
Category Archives: Talent
9 best health systems to work for: Fortune

Fortune and Great Place to Work released their list of the “Best Workplaces in Health Care” on Sept. 7.
Survey responses from more than 161,000 employees were analyzed to determine the best workplaces in the healthcare industry. To be considered for the list, organizations were required to be Great Place to Work-Certified and be in the healthcare industry. Learn more about the methodology here.
Below are the nine best large health systems to work for, ordered by their corresponding number in the overall list of 30 organizations. Health systems with 1,000 or more employees were considered for the large category.
1. Texas Health Resources (Arlington)
3. Southern Ohio Medical Center (Portsmouth)
5. Northwell Health (New Hyde Park, N.Y.)
6. Baptist Health South Florida (Coral Gables)
7. OhioHealth (Columbus)
8. Scripps Health (San Diego)
9. WellStar Health System (Marietta, Ga.)
10. Atlantic Health System (Morristown, N.J.)
21. BayCare Health System (Clearwater, Fla.)
Fortune and Great Place to Work also released a list of the best small and medium healthcare organizations to work for. Organizations with up to 999 employees were considered for the small and medium category. No hospitals or health systems were listed in that category.
These are the questions candidates must ask during a job interview

Job seeking is a grueling process, but it is also an opportunity to put your best foot forward in order to find a company that is the best fit for you.
Although it can be nerve wracking to sit through one interview after another, candidates should remind themselves that these interactions are a two-way street, and they have every right to ask challenging questions to make a decision, should the offer come.
Here are the critical questions you as a candidate must ask during a job interview—because remember, you’re interviewing the employer, too.
QUESTIONS TO ASK YOURSELF BEFORE APPLYING FOR THE JOB
Before setting off on your job search, make a list of the types of companies you’re interested in.
- Is this a place you see yourself thriving in?
- Do you believe in the mission?
- Why do you want to work at this place?
- What attracts you about the organization?
Oftentimes, our current situations dictate how we go about making our next move. Perhaps you’re working in an environment that you find suffocating and want out, or you’re seeking more responsibilities, or are looking to become a people manager.
Whatever the case, be sure to keep in mind that in every new workplace, there will be pros and cons, no matter the salary or job description. So be cognizant of all the aspects of a new role that are truly important to you; also, be mindful of what your personal dealbreakers are.
PREPARE A LIST OF STRATEGICALLY PLANNED QUESTIONS
Interviewing is a two-way exchange. While candidates are being scrutinized by the potential employer, the skilled candidate will have an opportunity to evaluate the company based on the flow of the conversation.
Typically, candidates aren’t given the opportunity to ask questions until the very end of the interview. That’s not to say there aren’t ways to integrate specific queries into the conversation, as long as you remember that you’ll get full control of the floor in the grand finale.
In a previous Fast Company story, Patrick Mullane, executive director of Harvard Business School Online, shares how interviewees often will drop the ball when the interviewer tosses out the famous line, “Do you have any questions for me?”
“Candidates forget that when they’re given control of the discussion, it’s an opportunity to do two very important things. First, it’s a chance to learn something genuinely useful about the firm you might be joining. Second, you get to show that you’re thoughtful and conscientious,” he said. “Both are hugely important as you look to make a change. Don’t waste the opportunity.”
When it comes to the questions candidates typically ask companies during an interview, the “big three” revolve around corporate culture, the interviewer’s personal experience (“How have you liked working here?”), and growth.
Rather than default on these inquiries (which interviewers likely receive quite often and may respond in kind with generic answers), Mullane challenged candidates to take these questions and reframe them in a more thoughtful, strategic way:
Culture questions: Rather than asking, “What’s the culture like here,” ask something along the lines of, “Can you share a time when the company’s culture made you excited to work here or helped you during a challenging time?” This bypasses a typical answer like “It’s collaborative,” and dives into the intersection of employees and culture, offering an in-depth look into a specific, and perhaps relatable, scenario.
Personal experience questions: Instead of “How do you like working here?” try, “I noticed you left X company for this one. What convinced you to make the jump?” This reframing achieves two things: It shows the interviewer you did your research and gives you insight into their decision-making, which may help you make your own.
Company growth questions: A question like, “I noticed the company is growing rapidly. Do you expect that to continue?” will often bear a generic, dead-end answer. To get additional, more useful information, put a spin on it. Ask something like, “I noticed the company is expanding rapidly. Is this putting a strain on your customer service team?” Getting information on a company’s financials is not particularly difficult, especially if it is already publicly traded. But asking a question of this nature is especially useful if you are interviewing for a role like Customer Success Manager, as it allows you to get a better sense of how growth impacts the day-to-day of the team.
Overall, it will only work in your favor when you do your due diligence in gathering intelligence on the company you are interviewing for; also, you’ll be setting yourself up for success by having prepared questions that lead to a conversation and present yourself as a thoughtful and conscientious candidate.
