Home care on the rise, but staffing crunch hit there, too

Home care agencies are in demand but hampered by the same acute staffing shortages plaguing nursing homes.

“As the COVID pandemic escalated and nursing homes were forced to close their doors to visitors, the demand for home health care increased significantly,” says Jane Shukitis, president and CEO of UR Medicine Home Care. “Unfortunately, the multifaceted stresses and fears associated with the pandemic, resulted in many people leaving the field, especially in our home health aide workforce, further reducing our ability to meet the increasing demand for in-home care.”

To address this staffing shortage, UR Medicine Home Care must prioritize, deploying staff to those patients with the greatest needs. To attract more certified nursing assistants, the home care agency increased the starting wage to $15.50 per hour. In addition to the pay hike, UR is offering other financial and recruiting incentives, which has helped fill staff vacancies.

“We are hopeful the downward trend is starting to turn, however it will take a long time to get back to full capacity,” says Shukitis.

The vaccination rate for UR Home Care staff is about 95 percent, but Shukitis notes that “the loss of even one clinician impacts our ability to provide services to all the patients who need our care.”

In mid-August, former Gov. Andrew M. Cuomo announced that all health care workers must be vaccinated against COVID-19 by Sept. 27.

Some home care agencies and nursing homes took a bigger hit to staffing due to the mandate. Thirty percent of Tina Pagano’s nursing aides left during the pandemic and another nine departed after refusing to be vaccinated.

“Every agency is struggling since all the aides had to be vaccinated. We’re definitely feeling the stress,” says Pagano, manager of All Metro Health Care’s Rochester office.

The vaccination reluctance was a combination of too little information coupled with misinformation, says Pagano.

“Some people didn’t know Wegmans was offering free vaccinations. Some were afraid they would die from the vaccine or get blood clots,” she says. “I had my RNs speak to them to try and give them the facts.”

She hopes those aides who left will return.

Like UR Home Care, staffing shortages mean All-Metro can only take the sickest patients — those who require round-the-clock care or are homebound and without family support.

At Venture Forthe, Inc. a home health care service in Rochester, staffing also declined significantly during the pandemic and dropped further due to the vaccination mandate.

“As the workforce decreased, there was a lot of competition for employment,” says James Tretter, Venture’s president.

Citing training requirements for nursing aides, burnout and concern over COVID, Tretter says a number of staff left for jobs in the service industry that paid similar wages. Venture Forthe currently has a waiting list of patients seeking home care, but doesn’t have the staff to take on new clients.

“We’re optimistic we’ll get staff recruited and trained,” says Tretter. “We fully intend to start accepting cases in the next 12 months.”

Most of Venture’s staff who refused to be vaccinated were certified nursing assistants.

“A lot are on leave,” says Tretter. “They might get the vaccine and then we’ll welcome them back. They are not formally terminated.”

The trend is toward home care and away from senior living facilities, believes Tretter.

“It’s way better for patients to be able to interact in the community and stay active.” Safety is another issue. “In your own home you can control who is coming in and out,” he adds.

Despite the challenges, there is reason for optimism, including a burgeoning advocacy movement dedicated to raising wages for home health workers. Venture’s CEO, David Hogan, is hopeful that a state bill, the Fair Pay for Home Care Act, will pass in 2021.

The legislation, which was tossed out of the state budget earlier this year during budget negotiations, would raise home care wages to 150 percent of minimum wage — an increase from $22,000 to $35,000 a year. At the federal level, as part of his Build Back Better Plan, President Joe Biden has proposed a $400 billion investment in home- and community-based services.

State and federal government share the cost of Medicaid, which is the largest payer of long-term care in the U.S.  Medicaid is a public health insurance program largely for low-income people, though some middle-class individuals qualify. Medicaid rates in New York have not risen in years, health care providers say.

“The message we’ve been trying to convey for a very long time is that it’s not a minimum wage job,” says Hogan. “It involves toileting, bathing, cooking, cleaning —these are very personal things that can’t be considered minimum wage going forward.”

Donna Jackel is a Rochester-area freelance writer.