Although North Carolina’s assisted living communities don’t employ large numbers of nurses, industry leaders noted that findings and recommendations from a state task force on addressing a shortage of nurses can apply across the continuum and job categories.
The North Carolina Institute of Medicine recently released a report on its recommendations and strategies to address the state’s looming nursing workforce shortage. A state nurse workforce model shows a 27% shortfall in licensed practical nurses by 2033, with the largest shortfall of 49% in long-term care settings, including assisted living communities and nursing homes.
According to the report, LPNs practice in 3% of the state’s assisted living communities, whereas registered nurses work in only 1% of assisted living communities.
The North Carolina Senior Living Association noted that although most assisted living providers in the state do not employ nurses, it agreed with the findings and recommendations in the report. Executive Director Jeff Horton told McKnight’s Senior Living that the state’s assisted living communities rely mostly on trained personal care aides, supervisors and administrators.
“Our main concern and emphasis is primarily on recruitment and retention of direct care workers, such as personal care aides,” Horton said, adding that his organization is working with the North Carolina Coalition on Aging’s Essential Jobs Essential Care work group, a multi-year partnership with national organization PHI tackling policy reforms for direct care workers.
The North Carolina Assisted Living Association pointed to language in the report regarding standardized mandatory staffing requirements, saying “one size does not fit all” for assisted living. As an experienced RN, NCALA President and CEO Frances Messer told McKnight’s Senior Living that she believes that staffing to residents’ level of needs gives communities the ability to match the caregiver to the resident based on an individualized resident care plan developed on resident assessment, needs and preferences.
Messer said that state staffing requirements for memory care units exceed skilled nursing facility minimums due to an increased need for supervision of residents with memory impairment, physical agitation, paranoia and other dementia-related behaviors.
“Our North Carolina assisted living rules give minimum staffing standards; however, staffing to meet the residents’ needs is the core of staffing requirements in North Carolina,” Messer said. “Standardized staffing is not the way to better quality care.”
Messer added that federal and state financial support for Medicare and Medicaid is needed to meet all of the recommendations proposed in the NCIOM report.
Both Messer and Horton said that their associations support the recommendations that apply to nurses, adding that those assisted living communities that do employ LPNs or RNs are working to implement the NICOM task force’s recommendations.
The Task Force on the Future of the Nursing Workforce report identified several challenges affecting the nursing workforce, many of which overlap with challenges facing the direct care workforce. According to Argentum, more than 3 million workers will be needed in senior living by 2040, with more than 20 million needed across long-term care settings in that time.
Those challenges include burnout, overload, stressful work environments, insufficient staffing and trauma. Many of those challenges, the report noted, were compounded by the COVID-19 pandemic.
The task force developed eight recommendations and 25 supporting strategies and other fractions to support the development and retention of LPNs and RNs in the state’s workforce.
Among the task force’s key recommendations were expanding and diversifying the nursing workforce, strengthening training programs, creating a supportive workplace culture, expanding the role of nurses in leadership and decision-making, providing flexibility in scheduling, promoting advocacy for nurses, valuing nurses and optimizing payment for healthcare services to support nursing care.
Task force members included representatives from the AARP, LeadingAge North Carolina and the North Carolina Healthcare Association, as well as representatives from various educational, professional and government organizations.
Source: McKnights Seniorliving