It has been over a year since the COVID-19 pandemic began. The prolonged crisis has had a substantial impact on the U.S. health care labor pool, including the home health workforce, though to a slightly lesser extent.
In February 2020, the nation’s health care employment peaked at nearly 16.5 million jobs, according to nonprofit research and consulting firm Altarum. As of this February, the health care workforce is smaller by roughly 3.5% — a loss of about 15.9 million jobs.
“As much as we might hope to leave the turmoil of 2020 behind, health employment has continued to show considerable fluctuation in the first two months of 2021,” Altarum analysts noted in a March data brief.
As for home health care, the industry’s workforce shrank by about 3.1% from last February to February 2021, according to the nonprofit group. In terms of raw employment figures, that translates to an overall loss of about 47,000 home health professionals.
At first glance, a loss of 47,000 home health workers may not seem too steep, especially considering the extraordinarily difficult circumstances of a global pandemic. But home health operators had already been feeling labor-supply pressures long before the public health emergency, with recruitment and retention being top priorities for practically all agencies.
Brent Korte serves as the chief home care officer for EvergreenHealth Home Care, a hospital-based home health and hospice provider in Washington state. He recently touched on the importance of recruitment and retention during the Home Health Care News PDGM Summit.
“Above all, the focus in 2021 is our people,” Korte said at the event. “One of our leaders said the other day that we need to re-recruit our staff daily. I love hearing that, and I absolutely agree with it.”
EvergreenHealth Home Care has more than 600 clinical and support staff, with an employee turnover rate that’s less than 12.5%. The average length of employment at EvergreenHealth Home Care is 7.7 years, though the organization is currently in the process of implementing measures to get that figure closer to 10 years.
“That’s a big deal for us, to try to do that,” Korte said. “Because long-story short, every time you … turn someone over, as a leader, you have to re-educate them. They have to go into a new situation, learn a new EMR and [more].”
Other home health executives have recently highlighted workforce challenges as well. Anecdotally, many have talked about in-home health care workers retiring during the pandemic or leaving the profession for a possibly less-risky job in another area of the economy.
Trinity Health At Home CEO Mark McPherson told HHCN in October that labor shortages sometimes stood in the way of his organization being able to take on new business. A member of Catholic health system Trinity Health, Trinity Health At Home is one of the largest home health networks in the country.
“We want to be able to take on new business, but we’re limited by what we can produce, what we can accommodate within our nursing staff,” McPherson said. “Nursing, in particular, is the area where we are struggling the most to find adequate staff.”
While health care employment has contracted in the past year, there are some positive signs, Altarum suggests.
In February 2021, health care added “a modest 19,900 jobs,” but those gains were largely offset by losses coming at the very start of the year. Although home health care saw its labor force shrink over the past 12 months, workforce numbers increased by 4.7% from January to February.
Other post-acute care settings have fared far worse than the home health industry when it comes to workforce contraction.
Nursing and residential care facilities saw their overall workforce shrink by about 11.5% from last February to February 2021, according to Altarum. That equates to an overall loss of about 310,000 nursing and residential care professionals during that time.
Nursing home workforce challenges took center during a special COVID-19 hearing on Wednesday. Among those to testify was Adelina Ramos, a certified nursing assistant (CNA) at the Greenville Center nursing home in Greenville, Rhode Island.
“We’re extremely short-staffed,” Ramos said of her experience throughout the pandemic. “At one point, I was caring for 26 critically ill residents with only the help of one other CNA, a nurse and a housekeeper. … I was horrified. We begged management for more staff on each shift, but they said they couldn’t find anyone.”