​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.

After decades in the industry and having visited facilities across the nation, Dr. David Gifford—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 LTC Heroes podcast. “More needs to be done to resolve this.”

Listen to the entire interview with host Peter Murphy Lewis, the director of marketing at Experience Care, below:

Innovative Solutions to the Staffing Crisis

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.”

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. In response to a question about creating a new position in long term care, 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.”

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.

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.

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.

Still More Needs to Be Done

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.”

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.

For more on recent trends in long term care, read our blog and subscribe to the LTC Heroes podcast.