| Detecting and Treating Dementia Early | <p><img src="/Breaking-News/PublishingImages/740%20x%20740/senior_woman_daughter_2.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:256px;height:179px;" />Dementia is staggeringly common, with an <a href="https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf" target="_blank">overall prevalence of 11 percent in people aged 65 and over</a>. This prevalence increases markedly with age, such that it affects over half of octogenarians and one in three will ultimately die in this condition. These statistics do not include mild cognitive impairment (MCI), mental changes that are measurable but not severe enough to affect daily function and are often but not always a precursor to dementia, or <a href="https://www.cdc.gov/aging/data/subjective-cognitive-decline-brief.html" target="_blank">subjective cognitive decline</a>, self-reported mental fogginess or memory depreciation that aren't able to be measured by a test.</p><h3>Detecting and Diagnosing Dementia</h3><p>Despite being widespread, official diagnosis lags behind the true prevalence, with only 3-4 percent of patients having “dementia" (let alone Alzheimer's disease or a specific type of dementia) written anywhere in their chart. This amounts to more than 3 million Americans lacking a diagnosis, a number which will double in the next decades if diagnosing doesn't catch up.</p><p>The early stages of dementia, particularly Alzheimer's disease, which most commonly manifests with short-term memory loss and difficulty navigating an environment, is not always obvious from a short interaction. Verbal abilities can be intact, and a patient can regale you with stories from their youth, masking the fact that when they are sent home from the doctor's office with instructions to take a medication once a day, they may not fully understand, remember, or have the capacity to follow instructions. Caring family members such as adult children living out of state may also take a long time to go from a subtle feeling or suspicion that something seems off or odd to the conclusion that there may be a real problem. This can obviously have catastrophic consequences—preventable adverse events and hospitalizations; missing the opportunity to reverse, slow, and mitigate disease; and treatment for symptoms that can improve quality of life and functional independence.</p><p>Improving detection and arriving at diagnosis before the onset of catastrophic events, more severe disease, and unmanageable symptoms begins with equipping clinicians on the front lines with validated tools to assess function rapidly, reliably, and comprehensively across <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772157/" target="_blank">cognitive domains</a>. Tools must be simple enough for the non-specialist to gain comfort with and fit reasonably within their established workflows. For example, a recent peer-reviewed study in the <a href="https://aging.jmir.org/2022/2/e36825/" target="_blank"><em>Journal of Medical Internet Research (JMIR) Aging</em></a> validates the efficacy of a computerized cognitive test. Conducted in-person or remotely, this type of assessment improves accessibility to testing while providing physicians with the tools necessary to diagnose and treat patients.</p><p>To better detect and diagnose dementia, physicians must go beyond patient interviews (i.e. do you feel like you are losing your memory?) and use formal assessment tools, looping in a specialist for complex cases when needed. If MCI is identified, the physician must further assess for functional impairment to arrive at a diagnosis of dementia and perform serial assessments for changes in cognitive status (improvement or decline) that could change diagnosis and management approach.</p><h3>Preventing Adverse Events and Hospitalizations</h3><p>People with dementia have much higher hospitalization rates than older adults without. According to a recent study, 40 percent of <a href="https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.16636" target="_blank">hospitalizations in the dementia cohort could have been preventable</a> with proper identification, education, and outpatient care. When care teams are on the same page about a person's cognitive status, the individual can be given additional supervision or support to prevent adverse events. Consistency between caregivers is essential toward preventing trips to the hospital as well as reducing uncertainty and conflict around patient care and well-being.</p><h3>Ruling Out and Addressing Reversible Causes</h3><p>Cognitive impairment does not always spell dementia. Many cases of MCI are due to reversible causes, with the most common offenders being medication adverse events, depression, sleep apnea, infection, and thyroid disease. Long COVID is another major driver, with more than 70 percent of sufferers calling out brain fog as a chief complaint.</p><p>It is for this reason that the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772157/" target="_blank">American Academy of Neurology</a> cites ruling out and addressing reversible causes as a primary reason for performing cognitive assessment. Clinicians should perform a medical evaluation of common reversible causes.</p><h3>Addressing Risk Factors to Slow Progression</h3><p>The landmark FINGER study and subsequent <a href="https://pubmed.ncbi.nlm.nih.gov/32627328/" target="_blank">World-Wide FINGERS network</a> found that 40 percent of dementia is preventable by addressing certain modifiable risk factors. These include:<br></p><ol><li>high blood pressure,</li><li>smoking,</li><li>diabetes,</li><li>obesity,</li><li>physical inactivity,</li><li>poor diet,</li><li>high alcohol consumption,</li><li>low cognitive engagement,</li><li>depression,</li><li>traumatic brain injury,</li><li>hearing loss,</li><li>social isolation, and</li><li>air pollution.</li></ol><p></p><p>The physician is charged with the task of working with the patient and caregivers to put together a comprehensive cognitive care plan that addresses these modifiable factors in a holistic manner. By giving them the knowledge, resources, and motivation to see the patient through the long journey of cognitive change, they can slow dementia's progression and give the patient a better prognosis.</p><p>There are now few pharmaceutical options to treat dementia, with cholinesterase inhibitors showing efficacy in dementia's early stages. There are multiple medications at different stages of the drug development pipeline, and all of them depend on patients being identified as early as possible to have the best chance of success.</p><p>Behavioral and psychiatric symptoms are common in dementia, and an early and specific diagnosis enables clinicians to treat these with the best approaches available.</p><p><em>Yael Katz, Ph.D., is co-founder and CEO of BrainCheck. Katz received her Ph.D. in neuroscience from Northwestern University and conducted her postdoctoral work at Princeton University.</em><br><br></p> | 2022-06-23T04:00:00Z | <img alt="" src="/Topics/Guest-Columns/PublishingImages/2022/YaelKatz.jpg" style="BORDER:0px solid;" /> | Dementia;Clinical | The early stages of dementia, particularly Alzheimer’s disease, which most commonly manifests with short-term memory loss and difficulty navigating an environment, is not always obvious from a short interaction |
