Archive for ‘turnover’

New Hampshire Analyzes the Needs of—and the Need for — Home Care Workers

Posted by on October 8th, 2009 at 12:35 pm | 2 Comments »
From Home Care Workers: Keeping Granite Staters in Their Homes as They Age.

From Home Care Workers: Keeping Granite Staters in Their Homes as They Age.

As Terry Lynch pointed out in his most recent blog post, the popular – and federally mandated – trend of using Medicaid to pay for less nursing home care and more home care cannot continue unless states can attract and keep more home care workers. A pair of recent papers from New Hampshire looks at just what that means for the state of New Hampshire.

In Home Care Workers: Keeping Granite Staters in Their Homes as They Age, (PDF) Kristin Smith of the University of New Hampshire’s Carsey Institute profiles home care workers. The 12-page policy brief provides a demographic and economic overview of the state’s licensed nursing assistants, personal care service providers, personal care assistants (PCA), and homemakers and companions. It also discusses the implication of low pay and high turnover among direct care workers for those who rely on their services. Continue reading »

Career Advancement and Supervisor Training Improve CNA Retention

Posted by on September 9th, 2009 at 1:39 pm | 1 Comment »

win a step up“It appears that the investment that North Carolina is making in quality improvement initiatives is having a positive and significant impact on nursing home performance and the stability of the nurse aide workforce,” says Workplace Interventions, Turnover, and Quality of Care Report.

The June 2009 report analyzes three workplace interventions aimed at improving turnover rates and care quality in North Carolina nursing homes:

  •   The WIN A STEP UP program. This gives nursing assistants an opportunity to advance in their careers and earn additional money by completing a 30-hour curriculum. They also commit to staying in their jobs. In addition, the program provides coaching supervision training for the CNAs’ supervisors.
  •   Culture change initiatives. 15 North Carolina nursing homes a year are granted civil monetary penalty funding to transition from medical-model care to a more homelike environment.
  •   Quality improvement collaborative. About one in five North Carolina nursing homes participate in this effort to improve reduce the rate of pressure sores and the use of restraints.

Continue reading »

Connecticut White Paper Identifies Causes for DCW Turnover and Recommends Cures

Posted by on August 7th, 2009 at 10:54 am | No Comments »

When No One Cares cover“Although Connecticut has expanded programming for services to meet the needs of older adults, persons with disabilities and persons with chronic health needs, we are losing the necessary labor force to properly provide these services,” says When No One Cares: Why We Need to Save Connecticut’s Direct Care Workforce. (PDF) The eight-page white paper outlines the state’s fast-growing need for direct care givers – particularly home care workers.

Connecticut’s “care gap” will be one of the more pronounced in the nation, with its population of elders is expected to increase by 69 percent by 2030, while the population that has traditionally supplied the great majority of direct care workers – women aged 25 to 44 – decreases by 10 percent. What’s more, home care, which is becoming more common as the long-term care system is “rebalanced,” requires more direct care workers than residential care, making it all the more urgent that the state find ways to attract and retain workers.

The paper organizes the roadblocks to building a stable and sufficient direct care workforce into three categories – recruitment, retention and reimbursement – and offers policy and practice solutions for each.

Continue reading »

Let’s Make Sure Our New Colleagues Get Orientation – For Everyone’s Sake

Posted by on August 5th, 2009 at 3:02 pm | 3 Comments »
Vicki Erickson

Vicki Erickson

One of the main reasons so many nursing assistants leave every year is that they don’t get enough orientation when they’re new to the job. I know because I had good mentors who trained me well, and now I’m working as a CNA mentor myself.

In my six years as a mentor, I’ve seen what a difference it makes to new workers to get a solid grounding. Even people who have done direct care before need time to get used to the new setting and the clients, residents, or consumers they’ll be working with there.

A lot of employers try to give everyone a week of orientation but often let that go by the wayside because someone calls in sick and there just aren’t enough people to do the work unless the new person carries a full load.

Those of us who have experience need to make time to slow down and teach new people. We need to nurture them, too. If someone you’re training does well, give them a little acknowledgement. I sometimes send someone a balloon with a snack that they like. And if they need a little more time, let the supervisor and the nurses know, so they can get a couple more days of orientation.

Continue reading »

No Health Care Without Health Care Workers, Warns Iowa Editorial

Posted by on July 22nd, 2009 at 12:15 pm | No Comments »

des moines register 1“It’s a simple fact: Access to coverage does not equal access to care. Ask the many Iowans who already have trouble finding and keeping a health-care professional,” writes John Hale, the policy director for the Iowa CareGivers Association, in the July 14 Des Moines Register.

In “Health Care Won’t Improve Without Enough Workers,” Hale says Iowa is ahead of most states in documenting and addressing the growing health care worker shortage. However, he argues, the state can’t fix the problem on its own: The federal government needs to help.

Hale’s editorial lists several things the federal government can do. The most important, he says, to “give this looming crisis the sense of urgency it deserves and provide funds to the states to allow them to act.” The health care reform bills currently being considered in Congress, he adds, provide “an opportunity to deal proactively with the health- and long-term-care work force that each of us depends on.”

Elise Nakhnikian
Communications Director
Direct Care Alliance

New York Times Calls for Fair Pay for Home Care Workers

Posted by on July 9th, 2009 at 1:08 pm | No Comments »

Act now! If you haven’t already sent Secretary Solis a letter urging her to extend Fair Labor Standards Act coverage to home care workers, visit our Legislative Action Center now and send one in. It will only take a minute of your time.

A strongly worded editorial in yesterday’s New York Times echoes the DCA’s call to the U.S. Department of Labor (DOL) to extend federal minimum wage and overtime protection to home care workers. 

