She said Presbyterian has had “a very heightened recruitment going on for a while now, trying to demonstrate why working in senior living community or longterm care or home health is a rewarding opportunity.
“It’s a job for people who are passionate about having meaning and purpose in life because you really have to like and feel passionate about older adults to do that job. That message had been out there awhile.
“Now during COVID-19, it becomes more important for us to heighten that awareness because, yes, we are going to have front-line people who are tired and stressed and need a break, and we will have a need for people to fill in for them.”
Presbyterian has not had a positive test yet across its network, Ms. Fischetti said, “but every day, we are sending out tests and every day, we hold our breath. Because it’s just a matter of time before we get that first case. When we do, we will be transparent.”
Anyone who is tested begins being treated immediately with precautionary isolation, “where people who go in and out of their room wear personal protective equipment. Everyone signs in and out, and there will be a sign telling people not to enter, i.e., housekeepers to change the trash,” she said.
The new federal protocol across the board in facilities that provide elder services is daily screening before all workers enter the buildings.
“We follow strict guidelines,” Ms. Fischetti said. “Every day when you come to your shift, you go through a series of questions and we take your temperature. That’s every single person, even if you bring in equipment. You have to sanitize your equipment in front of us. If you don’t meet [the guidelines], you won’t be able to go to work that day.
“You may not have COVID-19, but we need to take you out of rotation,” she said. “Because we have to be so cautious, it is affecting our staffing levels.”
More than one person a day in every location has to be turned away, Ms. Fischetti said, which accounts for about 10% of staff.
To fill in, “we start with our network first. Obviously, if a full-time person goes out, you turn to a part-time person to see if they can pick up a shift. The casual pool has to agree to be available a certain number of shifts a month. As this started to unfold, we started reaching out to our current network staff to ask what else can you do if we are in a pinch?
“Interestingly, a lot of people are able to do more because the home situation is different. We do have employees who are now able to give us more time. Why wouldn’t you want to work more time if your spouse is furloughed?”
Ms. Fischetti said the human resources team every day at 4 p.m. gets a list of everybody who has called off and everybody who got screened out, “so in the next 24 hours, they have to find people. But [on the March 2829 weekend] we had no calloffs. On just a regular weekend, you have call-offs. I think that is a testament to the passion the people have for the work they do.”
She said 40% of the 2,000 employees at Presbyterian SeniorCare are direct care givers — nurses, certified nursing assistants and personal care aides.
According to the U.S. Bureau of Labor Statistics, the median annual wage for home health and personal care aides was $24,200 in
May 2018.
Even as demand is expected to increase by 36% into 2028, largely because of the aging baby boomers, companies and agencies that serve the elderly anticipate growing challenges of recruiting sufficient numbers of care workers.That rate is much faster than the average for all occupations, according to the Bureau ofLabor Statistics.
In the best of times, employers have to sweeten the pot to get recruits.
Concordia recently offered eight new recruits for certified nursing assistant classes a $2,500 bonus, Mr. Llewellyn, the human resources director there, said, adding, “We’re ramping up for summer vacation.”
He said one reason Concordia has weathered the storm so far is “because we’ve always had incredible employees. We have some who have given 42 years of service. I’ve always heard employees say that our residents are like family to them.”
Mr. Hortert, the chief operating officer, said some staffers have gone beyond their duties lately, coming back after their shifts to help patients set up Skype so they can visit virtually with their families, or to help people write letters to loved ones.
“In the normal day-to-day, people may forget why they got into this business. Then a pandemic reminds them: ‘This is why I do this.’”
At the Haven at North Hills in Ross, a personal care home of 56 residents and 60 employees, executive director Jennifer Gross said the facility is at full staff “and always looking to hire.”
It currently needs one caregiver and an assistant beverage server, she said.
Workers there change into clean uniforms every day upon arrival, wearing gloves as needed, Ms. Gross said.
“We have been able to provide every employee with a mask through donations,” she said, noting that the Haven had “zero absenteeism in two full weeks.”