Business View Magazine - August 2023

117 BUSINESS VIEW MAGAZINE VOLUME 10, ISSUE 8 VI RGINIA HEALTH CARE ASSOCIAT ION-VI RGINIA CENTER FOR ASSISTED L IVING employees, or 5.7 percent of the workforce. Meanwhile other health care providers have mostly rebounded to pre-pandemic levels. Facilities cite competition with other employers, lack of applicants or no qualified applicants as the top reasons for vacancies. Nearly every facility in Virginia is actively recruiting and paying higher wages and bonuses. However, Virginia is not producing enough nurses to keep up with the demand for them. Training programs are too small, and more RNs are needed to serve as instructors. Few people want to take on this role as instructor salaries do not match what an RN can make working as a clinician. Rebuilding the long term care workforce will not occur overnight, but time is of the essence to ensure we are encouraging individuals to join this rewarding profession. It is also necessary to realize that as the acuity of residents has increased, more staff are needed to provide care. Providers were already having difficulty hiring before the pandemic. Even if the sector recovers its pandemic related staffing losses, facilities still want to hire more caregivers to meet the higher acuity needs of residents. Increasing wages is a common suggestion from those outside the sector who are unaware that providers already have and continue to. Hourly wages for employed clinical nursing staff (CNAs, LPNs, and RNs) have increased by a combined nearly 36 percent since 2018. From 2021 to 2022 alone, employed clinical wages increased an average of 15.5 percent. Combined with contract nurse staffing, total payroll is up over 47 percent since 2018. While providers have had no choice but to use contract staff to fill gaps in staffing coverage (a 443 percent increase in hours used since 2018), it is a significantly less effective care model with a tremendously higher cost. Solutions Are in Sight It will take shared effort and several state budget cycles to make lasting improvements that benefit Virginia’s seniors. First, Virginia needs to continue its efforts to reverse the effects of historic Medicaid underfunding. Recent gains are at risk if rates do not keep up with inflation