| Supporting Caregivers’ Emotional Needs to Avoid Burnout | <p>Imagine walking into a health care facility and finding there were no housekeepers, nurses, physical and occupational therapists, recreation, dietary, social workers and nutritionists onsite? Imagine if residents were left to fend for themselves in the absence of these valuable and often forgotten heroes? Despite the setbacks of the past few years, health care heroes continue to not only make themselves available to our most vulnerable population, but also strive to go above and beyond. They continue to provide optimum care even when they themselves, or their loved ones, may need this same care. </p><p>Think about the fallen heroes that died on the frontline caring for our most vulnerable population during the pandemic. Think about those that continue to put on their game faces every day to go out and give the best of themselves to the elderly, veterans, children, and anyone in need at our health care institutions. Yet who provides the caregivers with what they need to continue giving? <br></p><p>We hear about the efforts to locate staff to cover various shifts, but we seldom hear about locating services to cover the physical and emotional needs of current caregivers. Some have physically recovered from COVID, but never had the opportunity to explore resources for psychological support. Some have experienced the loss of their loved ones and didn’t have the opportunity for a traditional burial and therefore lack closure.</p><h3>When Caregivers Need Support</h3><p>Recognizing when to reach out for support is important and is often missed by caregivers as they are often the beacons of support for others. According to the National Alliance on Mental Health (NAMI), one needs to check in with themselves frequently and reach out for support if experiencing symptoms of depressed emotions and/or burnout. These symptoms include irritability or anger, anxiety, depression, loneliness, sleep deprivation, new or worsened substance abuse, fatigue, and finding it difficult to empathize with others. <br></p><p>Jeff Grzybowski, Director of Rehabilitation at Boro Park Center, a 505-bed skilled nursing facility in Brooklyn, New York, took the initiative to recognize four to five therapy staff employees during his weekly team meetings. He uses the designation “hero” when recognizing these individuals for their outstanding work. <br></p><p>“I felt that I needed to come up with ways to at least lessen, or hopefully remove, that feeling of burnout and to inject that second wind, if you will,” said Grzybowski. “As a result, several people on my team became motivated to pay it forward and made efforts to help those around them as well.”</p><p>Grzybowski’s efforts showed gratitude and awareness of staff efforts and this led to further acts of support. Staff were bringing in donuts, checking in with other therapists, and reaching out to other department employees and their supervisors to ask, “How are you doing?” and offering words of encouragement. <br></p><p>Jocelyn Nackley, Director of Rehabilitation at Onondaga Center, an 80-bed skilled nursing facility in Syracuse, New York, also praises her staff members during her internal weekly team meetings and publicly when she works alongside her team on the unit. </p><p>“Rehabilitation directors are treating this growing and common situation throughout nursing facilities,” said Nackley. “My team particularly enjoys it when I bring in their favorite foods from local lunch and coffee chains. It brightens their day and helps them go the extra mile. They love their patients but we’re no use for them if we cannot get past that burned out feeling.”</p><h3>Going Further</h3><p>Bringing in food and expressing gratitude is a start in the right direction, but it’s certainly not the entire answer. It shows that leadership is paying attention. It is a focus on helping ourselves so that we can better treat the residents and their loved ones.</p><p>Several free services are available to assist caregivers including <a href="https://www.covidmentalhealthsupport.org/" target="_blank">COVID Mental Health Support</a> from the Pandemic Crisis Services Response Coalition. The <a href="https://emotionalppe.org/" target="_blank">Emotional PPE Project</a> is another support service that connects heath care professionals with licensed mental health professionals who can help. This service is free and does not require insurance. NAMI can also be contacted directly to access confidential professional support. In addition to these, there are other numerous support services available for health care professionals with both local and nationwide access.</p><h3>Self-Care Suggestions</h3><p>In addition to professional support, leadership should encourage caregivers to use self-care as another strategy to combat burnout. Ideas for self-care include:<br></p><ul><li>Humor can be used to cope. Seek out the things that make you laugh. Laughter is the best medicine.</li><li>Recognize you are vital and are critically important in the fight against the pandemic. You are doing the best you can with what’s available.</li><li>Sleep is important and one of the best ways to rejuvenate. Try to get at least 7 hours of sleep daily.</li><li>Eat to provide fuel to your body. Ensure you eat as balance of a diet as possible. Adequate hydration is essential as well.</li><li>Meditate to relax, reduce anxiety, and manage stress. There are online classes and apps available.</li><li>Exercise is hugely beneficial. Walking increases circulation and endurance and can be a great way to escape from the everyday. Simple muscle stretching and coordinated breathing techniques add to the benefits of exercise. You don’t have to join a gym to get going as many activities are available free of charge. </li><li>Reach out to family, friends, and coworkers for support. Don’t go at it alone—talk to others for support. Many facilities also offer more formal support programs that can be helpful. </li><li>Stay positive. Healing improves when the mind is relaxed and in a positive state. Try to see the positive in others and yourself. Provide positive reinforcements to others every chance you get. </li><li>Connect with your spirituality. Ask yourself how you are feeling each day. Ensure you listen to the voice within and act in ways to support it. Calming environments and music may aid this journey. Learn to appreciate what you have and be thankful to yourself and others that helped along the way</li><li>Take a trip. Travel to a place you want to explore. This can be anywhere from the new restaurant down the street to another state or even international travel. This helps you to focus and reflect as you explore other worlds outside your own.</li><li>Love yourself and others. Find ways to remember the good you’ve done and show compassion to others.</li></ul><p>The pandemic stressed health care providers to their limits. Now it is time for leaders to provide additional support to these caregivers in order to avoid burnout. <br><br><em>Dexter Vickerie, RN-BC, MSN, RAC-CT, is Corporate Director of Quality/Clinical Compliance and Risk Management at Centers Health Care.</em></p> | 2022-06-01T04:00:00Z | <img alt="" src="/Topics/Guest-Columns/PublishingImages/2022/DexterVickerie.jpg" style="BORDER:0px solid;" /> | Caregiving | health care heroes continue to not only make themselves available to our most vulnerable population, but also strive to go above and beyond. |
| 5 Ways to Get Creative with Your Employee Referral Program | <p></p><p><img src="/Topics/Guest-Columns/PublishingImages/2022/MadelineCecil.jpg" alt="Madeline Cecil" class="ms-rtePosition-2" style="margin:5px;width:200px;height:200px;" />When it comes to the 2022 hiring market, cutting through the noise of job boards and reaching qualified applicants directly is a momentous task. The simplest way to do this is to tap into your employees' already existing networks of former colleagues, neighbors, and friends in the form of an employee referral program.</p><p>There is a myriad of reasons why companies are leaning heavily on employee referrals to keep fully staffed, including that referred applicants are hired at four times the rate of non-referral candidates. In addition, these programs allow candidates to move forward with the hiring process quickly, with an average hire being made eight days after starting the hiring process compared to 11 days with a non-referral. Employee referral programs produce the types of hiring results that businesses are looking for; in fact, out of Hireology's customers alone, referral programs drive one in eight hires.