As the long-term care sector pushes to build workforce pipelines substantial enough to address severe labor shortages, one group is ramping up efforts to make those pipelines more effective.
The Moving Forward Nursing Home Quality Coalition last week received a $1.69 million grant from The John A. Hartford Foundation to continue its work improving the work lives of certified nursing assistants and living situations of long-term care residents.
The most important thrust in that work is promoting career pathways for certified nursing assistants and making them scalable, said coalition chairwoman Alice Bonner.
“There are a lot of programs around the country now, but they’re very fragmented,” Bonner told McKnight’s Long-Term Care News. “We can do better in terms of having a standardized, replicable and portable credential.”
Provider leaders often call CNAs the backbone of nursing home work, but burnout and other retention issues have contributed to high turnover in the sector. As few as 30% of nursing facilities are able to meet the CNA hours requirement of the recent federal nursing home staffing mandate.
State government and training institutions have implemented many new care worker training programs across the country in recent years, some using federal funding from the Geriatric Workforce Enhancement Program (GWEP).
But trainees from those programs can run into problems when certifications don’t carry over across state lines, or even remain consistent within the same state.
“When we work with the Geriatric Workforce Enhancement Program going forward — and we’re starting that work now — we should be able to for each of the states … standardize better and learn about what the components are of these different approaches,” Bonner explained.
Federal agencies like the Department of Health and Human Services, Department of Labor and Department of Education also rarely share information about standards or records that would help keep track of which nursing assistants are certified and where, Bonner noted.
“There’s no one central place that owns this,” she said. “We can fix that. A lot of us have been trying for a long time and it’s not easy to fix … but it can be done and that would be another way to really improve things.”
Helping at the state level
The coalition’s efforts are partially focused on these longer-term goals, but its leaders are also busy working on problems on a smaller scale with state providers — such as in Pennsylvania, where they have been working with providers to parse through the many varied workforce programs and requirements already in place.
“We do need more research in key areas as well, but we can’t wait,” Bonner said. “Staffing is front and center and has been for us … Many nursing home leaders have said to us, we want to do more innovation, we want to do more great new programs, but we are literally struggling to keep our doors open right now because of staffing. We need to marshal our resources collectively to do something about that.”
The Moving Forward Coalition was founded in 2022, after its founders took the findings of a report on long-term care from the National Academies of Sciences, Engineering, and Medicine as a call to action.
Two other key coalition focal points have been strengthening resident councils and asking residents about their priorities to inform the coalition’s work.
That work — already underway in Pennsylvania, New Jersey, Michigan and Kansas — will continue to develop thanks to the new grant.
“Any effort to improve the quality of nursing home care must empower residents within their communities,” said Margaret Barajas, steering committee member at the Moving Forward Coalition and Pennsylvania’s long-term care ombudsman. “With this grant, we can coordinate resources, scale partnerships and effectively create nursing homes that foster a culture of resident engagement.”
