BCHIP, in conjunction with the Bucks County Commissioners, Bucks County Health Department, Bucks County Emergency Services, all Bucks County hospitals, and our long-term care facility partners, created the Bucks County Long-Term Care Partnership to create a non-competitive environment in which healthcare facilities and advocates can work together to overcome some of the issues facing long-term care services in Bucks County.
Our goal is to improve the experience for both patients and staff, so that residents feel nurtured, empowered, and respected, and employees feel appreciated, well-compensated, and motivated to come to work every day and provide the very best care.
Staffing
One of the major challenges in long-term care (LTC) revolves around staffing shortages and training.
Many LTC facilities, also called nursing homes, struggle with insufficient staffing and a high staff turnover rate. Certified nursing assistants (CNAs) provide the bulk of care in nursing homes. Fortunately, Pennsylvania ranks highest in the nation for nurse assistant ratio per 1000 jobs in the state (10.96 per 1000), but it is still third-highest in the nation for using contracted staff (17.7%), which means there are many opportunities in PA for steady nursing jobs. Bucks County has a much lower turnover rate than the state and national averages, which is also a sign that our nursing homes are generally seen as good places to work.
Working in a long-term care facility can have unique rewards because RNs, LPNs, and CNAs are able to develop relationships with people in their care. They get to hear about their families and their memories, help them maintain a quality of life and sense of belonging in their final years, and pour a whole lot of compassion on them, which is one of the main reasons for becoming a nurse. However, much needs to be done to retain and attract good nursing staff.
A number of steps are being considered to help us attain this goal, including:
- Increased pay
- Training in geriatric care and other issues specific to elderly, chronically ill, or disabled patients
- Training in patient safety specific to elderly, chronically ill, or disabled patients
- Tuition assistance, reimbursement, or forgiveness
- Developing apprenticeship programs
- Providing benefits such as daycare or daycare reimbursement for nursing staff
Other pressures on staffing are occurring because of the recent strategy of hospitals to send patients to nursing homes when they no longer need hospital care but are not yet well enough to be sent home. This creates another stress on the already strained LTC system.
Some LTC facilities are looking into ways of streamlining tasks that can be automated, such as billing and scheduling, to lighten some of the facility’s financial pressures and staff’s time pressures to allow for more efficient nursing and recordkeeping.
Funding and Regulations
The Long-term Care Partnership of Bucks County is also trying to address the serious issues of funding and regulations that cause additional stress on the system. Changes are necessary at the local, state, and federal levels to support long-term care.
The simple truth is that LTC facilities do not get sufficient funding. Medicare does not cover LTC expenses; Medicaid patients have to be quite poor to receive coverage, and that coverage is not sufficient, so they tend to be in facilities with lower standards that charge less. A patchwork of legislation and funding at county, state, and federal levels creates difficulty in developing sufficient financial stability and efficient facilities management procedures to guarantee the highest quality of care for everyone, even the sickest or most needy patient.
Additionally, in an effort to try to force LTC improvements from the top down, The Centers for Medicare & Medicaid Services (CMS) released minimum staffing requirements for LTC facilities in April 2024. Many nursing homes and long-term care facilities simply cannot meet these stricter staffing mandates; only 6 out of 100 nursing homes currently meet these requirements. This is forcing some LTC facilities to reduce the number of residents to meet the standards, sending many people out of the system and back home with family members who may not be able to give them all they need.
Family Caregivers
Many people prefer to stay home with the support and care of family caregivers. Others are forced to stay in the home, either because they cannot afford LTC or because there is not enough staffing to receive new patients in their local LTC facilities. Either way, this puts tremendous stress on loved ones who are simply not equipped to provide medical care.
Our Long-Term Care Partnership is looking into establishing support for families, including:
- Offering training in geriatric care and other issues specific to the needs of their loved ones
- Providing a system of respite care, to give caregivers a break from constant care and allow them to engage in much-needed self-care
- Developing support groups for family caregivers to provide emotional support and answers to questions they may have about helping their loved ones or helping their families cope
BCHIP is committed to working together with all Bucks County healthcare providers and organizations to ensure the very best care for all Bucks County residents. Our Long-Term Care Partnership is yet another way that we are working to reach our goal.