</p><p>Not all employee referral programs are created equal, however. Even if your company already has one in place, there's always room for improvement. To keep your employee referral program from going stale, here is a list of five ways to get creative with your employee referral program.</p><p><strong>1. Create multi-tiered ambassador programs.</strong><br>Tap into your employees' competitive side with a tiered ambassador program. With this type of program, you design multiple tiers that offer higher rewards and more payout the more referrals someone submits. For example, someone who refers one candidate might be entered into tier one, which pays out $500 per hire. But someone who refers three candidates might be entered into tier two, earning them $750 per hire and additional company swag.</p><p>This encourages your employees to refer as many qualified applicant leads as possible. Multiple levels in this arrangement motivate employees to actively recruit from their networks in order to move up in the tiers and then receive higher rewards—all while you receive applications that are already vetted.</p><p><strong>2. Utilize social media for referrals.</strong><br>Your employees are already spending time on social media, and most of them are connected to hundreds of other individuals on these profiles. Take advantage of this network by encouraging your team to share open roles on their social media profiles.</p><p>You could offer to enter folks into a lottery to win gift cards, cash prizes, or additional paid time off for every role they share on social media. Or, with modern employee referral platforms, you can even provide employees with a personal link that allows you to track exactly which post referral candidates come from, making it even easier for you to reward your employees for sharing roles and driving applicants.<br><strong> </strong><br><strong>3. Focus on values in your recruitment</strong><strong> </strong><strong>programs.</strong><br>Another way to get creative with your employee referral program is to build one designed to hire individuals who align with your company's values—widening your network of potential referral applicants.</p><p>With this type of program, you might broaden your employment parameters to candidates who meet certain values rather than your preferred list of skills and experiences. Many jobs can be learned, but values are hard to reshape; sometimes, encouraging your employees to refer folks who embody certain values over skills can help you find candidates who are a better fit in the long term. These types of programs can also be used to diversify your existing workforce.</p><p><strong>4. Renew messaging with seasonal pushes.</strong><br>With every season that passes, the world—and workforce—continues to change. Chances are your company is always in need of additions to your staff. People are always needed in some capacity. Some businesses experience temporary hires and labor shortages, but the perfect time to get ahead of being short staffed is before it affects your customers. That's why pushing an employee referral program seasonally with a simple rebranding can make all the difference in the hiring process and help keep your business running smoothly.</p><p>For example, during the holiday season, you could encourage employees to participate in this type of program by using messages like “Want to earn some extra cash for the holidays? Refer your friends to win $1,000," or “Use your vacation time to relax after earning $1,000 by referring a friend." With simple tweaks to the messaging, you use to incorporate the changing seasons, you can reuse the same reward program perpetually.</p><p><strong>5. Target specific locations.</strong><br>Say, for instance, that your branch in North Carolina is fully staffed, but the one in Kansas is in desperate need of employees. Instead of launching a company-wide referral campaign, you can tailor your employee referral messaging to receive only applicants from locations where you truly need them. By channeling your resources toward locations that need it most, you optimize your spending power and maximize ROI all in one go.</p><p>Employee referral programs work, so long as you put the effort into motivating your team to participate. Try one of the above strategies to breathe new life into your program today.</p><p><em>Madeline Cecil</em><em> is a content writer for Hireology.</em></p> | 2022-05-10T04:00:00Z | <img alt="" src="/Topics/Guest-Columns/PublishingImages/2022/MadelineCecil.jpg" style="BORDER:0px solid;" /> | Workforce;Recruitment | Employee referral programs produce the types of hiring results that businesses are looking for; in fact, out of Hireology's customers alone, referral programs drive one in eight hires. |
| Cultivating Continuous Improvement in Senior Care and in Leadership | <p><em><img src="/Topics/Guest-Columns/PublishingImages/2022/JeraldCosey.jpg" alt="Jerald Cosey" class="ms-rtePosition-2" style="margin:5px 15px;width:175px;height:175px;" />Jerald Cosey is the Operational Leadership Development Director for American Senior Communities (ASC), the largest senior living and senior healthcare company in Indiana.</em></p><p><em> </em><em>His goal is to help develop leaders for the organization in three ways:</em><br></p><ol><li><em>Oversee the administrator-in-training cohort program that accepts both internal and external candidates.</em></li><li><em>Coach 10 emerging operational leaders from a non-reporting position.</em></li><li><em>Teach behavioral science for leaders, workforce behavior, and maximizing stakeholder communication and engagement.</em><br></li></ol><em>He also serves as an industry advocate outside of Indiana as a speaker, thought leader, and senior advocate. Cosey is passionate about communicating </em><a href="http://jeraldcosey.com/2020/05/senior-healthcare-workers-are-the-forgotten-frontline/" target="_blank"><em>the lessons learned</em></a><em> by leaders and frontline senior health care workers throughout the pandemic.</em><p></p><p><strong><em>Provider</em></strong><strong> magazine: How did you become interested in the health care industry, and specifically senior care?</strong></p><p><strong></strong><strong>Jerald Cosey:</strong> I started as a volunteer while I was a pharmaceutical sales manager. I was part of that industry for 18 years. I started a <a href="http://jeraldcosey.com/2019/03/senior-isolation-grace-church/" target="_blank">senior ministry focused on minimizing isolation</a>, named Graceful Moments, when I was downsized for the first time. The mission of Graceful Moments is to minimize isolation and listen, love, and learn from our revered elders.</p><p><strong><em>PM</em></strong><strong>: You previously served as Executive Director at Greenwood Meadows, with the organization winning a 2019 American Health Care Association's Silver Quality Award. What helped you the most on the journey to improve quality at Greenwood Meadows?</strong></p><p><strong></strong><strong>JC:</strong> My father often said nothing worthwhile in life is ever easy. During the process of applying for the award, I learned five lessons.<br></p><ol><li><em>The value of continuous improvement.</em> In such a highly regulated industry, it's easy to get overly concerned about documentation, root cause interventions, and the possibility of missing something important. The consequences can be unforgiving. It's imperative to always evaluate and audit systems used to maximize the care for others. A common trend throughout the application process requires providing details of how your facility captures, evaluates, and improves performance/outcomes. For every level of leadership and operational processes within an organization, continuous improvement and development is necessary and expected.</li><li><em>Just start.</em> In the beginning, I found the award application process intimidating. As operational and clinical leaders, our days are packed, leaving little time for non-mandatory tasks. I acknowledged that this application process would require time and effort. The action and effort slowly defeated the intimidation and sparked enthusiasm for capabilities of our facility.