Fair Pay for Caregivers starts by outlining the DOL ruling and Supreme Court decision that led to the exclusion of home care workers from the Federal Fair Labor Standards Act. It then describes the House and Senate letters sent to Secretary of Labor Hilda Solis as a result of the DCA’s campaign. The editorial explains why failing to ensure that home care workers get fair pay is not only unfair to workers but also costly to taxpayers, who foot the bill for the food stamps and other public assistance that many home care aides must rely on. “The public pays in other ways, too: turnover is high, undermining the quality of care and driving up overall costs,” the editorial notes.  

Continue reading »

Ask Congress to Include Nursing Home Transparency in Health Care Reform Bill

Posted by on July 9th, 2009 at 12:24 am | No Comments »

nursing-home-hallway-220The DCA’s National Direct Care Partnership has endorsed the Nursing Home Transparency and Improvement Act, which is part of the draft health care reform bills being considered by both the House and Senate. The Act would give families a lot more information about the nursing homes they put their loved ones in, including whether they have adequate staff. 

The Act, which is being championed by NCCNHR, would require nursing homes to disclose their owners and all the related entities that own, finance, or operate them. It also includes nine other provisions, including:

  •   Require CMS to collect and report accurate information about the hours of nursing care facilities provide and their turnover and retention rates.
  •   Require better state complaint handling and provide resident representatives and workers better protection from retaliation.
  •   Include dementia care and abuse prevention in nurse aide training.

Visit our Legislative Action Center and ask your representatives in the House and Senate to make sure those provisions stay in the final health care reform bill.

Elise Nakhnikian
Communications Director
Direct Care Alliance

Texas to Hire More Direct Care Workers for Troubled State Schools

Posted by on June 16th, 2009 at 4:17 pm | 1 Comment »
Renee Tillman

Renee Tillman

There’s trouble in Texas’s so-called state schools, live-in institutions that provide campus-based long-term care for people with mental disabilities.

State investigators uncovered more than 500 cases of abuse and neglect in the schools between September 2007 and August 2008, and a U.S. Department of Justice (DOJ) investigation found systemic abuses of the civil rights of the school’s roughly 4,700 residents. The DOJ’s report said many of the problems are due to high turnover rates, staff vacancies, and inadequate staff training and supervision. Late last month, the state reached an agreement with the DOJ intended to improve conditions in the schools. Among other things, the schools will get 1,160 more staff, most of them direct-care workers.

Here’s what CNA/CHPNA Renee Tillman, the founding president of the Texas Association of Nurse Assistants, has to say about this unfortunate situation and the proposed solution.

Hiring more workers should help. Direct care workers employed in mental health also need better initial and ongoing training. We have to have yearly in-services on Alzheimer’s and dementia care, but the kinds of mental health issues these kids have are completely different

I think Governor Perry feels he needs medical professionals monitoring the care in these schools. Two very close friends of mine were working in one of the schools that was shut down, and from what I’ve heard, some of the people who worked there were acting more like guards than caregivers or teachers, treating the kids almost like felons. They were also trying to impose discipline without much training, and there wasn’t much of a monitoring system in place to oversee what they were doing.

The kids who are in these institutions often come from pretty tough circumstances. If we’re not careful, they can easily be neglected inside the schools. We need to make sure the people who work there get the training they need. There should also be a special committee to oversee the program, to prevent the physical and sexual abuse that has been happening to these kids.

Legal Expert Calls for Minimum Labor Protections for Home Care Workers

Posted by on June 8th, 2009 at 6:57 pm | 4 Comments »
Peggie Smith

Peggie Smith

“Federal reform is urgently needed to provide home care workers with the compensation and respect they deserve,” says Peggie Smith.

Smith, who is the Murray Family Professor of Law at the University of Iowa College of Law and a graduate of Harvard Law, is talking about a U.S. Supreme Court decision that excluded home care workers from protection under the federal Fair Labor Standards Act (FLSA). The court said the workers were providing companionship services.

In Protecting Home Care Workers under the Fair Labor Standards Act, (PDF) the second in a series of Direct Care Alliance policy briefs, Smith says the decision “threatens to destabilize the home care industry, erode the precarious economic status of home care workers, and undermine the quality of care that they provide to home care clients.”

She outlines two approaches the federal government could take to reverse the ruling:
1. Amend the FLSA to explicitly include home care workers; and
2. Revise Department of Labor (DOL) regulations to significantly limit the reach of the companionship exemption.

Smith recommends that the government do both, with the DOL taking immediate action to revise the companionship exemption while Congress works to reverse the impact of the Supreme Court decision by passing the Fair Home Health Care Act. Continue reading »

Gerontologist Reports on CNA Characteristics and What Causes Turnover

Posted by on May 27th, 2009 at 6:01 pm | No Comments »

the-gerontologist-april-2009-coverThe April issue of The Gerontologist reports on several important studies about direct care workers, starting with the long-anticipated National Nursing Assistant Survey (NNAS).

A paper about the survey, which is based on data from 2004, says it represents “a major advance in the data available about CNAs in nursing homes.” The report lists some of the survey’s major findings and suggests that the data be used for “evidence-based policy, practice, and applied research initiatives to address the CNA workforce shortage and to improve recruitment and retention efforts.”

Among the findings of the NNAS:
• Almost half of all CNAs are members of a minority group;
• Their median hourly wage was $10.04, and almost two-thirds lived on an annual family income of less than $30,000; and
• More than 40% did not participate in their employer’s health insurance plan because they couldn’t afford the premiums.

The April Gerontologist also looks at the causes of high CNA turnover rates from two different angles.  

Continue reading »

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