Workforce development initiatives have increased Hawaii’s supply of healthcare workers and dampened its need for additional workers over the past two years, but a growing aging population is leading to increasing demand for those professionals, according to a new report from the Healthcare Association of Hawaii.
The 2024 Healthcare Workforce Initiative Report, the third such report since 2019, shows that almost 4,700 open positions are available across the state, which can be partially attributed to more providers reporting data this year and new job categories added to total job openings.
Based on surveys of 119 organizations throughout the state — including assisted living facilities, skilled nursing facilities, acute car hospitals and Medicare-certified home health agencies — the data show a modest decrease in open positions, from 17% in 2022 to 14% in 2024. The 2024 report looks at 94 roles in direct resident/patient care and support, including nurses, certified nurse aides and medical assistants. Jobs in food services and environmental services also were included for the first time.
Assisted living keeps pace
As assisted living communities work to meet the needs of an aging population, total positions overall increased, according to the report. At the same time, the percentage of all open positions in assisted living decreased from 14% in 2022 to 9% in 2024, showing that hiring is keeping pace with or outpacing job expansion. Comparatively, skilled nursing facilities saw their job vacancy rate grow from 18% in 2022 to 23% in 2024. Home health had the highest vacancy rate, although it went down, going from 39% in 2022 to 30% in 2024.
The greatest need among assisted living communities is for CNAs, according to the report. Although more openings for this profession exist now than in 2022, the percentage of open positions decreased from 15% to 11% in the same time period. This change is due to concerted efforts to increase the entry-level workforce, the report authors said.
Open licensed practice nurse positions decreased 28% from 2022 to 2024, despite the fact that assisted living communities still struggle to fill LPN, registered nurse and nursing assistant roles. Assisting living saw other clinical specialty RN vacancies spike from 4% to 16% between 2022 and 2024 — it was the only role that experienced an increased percentage of open positions in the setting during that time.
Assisted living reported the highest turnover rate among the sectors studied, at 36%, followed by 26% in SNFs and 19% in home health. Overall, healthcare has a 19% turnover rate in Hawaii. Tricia Medelros, chief operating officer of The Plaza Assisted Living and chair of the HAH assisted living community/adult residential care homes committee, said the organization found that most turnover occurred in the first 30 to 90 days on the job, a problem that became exacerbated since the COVID-19 pandemic, when communities hired individuals with less experience.
Workforce development initiatives
Wesley Lo, CEO of Ohana Pacific Health and Hale Makua, told McKnight’s Senior Living that healthcare jobs are difficult, and the industry is competing against other industries for the same workers. He said HAH learned over the years they needed to better prepare people going into long-term care careers so they could be comfortable with the work.
Janna Hoshide, HAH associate vice president of workforce development, told McKnight’s Senior Living that HAH realized that, especially at the high school level, students in workforce development programs were new to the workforce and needed a lot of support. They found that young students in their first year lacked confidence in a work setting. So HAH worked with employers to provide additional support and wraparound services — including clinical experience, professionalism training, coaching and help with filling out job applications — to effectively transition students into jobs..
Since 2018, collaborative partnerships have yielded measurable progress, including high school certificate workforce development programs, adult healthcare education programs, expanding nursing residency and transition-to-specialty RN programs and Hawaii’s first CNA to LPN (Glidepath) program.
“We can see in this report how the multiple efforts by community, government and educational partners through the Healthcare Workforce Initiative are bearing fruit, yet at the same time the need for healthcare workers keeps growing,” HAH President and CEO Hilton Raethel told McKnight’s Senior Living.
More work needed
The results of the report, according to HAH, show that additional work is needed by educational institutions, employers and policymakers to ensure a continued robust pipeline of workers.
“The whole point of the study and program was to better match supply and demand,” Raethel said. “The good news is that we are making some progress, but the challenging news is the demographics are working against us. It’s a real challenge to find enough workers to meet the needs in healthcare, especially in long-term care and assisted living and health centers.”
Hawaii’s population of people aged 80 or more years is projected to increase more than 63% between 2020 and 2030, going from almost 68,000 to more than 110,400 people, according to the US Census Bureau.
“We have a historic rapidly aging population that has more medical needs, which equates to a need for a larger healthcare workforce,” Lo said. “The report shows the growing need for CNAs and home health aides. We have also been working hard to offer nurse aides a pathway to becoming higher-paid LPNs. A collective goal of the HWI team is to keep developing programs where people can upskill and earn more, and stay in Hawaii.”
The first Healthcare Workforce Initiative report came out in 2019 and was followed by a second report in 2022.
Source: McKnights Seniorliving
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