</li><li><em>It's not about winning.</em> With every advancement through the process, the pride for the facility, the care, and outcomes seem to bubble up daily. Early in the application process, we realized it was never about winning. The goal is to recognize the performance excellence of your facility; moreover, the performance excellence required to complete the application. When it's all said and done, we had already won by completing an application worthy of review.</li><li><em>You are part of a professional community.</em> The senior healthcare industry is loaded with resources and support. I will never forget being stumped by a question and calling a fellow administrator. She allowed me to vent, listened, and translated the question, helping me to understand. This industry is loaded with state health care associations and operational/clinical leaders, all of whom are committed to advancing quality healthcare and performance excellence.</li><li><em>The industry is honorable.</em> Professionally caring for people is a great responsibility and penetrates beyond business, careers, and professions. Honor comes from putting others' needs before your own. Moreover, caring for people who are held in high regard within a family can come with unreasonably high expectations. With that, continue doing your level best each day and performance excellence will follow.</li></ol><strong><em>PM</em></strong><strong>: What trends do you see on the horizon for the senior health care sector?</strong><p></p><p><strong></strong><strong>JC:</strong> Category or position excellence doesn't automatically translate to leadership excellence. I believe the number one trend or need in our industry is being intentional with the development of leaders. Senior healthcare is a very emotionally demanding industry, and the last thing we need to do is lose outstanding talent from a lack of investment in their leadership.</p><p>I see leadership evolving to maximize communication and effectiveness between stakeholders. For example, many leaders tend to lead as they like to be led. Understanding your key stakeholder drivers for work satisfaction is critical for it allows the leader additional tools to maximize communication, effectiveness, and job satisfaction.</p><p>At American Senior Communities, we have committed to using the Predictive Index as the source of gathering this insight and leveraging tools to maximize understanding. For me, I like independence and flexibility. It doesn't mean I can't accept direction or formalities. However, I want my key stakeholders to know I receive job satisfaction when I can meet these needs in the workplace.</p><p><strong><em>PM</em></strong><strong>: How do you describe your leadership style? How do you build and refine those leadership skills?</strong></p><p><strong></strong><strong>JC:</strong> My teachable point of view on leadership: A leader separates themselves in the ability to embrace the philosophy of team—a team that is built upon respect for people, continuous improvement, and a high regard for results. All of which allow a leader to empower.</p><p>I always have a developmental plan. Every leader should have a developmental plan throughout every organization. I also have mentors and follow their guidance to grow my leadership skills.</p><p><strong><em>PM</em></strong><strong>: What advice do you give to someone just beginning a career in health care?</strong></p><p><strong></strong><strong>JC:</strong> Make time to document why you want to lead in this space. Senior healthcare is a very emotional and intimate career choice. You must know your why and embrace it to the core. It will prove to be your foundation on the day when your career choice comes into question.</p><p>You can't do everything by yourself so take the time to establish your vision and allow leaders to contribute to the development of the vision. I was never an expert in a specific department. I hired the best, built next-up talent, and leveraged departmental excellence.</p><p><em>Hear more from Jerald Cosey in a keynote session at the 2022 AHCA/NCAL Quality Summit, May 16-18 in Kissimmee, FL. For more information and to register, </em><a href="https://www.ahcancal.org/Education-Events/Quality-Summit/Pages/default.aspx" target="_blank"><em>click here</em></a><em>.</em></p> | 2022-05-04T04:00:00Z | <img alt="" src="/Topics/Guest-Columns/PublishingImages/2022/JeraldCosey.jpg" style="BORDER:0px solid;" /> | Caregiving;Quality | I like independence and flexibility. It doesn't mean I can't accept direction or formalities. However, I want my key stakeholders to know I receive job satisfaction when I can meet these needs in the workplace. |
| If We Build It, Caregivers Will Come | <p>This week we celebrate “Careers in Aging Week”—a national observance honoring the many career paths in the long term care profession. You hear so many stories of certified nursing assistants (CNAs) who became nurses, who then became directors of nursing, and onward. The same was true for me. I started as a CNA and eventually became the administrator of a nursing home in my home state of Maine. </p><p>Building a career in long term care can be personally and professionally rewarding, but how do we get more job seekers to want to enter our field in the first place? This is the surmountable challenge facing providers today, as we grapple with a historic staffing shortage exacerbated by the COVID-19 pandemic. According to data from the Bureau of Labor and Statistics, long term care facilities have lost more than <a href="https://www.ahcancal.org/News-and-Communications/Fact-Sheets/FactSheets/BLS-MARCH2022-JOBS-REPORT.pdf" target="_blank">400,000</a> employees over the course of the pandemic<span>—</span>more than any other health care industry. Meanwhile, staff vacancies at many facilities sit open for months, even a year, and applicants are limited as many job seekers are now preferring work from home opportunities. </p><p>We all agree that nursing homes and other long term care facilities need more staff. The difference of opinion is how we get there. Some argue that nursing homes need more staffing mandates to ensure facilities have enough caregivers. Providers will tell you their reality—they can’t find more staff and are struggling retaining the staff they have due to a number of forces driving caregivers away from long term care. Focusing solely on more mandates and punishing providers with more citations and fines does not help the residents, fails to address the underlying issues, and takes away precious resources needed to recruit caregivers. And ultimately, continuing on this enforcement trajectory will mean facilities having to further reduce the number of residents they can serve or close their facilities altogether. Too many already have, <a href="https://www.pressherald.com/2021/09/01/three-maine-nursing-homes-closed-this-week-and-more-closures-appear-imminent/" target="_blank">including in my home state of Maine.