The Impact of Labor Shortages on Long-Term Care and Homecare

Oksana Chernogor, Coordination Team Manager, S&A Unified Home Care, Inc, and Stephen Vaccaro, President, HHAeXchange

Please share your name, title, and a brief overview of your professional history.

Chernogor: I have worked in homecare since 2015 in various communities. In my current role, I train our coordinators on what kind of care our members expect to receive, familiarize them with the homecare process and details, and assist members with any issues they may encounter while receiving homecare services. I supervise our coordinators to see that members’ needs are met and perform quality-control calls to ensure they’re receiving the level of care they deserve. If changes in care plans or schedules are needed, I guide our coordinators to take care of that and any other patient-care-related challenges that may arise. 

Vaccaro: In my role, I lead HHAeXchange’s market strategy and the national expansion of our state, payer, provider, and fiscal intermediary portfolios. I have over 25 years of leadership experience in the health care industry, having spent time on both the payer and provider sides of the market. I also have a background in sales, service delivery, strategic planning, project management, profit and loss management, product development, and acquisition integration.

Why is there a lack of caregivers available and high turnover rates within the caregiving and homecare industry?

Chernogor: Delivering excellent homecare requires dedication and commitment that exceeds expectations. Sometimes, the challenge has less to do with the availability of caregivers and more to do with finding individuals who are dedicated and passionate to remain with the job. Those who wholeheartedly embrace their roles often remain devoted caregivers to the same members for years, usually until the member no longer needs care. However, the industry runs into trouble when caregivers underestimate career demands, resulting in departures from the industry or trouble coping with job-related stress. To ensure quality services, we select caregivers who demonstrate an unwavering commitment to caring for our members.

Vaccaro: The large size of the aging population is also likely a factor. As the number of older adults requiring care rises, the supply of caregivers isn’t robust enough to keep up with the demand. It can lead to overly packed schedules and long days. Also, infrequent training opportunities can contribute to job frustration and turnover. Without proper training and guidance, caregivers may feel ill-equipped to handle the challenges of the job.

What is motivating an increased interest among older adults to age in place and at home?

Chernogor: The reasons are varied and, often, personal. Overwhelmingly, though, the idea of aging in place is compelling because it allows seniors to continue enjoying a sense of independence. In most cases, they can maintain a good quality of life, stay active in their communities, and see their friends and families as often as they want. As people age, their bodies go through significant changes, which can be stressful. However, by allowing seniors to experience these changes in the familiar surroundings of their own homes, we can reduce stress and improve their overall well-being.

Vaccaro: Cost can also be a significant factor. For some seniors, the cost of moving to a senior residential facility can present significant hardships and may even be unattainable. Aging in place allows older adults to enjoy lower monthly housing costs and a more manageable budget overall. According to the U.S. Department of Housing and Urban Development, approximately 20% of adults aged 65 and above own their homes, eliminating the need to factor mortgage payments into financial plans.

In addition, seniors who can age in place generally experience better health compared to those in senior living facilities for several reasons. They tend to have more control over their daily routines, including meal choices, exercise routines, and social interactions, allowing them to maintain healthier lifestyles. When they do need care, it typically is administered by family members or home health care providers, which means the care received is more personalized and tailored to the specific needs of the individual, leading to improved health outcomes.

What can care providers do to make sure that they are maintaining a robust, engaged, and well-trained workforce?

Chernogor: S&A Unified HomeCare employs a range of strategies. We recognize outstanding caregivers through our Caregiver of the Year award and have previously provided additional bonuses as a token of appreciation. We offer training opportunities but, above all else, we ensure our caregivers receive the help and support they need. For instance, when a member's condition undergoes a change that the caregiver has not encountered before or when the workload increases, an additional caregiver may be assigned, or a nurse will accompany the caregiver to provide additional training and education. By closely monitoring our members' conditions, we can tailor the caregiving approach accordingly.

Please elaborate on the technological solutions available for caregivers and how these resources may impact member care outcomes.

Vaccaro: The first tool that comes to mind, of course, is Electronic Visit Verification (EVV). The progress of EVV and its underlying technology have the potential to greatly improve access to data for all parties involved. This includes provider teams, caregivers, and payers, who can leverage useful insights more efficiently. By combining homecare visit data with other population health analytics, this technology has the potential to transform service delivery and enhance health care outcomes. EVV’s capabilities, designed to record a member’s experience from beginning to end, can help caregivers identify and address social determinants of health and other factors that may impact a member's health. It’s great that this technology can be leveraged for so much more than complying with federal regulations.

What homecare trends are emerging currently and how do you anticipate the industry landscape changing over the next few years?

Chernogor: We’re seeing more of an emphasis on personalized care plans tailored to individual needs and preferences. It’s encouraging when clients feel empowered enough to take an active role in their care. To keep pace, providers are increasingly focused on person-centered care, considering the unique circumstances and goals of each member. I think this trend will continue as the industry recognizes the importance of individualized care and sees more benefits from it.

Vaccaro: Collaborative care models are emerging more frequently, entailing partnerships between homecare agencies, health care systems, and other community organizations. These collaborations aim to improve care coordination, enhance communication, and provide comprehensive support to individuals receiving specialty care from various sources.

Regulatory changes have also been making headlines recently. Anticipated changes to the homecare industry, which is subject to evolving regulations and policies, may include increased oversight, standardization of care practices, and potential reimbursement reforms. These regulatory shifts will likely impact how homecare services are delivered and may influence the structure of the industry.

Is there any final message you'd like to impart to our audience on this topic?

Vaccaro: I’d be remiss if I didn’t touch on the ways that EVV platforms can help caregivers stretch their time and energy by streamlining and simplifying certain duties. As the industry struggles with homecare worker shortages, it’s essential to note that EVV provides valuable tools that can ease certain processes while saving time, increasing accuracy, and strengthening online security. With the availability of resources like automated billing, scheduling assistance, and other forms of administrative support, agencies can empower their caregivers to focus their attention and efforts where they belong – prioritizing members’ health and providing them with the best care possible.

Chernogor: Homecare workers play a crucial role in supporting members with their daily needs and ensuring their well-being within the comfort and safety of their own homes. It’s essential to recognize and appreciate their dedication, compassion, and hard work as they help to support the quality of life and independence of those they care for.