“In a hot job market, it’s tempting to be lazy when doing the upfront work to prepare for an interview,” said Mullane. “It’s easy to figure that the interview is over when the person interviewing you gives you the floor. But it’s not. Asking better questions in the right way can significantly increase the chances you’ll not only impress the interviewer, but also gain valuable insights that can help you decide if the position is right for you.”
COVER THE BASICS
It can be easy to get caught up in nerves when interviewing for a company you are extremely attracted to—or even in general. Interviewing is a lot of pressure!
However, when preparing to ask your questions, the areas that you as a candidate must focus on should give you a well-rounded perspective on multiple aspects of the company, not just the specific job description.
This Fast Company article shared a roundup of all the pertinent focus areas that your questions should fall under to get you the best answers, which include:
- The specific role you are interviewing for
- The management style of your would-be boss or team
- Company culture and reputation
- What performance metrics look like
- What kind of colleagues you can expect to work with
- Opportunities for growth
ASK TOUGH BUT FAIR HIGH-LEVEL QUESTIONS
Sometimes it’s not enough to consider the high-level questions, such as salary and work culture. Many of us are in a unique position in life, whether that involves our personal situations, families, health, or other concerns.
When considering your interest in a company, it’s helpful to understand how they can help or support you as an individual beyond your contributions to the job.
On the flip side, you’ll want to know other aspects of internal support for employees. How does this company support internal mobility? How do managers deliver feedback? In other words, what will a day in the life of this role really be like?
Prepare to ask the employer a series of questions tailored to your situation. FlexJobs’ team of career coaches offers guidance in this Fast Company story, including specific inquiries to ask your interviewer, such as:
- Why is this position available? This can give you some insight into the way things are handled at the company. Was someone fired? Are they unable to keep the position filled because of the workload?
- What makes it a great day at work, and what makes it a challenging day? Answers to this question can vary depending on the personal experience of the interviewer, but it’s good to get a sense of how they approach the question.
- How are criticism and feedback handled within the team? Mistakes can happen, and knowing that managers on the team can handle employee errors with grace will offer a sense of relief rather than unnecessary conflict when they do occur.
- Do you have any Employee Resource Groups (ERGs)? How do they support the company’s DEI plans? This question gives you an opportunity to understand where the company stands in terms of diversity, equity, and inclusion (DEI) and how well they support the objectives of ERGs, as well as pushing forward their higher-level strategy.
- How does the company approach salary differences? This can highlight whether the company pays people differently based on location, if they work remotely, in-office, or hybrid. It can also shed light on whether the company has done a pay audit to achieve equity, especially for women and underrepresented groups.
- What’s the company’s approach to supporting work-life balance? Many companies have put forth specific benefits and incentives to support employees in the past two years, including mental health initiatives, fitness classes, therapy, and flexibility. This critical question will help you determine just how the company views employees as individuals and not just by their work output.
An example of a tough conversation to navigate can pertain to how the organization supports employees in specific work situations. If this particular job requires you to relocate, an example of how to navigate the question of moving-cost accommodations might go something like this:
Candidate (C): I noticed this position is based in San Francisco. Is there an option for potential hires to work remotely?
Interviewer (I): I’m afraid our new company policy is to operate on a hybrid schedule. This particular role is based in the Bay Area and requires the individual to come into work three times a week.
C: I understand. Sometimes companies need to make tough decisions based on their needs.
I: Do you think you would be willing to relocate, should we decide to move forward with your application?
C: I think this role is a wonderful opportunity for me, and I truly believe my personal values align with those of this company and its culture. If all goes well, I’d like to learn what the company’s budget is in regards to supporting moving and transition costs.
In this scenario, the interviewer is honest about the new hybrid model their company has adopted. If you, the candidate, are first learning about this aspect during the interview, it’s important to ask direct questions about how the company plans to support potential moving costs, rather than framing the question in a way that offers a loophole or an out.
Organizations are aware that with the plentiful options of remote jobs, finding talent willing to relocate or adopt a hybrid work life will be tougher. Know that the ball is in your court and be straightforward about expensed costs if you are willing to relocate.
WRAP UP THE INTERVIEW WITH THESE KEY QUESTIONS
This will likely be the last time you interact with this team member before either moving onto the next stage or the decision-making process.
In a prior Fast Company story, the founder of executive search firm The Mullings Group shares the best questions to ask when wrapping up.
Don’t let the conversation end without answers to the following questions, so you have enough information to help you reflect on and assess your experience and understanding of the company.
Am I a good fit for this company? The feeling needs to be mutual. Be sure to determine whether your skills, interests, personality, and goals align with the direction of the company.
What are the expected deliverables for this role over the next three months to a year? Depending on the role of the person you are interviewing with, you may get different answers. This is a good question to ask to get a sense of the priorities as it relates to different stakeholders.