</a> </p><p>I want to be clear, the long term care profession supports accountability to ensure residents have the caregivers they need, but we cannot regulate our way out of this labor crisis. And no one silver bullet will fix it either. This is why in our reform agenda, the <a href="https://www.ahcancal.org/Advocacy/Pages/Care-For-Our-Seniors-Act.aspx" target="_blank">Care For Our Seniors Act,</a> the American Health Care Association (AHCA) developed a<a href="https://www.ahcancal.org/Advocacy/Documents/Workforce-Strategies.pdf" target="_blank"> comprehensive set of workforce solutions</a> that policymakers should implement, along with meaningful funding, to tackle this crisis from all angles. We need to develop programs that help recruit new caregivers, retain current ones, and rebuild our training infrastructure. </p><p>First, we need to recruit new caregivers to the field, and that includes incentive programs that make the everyday lives of caregivers a little easier, like affordable housing, childcare assistance, tax credits, and loan forgiveness for new graduates who work in long term care. We are also long overdue for common-sense immigration reform to expand opportunities for individuals around the world to come serve our seniors here in the United States. </p><p>Second, AHCA believes there needs to be a comprehensive approach to staffing beyond ratios—staff training and experience matters. Facilities with high staff retention can help caregivers perform responsibilities more effectively, and they know the residents intimately and can better anticipate their needs. Therefore, staff retention is key to addressing the labor crisis and continuously improving care. Our plan proposes helping to retain current caregivers by providing career ladder and mentoring programs as well as grants to pay for ongoing training. Meanwhile, we must ensure caregivers feel valued and appreciated, especially given the burnout we’re seeing due to COVID. So, empowering staff, measuring staff satisfaction, and being responsive to staff needs are tactics providers can take to improve the workplace culture on their own. In addition, regulators should examine the unintended consequences of punitive enforcement approaches that are driving valuable caregivers away from the field. </p><p>Next, we need the infrastructure to train potential caregivers through higher learning institutions. Waiting lists for nursing schools because of a lack of teachers is unacceptable. Federal policymakers should offer direct incentives to states that invest in nursing education programs as well as to universities that have graduates work in long term care for two years or more. We should also establish formal partnerships between nursing homes and universities through grants to provide tuition-paid scholarships to nursing students who plan to work in long term care. Embracing innovative models that encourage more entry-level, non-clinical positions—like the temporary nurse aide or universal worker roles we’ve seen during the pandemic—can help attract a new force of caregivers and is a key opportunity for the future. </p><p>At the heart of these workforce proposals is offering better pay and benefits to our frontline heroes, something nursing homes cannot do on their own. With most residents relying on Medicaid and the program’s chronic underfunding, long term care providers are often out competed for workers by hospitals and other health care and private industries. Policymakers must fully fund Medicaid and provide sustainable resources alongside new staffing policies, so that providers can enhance investments in retaining their staff and recruiting additional caregivers. </p><p>Meanwhile, we must learn from this pandemic and follow the evidence on what will truly improve care for residents. That’s why in the Care For Our Seniors Act, AHCA proposes having a <a href="https://www.ahcancal.org/Advocacy/Documents/24-Hour-RN.pdf" target="_blank">24-hour registered nurse</a> (RN) and enhancing the role of <a href="https://www.ahcancal.org/Advocacy/Documents/Infection-Preventionists.pdf" target="_blank">infection preventionists</a> in nursing homes, as long as these increasing requirements are fully funded by the government and the availability of workers exists to meet the requirements. </p><p>Lawmakers should be working hand in hand with nursing home providers to implement this multi-pronged approach to build back our workforce. Unfunded government mandates will only make matters worse. We must address the negative misconceptions around long term care and barriers to offering frontline caregivers the compensation they deserve. Investing in childcare, affordable housing, tuition, loan forgiveness and expanded nursing school programs will encourage individuals looking to join this rewarding field. </p><p>Addressing this long term care labor crisis requires comprehensive precision. Pinpointing where the challenges truly lie and applying carefully thought-out solutions is critical. The Care For Our Seniors Act does this. AHCA looks forward to working with lawmakers to ensure every nursing home and assisted living community has the hardworking, dedicated employees they need, so that our nation’s most vulnerable receive the care they deserve.  We cannot do it alone, but we sure can do it together. </p><p><em>Holly Harmon is the senior vice president of Quality, Regulatory & Clinical Services for the American Health Care Association and National Center for Assisted Living and a registered nurse, licensed nursing home administrator, and a fellow of the American College of Health Care Administrators. </em><br></p> | 2022-04-22T04:00:00Z | <img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/senior_woman_nurse_3.jpg" style="BORDER:0px solid;" /> | Management;Workforce | Building a career in long term care can be personally and professionally rewarding, but how do we get more job seekers to want to enter our field in the first place? |
| Strengthening the Lives of the Elderly with Teletherapy | <p>Technology has unquestionably enhanced many parts of life, particularly in terms of access to health care services. Telehealth services have been around for a long time but have only recently <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6943a3.htm" target="_blank">gained popularity</a> owing to ongoing lockdowns, social isolation, and technological improvements. In fact, a <a href="https://www.psychiatry.org/newsroom/apa-public-opinion-poll-2021-access-to-care" target="_blank">public opinion poll</a> conducted by the American Psychiatric Association revealed that 82 percent of people used telehealth services for the first time since the start of the pandemic. Telehealth can take many forms but generally refers to any sort of medical treatment delivered by technology. </p><p>Geriatric medicine has started to use multiple technologies to continually enhance elderly care and meet the demands of the aging demographic. Using telehealth, older adults (aged 65+) can continue to receive care while remaining safe in their own homes. For example, <a href="https://www.coastalhomerehab.com/teletherapy-for-the-elderly" target="_blank">teletherapy and online therapy</a> techniques are proven to be useful in improving the quality of life among <a href="https://www.coastalhomerehab.com/teletherapy-for-the-elderly" target="_blank">people with chronic pain</a>. Teletherapy is a great option for those who are unable to attend traditional therapy owing to a lack of mobility, a lack of health facilities, privacy concerns, and so on.</p><h2>Uses of Teletherapy in Geriatric Care</h2><p>According to the Census Bureau,  24 percent of the United States' population are over 60 years old and one in every five Americans will be <a href="https://www.census.gov/content/dam/Census/library/publications/2020/demo/p25-1144.pdf" target="_blank">65 or older by 2030</a>. Older adults, according to <a href="https://www.americashealthrankings.org/explore/annual/measure/pct_65plus/state/ALL" target="_blank">America's Health Rankings</a>, experience more complicated health issues due to life situations such as aging-related chronic diseases, food insecurity, a need for a safe home, insufficient sleep, and lack of access to medical attention. Teletherapy encourages longevity and a healthy lifestyle in general by providing educational techniques to help the elderly reinvent their lives, resulting in a higher quality of life. A step-by-step teletherapy technique enables a therapist to use behavioral adjustments to help with personality changes, as well as re-adjust the strategy if cognitive abilities decline over time.