A Critical Look at the Looming Long-Term-Care Workforce Crisis

By Harahan, Mary F. | Generations, Winter 2010 | Go to article overview

A Critical Look at the Looming Long-Term-Care Workforce Crisis


Harahan, Mary F., Generations


To alleviate coming workforce shortages, employers, educational institutions, federal and state policy makers, and consumer advocates must recognize long-term care as a vital component of the larger healthcare market.

Over the past decade, numerous studies have documented a growing long-term-care workforce crisis. These studies have usually focused on the shortages of direct-care workers who provide the great bulk of formal care (Stone and Harahan, 2010; Institute of Medicine, 2008; Health Resources and Services Administration, 2004; Office of the Assistant Secretary for Planning and Evaluation, 2003). Much less attention has been paid to the role and status of licensed professionals who supervise direct-care staff and provide health and ancillary services in long-term-care settings. Shortages of competent and dedicated long-term-care professionals- particularly among licensed nurses-continue to be ubiquitous across all long-term-care sectors. In comparison, the recession has significantly eased the shortage of hospital-based nurses. Between 2007 and 2008, employment of registered nurses (RNs) in hospitals increased by 18 percent-the largest increase in thirty years. During this same period, 50,000 nursing positions were lost in non-hospital settings, including nursing homes and homecare agencies. Hospitals offer a competitive advantage over long-term-care employers because of higher wages, better benefit packages, and more attractive work schedules (Buerhaus, Auerbach, and Staiger, 2009).

The remainder of this article summarizes the roles and responsibilities of licensed long-termcare professionals, discusses the capacity and commitment of these professionals to meet the increasingly diverse long-term-care needs of a growing older adult population, and suggests reforms to attract and retain high-quality long-term-care professionals.

The Roles of Licensed Long-Term-Care Professionals

Licensed professionals employed by nursing homes, assisted living facilities and home health and personal care agencies include administrators, physicians, nurses, social workers, mental health professionals, and consulting pharmacists.

Physicians

Nursing homes reimbursed by Medicare or Medicaid are required to have a physician medical director to oversee the medical care of residents and participate in the design of residents' care plans. The federal government does not require assisted living facilities and home health agencies to have a medical director, although many do. According to recent research, medical directors, usually primary care physicians, devote about 44 percent of their practice to nursing homes. A significant minority have some special training in geriatrics (Caprio, Karuza, and Katz, 2009). The involvement of other physicians in caring for long-term-care patients seems to fade away once an individual is admitted to a long-term-care institution. A 2006 survey conducted by Katz and Karuza found that only one in five self-identified primary care physicians reported any involvement in nursing homes. Those who were involved averaged about two hours per week (Katz and Karuza, 2006). An important factor in physicians' reluctance to work in nursing homes is their fear of medical malpractice and liability risk (Kapp, 2008).

Nursing home and home health administrators

Nursing home and home health administrators are responsible for all aspects of their respective organizations, including supervision and management of staff, and compliance with federal and state regulations. The federal government requires states to license nursing home administrators. However, there are no national standards, and state licensing requirements vary widely. Several studies (Singh and Schwab, 2000; Castle, 2001; Castle, 2006) show high rates of administrator turnover in nursing homes. The credentialing of assisted living facility, home health agency, and other home- and community-based service agency administrators is left to states. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

A Critical Look at the Looming Long-Term-Care Workforce Crisis
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.