How will we both know that I have succeeded in this role? This is another question in which the answers may vary, but it will be helpful for you as a candidate to understand how to work toward specific goals and measure your own impact so that, when it comes time for a raise or promotion in the future, you have the evidence to back it up.
What are the growth opportunities in this role, and what important skills will I learn? It’s not enough to make a lateral move. You need to know how will working for this company enable you to grow and thrive.
Who will I become? Your environment and the people you work with will directly influence your work output, ethic, and your future values. Asking questions about the kind of people you will interact with regularly will help you get a sense of what your day-to-day experiences will look like.
Getting a new job is a big deal. You will be working 40 hours a week in a specific environment that supports a certain culture and hires a certain type of colleague. It’s not just the job description that matters, nor the skill set the company requires to perform in that role. A new job is a combination of your livelihood, a commitment to learn and grow, and contribute.
Remember to be selective in your process because you’re interviewing your next employer, too.
Stay Vigilant, CFOs: Your Compensation Strategy Matters More Than Ever

There’s been some speculation in the news lately that wage growth in the United States might be topping out. This could be the case for some employers, especially smaller companies that don’t have much more give in their current staffing budget. However, don’t think for a moment that compensation is suddenly losing its power as a tool to help secure top talent in a market where unemployment is low, the quits rate is high, and there are nearly twice as many open jobs as there are available workers.
The suggestion that employers are becoming more conservative in their salary offers also might be hopeful thinking for those trying to control rising inflation. Federal Reserve Chair Jerome Powell, for example, recently referred to the labor market as “unsustainably hot.”
While some big companies may be considering cooling down on hiring, some are paying higher wages to median-salaried employees than they did before the pandemic. (Significantly so, in some cases — think six figures.) And although the U.S. economy has seen some job-shedding in recent months, layoffs overall are at their lowest level on record.
The takeaway for chief financial officers (CFOs) is that you can’t afford to sit back and wait on wages. You can never really be sure when or if it will “top out,” especially in this unusual economy and candidate-driven hiring market. Your business needs to be prepared to provide standout compensation packages to hire stellar candidates — and keep your best people, too.
Compensation remains the not-so-secret weapon for besting competitors targeting the same talent, including the high performers who are already part of your organization. The trick is to use compensation as an offensive strategy that gives you more control. Following are three ways to help your organization make that pivot:
1. Review Current Employees’ Compensation Levels Now
While its name has been overexposed in the media, the Great Resignation is real and still in motion. Some are even referring to the phenomenon now as the “Forever Resignation”— a cycle of voluntary turnover that may never end. Buzzy labels aside, the pandemic has fundamentally changed the way people look at work, and what it means to them. They aren’t as willing to put up with things they don’t like about their job — like a low rate of pay. They know they have options, and they will seek them out.
Nearly two-thirds of U.S. workers who left their jobs in 2021 cited insufficient compensation as a reason for quitting, according to a Pew Research Center survey. To avoid turning your company’s valued staff into part of the “Class of 2022,” don’t wait for them to ask for a raise. Make sure to review their current compensation and if needed, bump it up, or extend another financial perk, like a spot bonus or paid time off.
And, if you find that employees are beating you to the punch, encourage an open discussion about pay. For example, if this person’s job responsibilities recently expanded or they’ve gained new skills, an immediate raise (or the promise of one soon) may be in order. If the employee is just feeling the crunch from inflation, offering a flexible work arrangement to reduce the burden of a costly commute might be an alternative solution for in-office workers.
2. Designate an Expert to Oversee the Compensation Process
In addition to taking stock of staff compensation levels as soon as possible, consider putting a formal process in place to ensure these levels will be monitored and adjusted proactively.
Compensation analysis will require, among other things, keeping tabs on the latest salary research and market trends, analyzing and updating job descriptions, and setting pay ranges and communicating them to staff. Look for someone in your human resources organization who could take the lead on managing this critical process. Because the market has changed so fast, it’s critical to keep continual tabs on what’s happening with pay rates and hiring dynamics for your company’s most mission-critical roles.
3. Watch Out for Pay Compression
The need to pay higher salaries to top candidates is in many cases resulting in new hires earning more than existing staff. Even small differences in pay between employees who are performing the same job, regardless of their skills or experience, can turn into big staffing headaches — namely, turnover. Feelings of resentment and disengagement can especially rise in the workforce when new hires with less experience are paid the same as, or more than, tenured employees in the same positions, or when individual contributors are paid more than their managers.
Inflation, competition for in-demand talent and the company’s failure to keep up with current market rates for compensation can all lead to pay compression. Conducting regular pay audits as described above and quickly bringing up the base salary of underpaid employees are solutions for resolving and, ideally, preventing, pay compression.