<br></p><h3>Teletherapy for Rehabilitation and Mobility</h3><p>Physical therapy and occupational therapy programs, despite their many similarities, take <a href="https://www.mcphs.edu/about-mcphs/news/occupational-therapy-versus-physical-therapy" target="_blank">distinct approaches</a> to each patient's rehabilitative care. The former focuses on increasing the person's physical ability, whereas the latter focuses on improving his or her ability to do daily tasks. A physical therapist has virtual sessions with senior patients at their homes to help them improve their strength, balance, and endurance, as well as advise them on how to avoid physical risks and lower their chance of falling. Telehealth initiatives in the field of occupational therapy are utilized to provide fall prevention methods, safety interventions, and health education to at-risk adults with disabilities who are living in their homes.  </p><h3>Teletherapy for Mental Health</h3><p>People normally endure moderate mental deterioration as they age, but some individuals get dementia, which causes functional impairment as well as depression, paranoia, and anxiety. A <a href="https://pubmed.ncbi.nlm.nih.gov/31566651/" target="_blank">telehealth-based Care Ecosystem</a> successfully enhanced physical health, energy levels, cognition, and relationships in a study involving 780 caregivers and seniors with dementia. In addition, caregiver depression was shown to be lower in the research, as was the number of emergency room visits. A <a href="https://c19hcc.org/telehealth/patient-survey-analysis/" target="_blank">patient survey analysis</a> of the rise of telehealth in the United States also discovered that 45 percent of older adults strongly believed that their telehealth visit provided them with a sense of access and continuity of care. According to the same survey's findings, 30 percent of older adults agree and 40 percent strongly agree that they will use telehealth services in the future.</p><h3>Teletherapy for Speech and Swallowing</h3><p>Speech therapy can assist older persons who find chewing and swallowing laborious, who have coughing fits before, during, or after swallowing, or whose voice quality has deteriorated. Apraxia, dysphagia, and orofacial maillot functional abnormalities are just a few of the conditions that can impact swallowing and speaking. Patients with these illnesses have problems with basic muscle motions, which affects their ability to communicate by making it more difficult to articulate words and swallow. Teletherapy has the potential to be a feasible and possibly effective method of improving attrition and enhancing care partner involvement. Teletherapy programs, for example, have demonstrated <a href="https://www.ahajournals.org/doi/10.1161/str.52.suppl_1.P208" target="_blank">significant clinical gains</a> in standardized performance for stroke survivors with persistent speech impairment.<br></p><h2>Delivery Mediums</h2><p>Telehealth is defined as the use of electronic information and telecommunications technology to assist long-distance clinical health care, patient and professional health-related education, public health, and health management, according to the Health Resources Services Administration. Virtual visits, chat-based interactions, remote patient monitoring, and technology-enabled modalities are the most frequently used telehealth techniques, according to <a href="https://www.americantelemed.org/resource/why-telemedicine/" target="_blank">the American Telemedicine Association.</a> Patients can use a mix of audio, video, and text communication tools to experiment with multiple formats and find the medium that best suits their needs.</p><p>There is a <a href="https://journals.sagepub.com/doi/full/10.1177/23337214211036255" target="_blank">great deal of research</a> that shows how technology can improve the lives of older adults. This involves enhancing people's everyday routines and behaviors, as well as their cognitive performance, physical and emotional health. An <a href="https://www.statista.com/statistics/1238239/satisfaction-with-telehealth-experience-us-by-age/" target="_blank">analysis of telehealth treatment satisfaction levels</a> in the United States between 2020 and 2021 additionally found that 34 percent of older adults were satisfied and 44 percent were very satisfied with the care they got.</p><h2>Conclusion</h2><p>Telehealth services eliminate the need for in-person appointments, cut healthcare costs, reduce costly emergency department visits, and increase patient satisfaction. Families may need to rely on such services to care for their loved ones as they age. Security and social support, sufficient training for geriatric care workers, promotion of excellent mental and physical health, and community initiatives can all contribute to meeting the requirements of the elderly.</p><p><strong>Note: </strong>Telehealth coverage and payment policies vary by where the patient is located (in their home or in a facility) and by type of insurance coverage as well as state law. Providers should confirm with these entities prior to furnishing telehealth services<strong>.</strong></p><p><em><strong></strong></em><em>Mark Taylor is a writer covering health care issues that affect the geriatric population.</em><br></p> | 2022-04-21T04:00:00Z | <img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/telehealth.jpg" style="BORDER:0px solid;" /> | Telemedicine | Telehealth services have been around for a long time but have only recently gained popularity owing to ongoing lockdowns, social isolation, and technological improvements. |
| Creative Solutions for the Staffing Crisis in Long Term Care | <p>Nursing homes continue to struggle with staffing to the point where facilities are having to close their doors or limit admissions. Even worse, facilities that fall behind risk getting tagged in their next surveys and may even receive bans on their training programs on account of deficiencies.<br></p><p>After decades in the industry and having visited facilities across the nation, <a href="https://www.linkedin.com/in/david-gifford-22426816/" target="_blank">Dr. David Gifford</a>—the chief medical officer at the American Health Care Association—has heard the concerns about the staffing shortage from both industry leaders and policymakers. “There just isn’t enough staff to care for residents,” he said bluntly on the <a href="https://ltcheroes.com/" target="_blank">LTC Heroes podcast</a>. “More needs to be done to resolve this.” </p><p>Listen to the entire interview with host Peter Murphy Lewis, the director of marketing at <a href="https://experience.care/" target="_blank">Experience Care, </a>below: </p><p></p><center><iframe src="https://www.youtube.com/embed/qeSwAhRZHZs?enablejsapi=1&origin=https://www.providermagazine.com" title="YouTube video player" allowfullscreen="" data-gtm-yt-inspected-32388671_20="true" id="468509439" width="560" height="315" frameborder="0"></iframe></center>
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<p></p><h2>Innovative Solutions to the Staffing Crisis</h2><p>Faced with unprecedented staffing challenges during the pandemic, Dr. Gifford decided to invent solutions. His first brainchild was the temporary training program. On the podcast, he shared that he presented the concerns of long term care to the CMS and said, “We need lots of bodies in here.” The result was the Temporary Nurse Assistant training program, which was implemented by Pam Truscott and Holly Harmon. “With that idea, they developed the temporary nurse aide,” he said. “And I think we've successfully trained over 350,000 people.” <br></p><p>Still, Dr. Gifford realizes there is an opportunity to create an entirely new role in nursing homes, one that would reduce the burden upon nurses and only require minimal training. <a href="https://ltcheroes.com/episode-59-wins-and-personal-stories-with-the-ahcas-cmo/" target="_blank">In response to a question about creating a new position in long term care,</a> Dr. Gifford said: “I've been trying to really push this concept. It’s what I would call a hallway ambassador.” In his vast experience, he has come to learn that much of the burden of care can be removed from the shoulders of specialists and placed on those of other aides. “If you look at most of the calls, and most of the requests for help by residents, they don't require a CNA or RN,” Dr. Gifford said. “They just require a nice compassionate person.”
