What They Are Saying: Senators, Experts Discuss Health Care Staffing Shortages

Workforce; Advocacy
Members of the Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing last week to discuss the impact that nationwide staffing shortages are having on the entire health care sector, as well as potential solutions to help alleviate the crisis. Nursing homes in particular have experienced the worst job loss within the entire health care sector during the pandemic and are not expected to return to pre-pandemic workforce levels until 2027. 
Senator Tim Kaine (D-VA) underscored the impact of staffing shortages on direct care professionals, such as those that care for seniors and individuals with disabilities:
“This workforce shortage kind of compounds other shortages. I go to hospital emergency rooms, and they say we have to keep people in hospitals longer because the direct care workforce shortage means that there’s no placements where we can discharge someone from a hospital to a long term care setting or to appropriate home health care, right. So, I hope as we look at this problem, we’ll focus on the direct care workforce.”
Senator Mitt Romney (R-UT) pointed to the significant backlog of immigrants who want to come to the U.S. to work in health care but can’t because of visa processing delays:
“My understanding is that typically almost 20 percent of the nurses and medical professionals in this country come from foreign countries, but the backlog of medical professionals that want to come into this country has become enormous. We require them to be interviewed, and given our security needs it’s appropriate that they be interviewed by the State Department. Apparently, the State Department is still so concerned about COVID that they’re not interviewing these people. So, places like the Philippines where there’s some 30,000 people who want to come here and serve as nurses, we can’t get those nurses in.” 
Senator Susan Collins (R-ME) said we have thousands of nursing prospects but not enough faculty to teach them:
“It just is astonishing to me that last, I guess it was in 2021, almost 92,000 applications for baccalaureate and graduate nursing programs were turned away with faculty shortages cited as the top reason, and the University of Maine this year had 1,239 applications for only 80 slots. So, I think there’s this misperception that people don’t want to become nurses when in fact, we have a ton of applicants from people who do want to enter the field of nursing, but we don’t have the professors to teach them.” 
Dr. Sarah Szanton, Dean of Johns Hopkins School of Nursing and a witness at the hearing, expressed concern for the future, as more nurses enter retirement while a growing elderly population will require more care:
“One thing that has not been mentioned is the average age of nurses today is 54 years old, and 19 percent of them are 65 or older. So, you can imagine we’re worried about the future as well. And that is coupled with the aging population that has more and more chronic conditions as well. There is 4.5 million nurses, and nurses are often considered the oxygen of any health care setting. So as a country, we need people to become new nurses, and we need to retain current nurses.” 
As nursing homes struggle to find workers, the Centers for Medicare & Medicaid Services (CMS) is expected to implement a federal minimum staffing mandate in the coming months. A staffing mandate amid a historic labor shortage and without the appropriate funding to help providers recruit and retain caregivers would make this crisis considerably worse.
We need a comprehensive and supportive approach that will help the long term care sector rebuild its workforce as well as help the nation create a strong pipeline of caregivers for the future. The American Health Care Association and National Center for Assisted Living’s (AHCA/NCAL) reform proposal, the Care for our Seniors Act, offers strategies ​to boost workforce recruitment and retention, including student loan forgiveness, tax credits for licensed health care professionals who work in long term care, and assistance programs for affordable housing and childcare. 
Nursing homes have done everything they can to address the workforce crisis, but they need help. Policymakers must develop meaningful policies and resources to strengthen the long term care workforce and ensure our most vulnerable have access to the high-quality care they need.