<br></p><p>A hallway ambassador, Dr. Gifford continued to say, would walk the hallways of a nursing home and respond to non-medical needs and requests by residents, their families or other nursing home staff. This would speed up processes by delegating simpler tasks to those who patrol the hallways looking to help nurses and even maintenance workers assisting residents.
<br></p><p>For example, if the family of a resident is visiting and has straightforward questions, the hallway ambassador could be on hand to answer them immediately. This would allow nurses to focus on more pressing needs that require specialized training. Other examples included separating residents acting inappropriately and handing things off a cart to housekeepers already in a resident’s room.
<br></p><p>Dr. Gifford imagines that hallway ambassadors would need minimal training. “This could be a great entry job, and someone can then go on to become a CNA,” said Dr. Gifford. “To be a hallway ambassador, you don't need a license and you don't need certification. I think we forget how much work we do doesn't require a certification.” In this way, long term care facilities could rapidly expand their workforce by opening up applications to a far larger demographic. </p><h2>Still More Needs to Be Done</h2><p>The innovative solutions of Dr. Gifford, though, can only accomplish so much. Ultimately, he believes that it is the job of the federal government to provide financial incentives in order to get more people into long term care facilities that need support. This could be as simple as replicating an already-existing policy in acute care. “The federal government prioritizes rural health and health care shortages in primary care by offering loan forgiveness to doctors and nurses who work in those areas,” said Dr. Gifford. “We have a huge shortage more than anywhere else, and I think they should do the same for us.”<br></p><p>Operating in an industry that is not given the attention it deserves, Dr. Gifford has proven to be a source of novel ideas and actionable advice. One of his solutions, a temporary nurse assistant training program, has already been implemented on a grand scale. In his expert analysis, the issues come down to numbers, and that is where large-scale support is needed. That is why he is lobbying for more support from the government. Should he be successful in doing so, long term care could make significant progress in the coming years.
<br></p><p>For more on recent trends in long term care, read our <a href="https://experience.care/blog/" target="_blank">blog</a> and subscribe to the <a href="https://ltcheroes.com/" target="_blank">LTC Heroes podcast.</a></p> | 2022-03-29T04:00:00Z | <img alt="" src="/PublishingImages/Headshots/DavidGifford.jpg" style="BORDER:0px solid;" /> | Caregiving;Quality | Operating in an industry that is not given the attention it deserves, Dr. Gifford has proven to be a source of novel ideas and actionable advice. |
| First CNA Career Ladder Apprenticeship Program in DC Encourages Retention Through Support, Training, and Connections | <p>We would all love to clone the exceptional certified nurse aides that are the backbone of nursing home and long-term care communities. The first CNA career ladder apprenticeship program in DC seeks to take shining-star-potential CNAs, sharpen their skillsets in an 8-month program, and set them loose to inspire, engage, and lead their peers.</p><p>To achieve this, Forest Hills of DC (FHDC) has partnered with Suma Prime School of Healthcare. In collaboration with the DC Department of Employment Services, the partnership is building an apprenticeship program for the advanced CNA that combines traditional CNA classroom instruction with structured and supervised on-the-job learning. </p><p>New CNAs are often surprised at the actual work of being a CNA. This program provides on-the-job coaching to help CNAs successfully adapt to their new work environment with supported mentoring. Competency paths for Dementia and Behavioral Health, End-of-Life, and Leadership foster career tracks. CNAs receive a portable, industry-recognized credential as the apprenticeship program meets national and DC standards, as well as an agreed bump in wages.</p><p>Graduates of the program will also receive encouragement, support, and connections to resources to further their nursing education into LPN and RN careers. FHDC received grant funds from DC Healthcare Career Advancement Program (H-CAP) to jumpstart the program. </p><p>The first cohort of students will start in Spring of 2022.</p><p>Expected outcomes from this program include: <br></p><ol><li>Improved recruitment and retention of a skilled workforce as 94% of apprentices continue in their employment after completing apprenticeships;</li><li>Reduced costs for on-boarding and turnover of staff; and </li><li>Improved productivity.<br></li></ol><p>Our mission is to continually grow as a supportive community that inspires and engages seniors.</p><p>Seniors have been served at our non-profit community for more than 135 years via assisted living, assisted living memory care, respite, CMS 5-star skilled nursing care, and rehabilitation services. Our values of compassion, growth mindset, inclusion, integrity, respect, and sustainability keep us grounded during changing times.</p><p>For further information, contact Tina Sandri, CEO of Forest Hills of DC, at 202-966- 7623 or <a href="mailto:tsandri@foresthillsdc.life" target="_blank">tsandri@foresthillsdc.life</a>.</p> | 2022-03-23T04:00:00Z | <img alt="" src="/Topics/Guest-Columns/PublishingImages/2022/TinaSandri.jpg" style="BORDER:0px solid;" /> | Workforce;Recruitment | We would all love to clone the exceptional certified nurse aides (CNAs) that are the backbone of nursing home and long term care communities. |
| Staffing Agencies Charging Health Care Industry Exorbitant Rates Amidst A Historic Workforce Crisis | <p>Nurses and nurse aides are the lifeblood of long term care. They spend each day making sure residents have not only their physical needs met, but also their mental and emotional needs. They do everything for residents from monitoring their vitals, to combing their hair, to helping them walk again, or just sitting and listening to their stories. But they’re burned out from the pandemic. And an alarming number have left their positions in long term care—for another field, to stay at home, or to work for a health care staffing company. </p><p>The rise of staffing agency nurses and nurse aides is not surprising. The allure of a bigger paycheck with flexible hours is a dream for many. However, the phenomenon is exacerbating a workforce crisis in our long term care facilities and raising considerable questions about their employers—temporary staffing agencies. <br>According to the Bureau of Labor and Statistics, the long term care industry has lost more than 400,000 caregivers over the course of the pandemic, more than any other health care sector. </p><p>Health care providers have gone to great lengths to attract and retain staff, and are doing everything possible in an employee’s market, but limited government reimbursement rates are making it enormously difficult for nursing home providers to outshine the local competition.</p><p>Long term care providers cannot limit their hours or close their doors for a day or two a week as some other businesses may do to counter the workforce issues amidst this pandemic. To ensure patients and residents can receive care and services during this challenging time, long term care providers, hospitals and other health care facilities have no choice but to turn to nursing and direct care staffing agencies. Unfortunately, many staffing agencies are charging exorbitant rates – exploiting the pandemic and the labor shortage in a time of national emergency. <br></p><p>These agencies are charging long term care facilities and hospitals two or three times pre-pandemic rates, increasing their profit margins in the process. As a result, middlemen line their pockets, passing only a fraction onto the nurses and nurse aides that work for the staffing agencies doing the real work. The high fees rapidly consume facility resources making it increasingly difficult for health care providers to increase pay and benefits for their current employees, particularly after the economic crisis the pandemic has caused, especially in long term care.</p><p>It’s a vicious cycle, and it’s unsustainable. As the remaining workforce is stretched even further, it creates an extremely challenging situation where more and more staff burn out, get poached by the agencies, or leave the industry altogether. Providers are then forced to rely more on staffing agencies, stretching already limited resources.</p><p>That is why leaders in the health care industry recently called on regulators and lawmakers to investigate and take appropriate action against this blatant effort to take advantage of the pandemic and the health care workforce crisis. The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) partnered with the American Hospital Association (AHA) in sending a <a href="https://www.ahcancal.org/News-and-Communications/Fact-Sheets/Letters/AHA-AHCA-Letter-Staffing-Agencies.pdf" target="_blank" title="Joint letter">joint letter</a> to White House COVID-19 Response Team Coordinator Jeffrey Zients to bring attention to this matter. We’ve also partnered with many other senior living organizations in <a href="https://www.ahcancal.org/News-and-Communications/Fact-Sheets/Letters/Coalition-Letter-WH-Agency-Price-Gouging.pdf" target="_blank">writing</a> the White House. These letters follow a request to the <a href="https://www.aha.org/system/files/media/file/2021/02/aha-urges-ftc-examine-anticompetitive-behavior-nurse-staffing-agencies-commercial-insurers-2-4-21.pdf" target="_blank">Federal Trade Commission</a> urging investigations into these exorbitant rates since we have yet to receive a response.</p><p>With this issue unlikely to resolve itself, and due to the seriousness of the potential consequences, AHCA/NCAL will continue our calls for the Biden Administration to advance a solution that ensures health care providers are able to recruit and retain the staff they need to ensure patients and residents have access to the care and services they deserve.</p><p><em>Holly Harmon is the senior vice president of Quality, Regulatory & Clinical Services for the American Health Care Association and National Center for Assisted Living and a registered nurse, licensed nursing home administrator and a fellow of the American College of Health Care Administrators.  <br></em></p><p><br></p><p style="text-align:center;"><a href="http://ahcancal.org/" target="_blank"><img src="/SiteCollectionImages/logos/ahca_ncal_cobrand.jpg" alt="" style="margin:5px;width:334px;height:33px;" /></a> </p><p><em></em></p> | 2022-02-17T05:00:00Z | <img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/nurse_clipboard.jpg" style="BORDER:0px solid;" /> | Workforce;Nurse Shortage | These agencies are charging long term care facilities and hospitals two or three times pre-pandemic rates, increasing their profit margins in the process. |
| AHCA/NCAL Addresses Agency Price Gouging | <p style="text-align:center;">
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<br></span></p><p style="text-align:left;">AHCA/NCAL has heard countless examples from providers of nursing and direct care staffing agencies charging supercompetitive prices to desperate long term care (LTC) centers that simply need workers. Agencies are charging double to quadruple plus of what providers can pay their staff. The staffing agency worker makes only a fraction of what the agency is charging the provider for that worker. Providers have noted that that they have little choice but to pay the exorbitant prices, and hope that the agency does not poach their staff once in the building. It is also important to remember that most LTC centers are paid through the Medicare and Medicaid programs – and thus, taxpayer dollars. This price gouging is simply not sustainable for our providers and the current reimbursement system structure. The money going to these staffing agencies is stripping facilities of funds that should be going to resident care and services.  <br></p><p style="text-align:left;"></p><p style="text-align:left;"></p><p style="text-align:left;"></p><p>AHCA/NCAL, along with several other health care providers, have asked that the Federal Trade Commission (FTC) and Administration use its authority to protect consumers from anticompetitive and unfair practices to investigate this activity and take swift appropriate action to protect LTC centers -- and ensure that our nation's elderly and those individual with disabilities receive the quality care they deserve.<br></p><p>Here are just a few examples of the recent efforts around this matter:<br></p><ul><li>
<a href="https://welch.house.gov/media-center/press-releases/welch-and-griffith-lead-nearly-200-house-members-letter-urging-covid-19" target="_blank">Welch and Griffith Lead Nearly 200 House Members in Letter Urging COVID-19 Response Team to Investigate Price Gouging by Nurse-Staffing Agencies</a> – AHCA/NCAL advocated for this letter</li><li> <a href="https://www.ahcancal.org/News-and-Communications/Press-Releases/Pages/America%e2%80%99s-Hospitals%2c-Nursing-Homes-Send-Joint-Letter-To-White-House-On-Exorbitant-Staffing-Agency-Rates.aspx" target="_blank">America's Hospitals, Nursing Homes Send Joint Letter To White House On Exorbitant Staffing Agency Rates</a> – AHCA/NCAL and AHA joint letter and media statement</li><li>
<a href="https://www.ahcancal.org/News-and-Communications/Fact-Sheets/Letters/Coalition-Letter-WH-Agency-Price-Gouging.pdf" target="_blank">LTC Coalition Letter to the White House</a> – AHCA/NCAL led LTC Coalition effort
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<span style="background-color:#ffffff;">Please contact AHCA's Senior Director of Not for Profit and Constituent Services at </span><a href="mailto:dritchie@ahca.org" target="_blank" style="background-color:#ffffff;">dritchie@ahca.org</a><span style="background-color:#ffffff;"> if you have any questions, ideas or stories to share around workforce matters.</span></p><p>
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<img src="/SiteCollectionImages/logos/ahca_ncal_cobrand.jpg" alt="" style="margin:5px;width:375px;height:45px;" /></a><br><br></p> | 2022-02-07T05:00:00Z | <img alt="" src="/Topics/Special-Features/PublishingImages/2022/PriceGouging.jpg" style="BORDER:0px solid;" /> | Workforce;Management | AHCA/NCAL has heard countless examples from providers of nursing and direct care staffing agencies charging supercompetitive prices to desperate LTC centers that simply need workers. |