When raises aren’t an option, consider offering compelling non-monetary perks such as upskilling opportunities, better benefits, health and wellness programs, a more welcoming corporate culture, or all of the above.
That said, you can be sure that, no matter what, leading employers will continue to pay salaries that will attract the top talent they need to drive innovation and stay competitive.
More Americans are quitting — and job openings hit record high

Across industries, 4.54 million Americans quit or changed jobs in March, the highest level since December 2000, according to seasonally adjusted data released May 3 by the Bureau of Labor Statistics.
The count is up from 4.38 million in February. In the healthcare and social assistance sector, 542,000 Americans left their jobs in March, compared to 561,000 the previous month, according to the bureau.
The number of job openings in the U.S. also hit a record high of 11.55 million in March, up from 11.34 million in February, according to the bureau. Job openings in the healthcare and social assistance sector remained similar in February and March, at around 2 million.
During the pandemic, hospital CEOs are among those who have joined the list of workers quitting. Additionally, older, tenured employees in America are part of the trend.
Although there continues to be churn in the labor market, Fitch Ratings projects the U.S. labor market will recover jobs lost during the pandemic by the end of August.
Snapshot Analysis Shows ‘Unprecedented’ Decline in RN Workforce

The number of registered nurses plunged by 100,000 in 2021, representing the steepest drop in the RN workforce in 4 decades, according to a new analysis.
From 2019 to 2021, the total workforce size declined by 1.8%, including a 4% drop in the number of RNs under the age of 35, a 0.5% drop in the number of those ages 35 to 49, and a 1.0% drop in the number of those over 50, reported David Auerbach, PhD, of the Center for Interdisciplinary Health Workforce Studies at Montana State University College of Nursing, and colleagues in Health Affairs Forefront.
“The numbers really are unprecedented,” Auerbach told MedPage Today.
“But … given all that we’ve been hearing about burnout, retirement, job switching, and shifting,” and all of the ways the pandemic disrupted the labor market, including healthcare, “I am not super surprised either,” he added.
While Auerbach said he and his co-authors can’t definitively say what caused this shift, he does not think it’s merely a problem of “entry and education” — in other words, fewer people choosing nursing as a career.
There have been no “major changes” in the enrollment and graduation rates reported by the American Association of Colleges of Nursing (AACN), and the number of RNs completing the National Council Licensure Examination actually increased in 2020 versus 2019, according to the National Council of State Boards of Nursing, Auerbach said.
This suggests that the decline in younger RNs is more likely due to nurses “either pausing or leaving nursing. What we really don’t know is whether this is a temporary or more permanent phenomenon,” he added.
The overall decline was not spread evenly across sites, but instead was “entirely due” to a 3.9% reduction in hospital employment, offset by a 1.6% increase in nursing employment in other settings, the authors said.
For decades, the RN workforce grew steadily, from 1 million nurses in 1982 to 3.2 million in 2020. Though the profession saw a rocky period in the late 1990s, during which growth looked less certain, millennials reversed this temporary downward trend in the early 2000s, Auerbach and team explained.
In a prior Health Affairs analysis, Auerbach and colleagues found that the labor market for nurses had “plateaued” during the first 15 months of the pandemic.
Auerbach’s team had previously projected that the supply of nurses would grow 4.4% from 2019 to 2021.
The data may reflect a mix of RNs leaving “outright” and those shifting to non-hospital jobs. The authors were unable to follow the same people from pre-pandemic to now, Auerbach noted. “Based on taking a snapshot of the world in 2019 and then taking another snapshot of the world in 2021, we’re inferring from what we see what we think might have happened.”
Auerbach said that he and his colleagues are close to ruling out childcare problems as a core reason for younger nurses departing. “We didn’t see some huge reduction in nurses with kids at home,” he explained.
However, if that had been the case, then the decline might be seen as something temporary that could be “ironed out,” compared to more deeply rooted structural problems, like poor working conditions, he said.
Auerbach and colleagues stressed that more needs to be done to help early-career nurses who have endured a “trial by fire” during the pandemic, and that “more effective strategies” must be leveraged to reward nurses who have stayed on the front lines and to bring back those who have left.
On a hopeful note, Auerbach pointed to recent AACN data, which showed a “big jump” in the number of applications to nursing schools. Additionally, prior research found that “times of natural disaster or health crisis could increase interest in RN careers,” the authors noted.
“That doesn’t sound like people are just going to abandon nursing altogether,” Auerbach said.
Viewpoint: It’s the Great Aspiration, not Resignation

Those who left their jobs during the Great Resignation did so out of more than just frustration, but instead used it as an opportunity to follow their dreams and aspirations, writes Whitney Johnson, CEO of Disruption Advisors, a talent development company, in the Harvard Business Review April 6.
The pandemic forced many people to reevaluate many facets of their lives, from where to live to how to spend more time with family. Ms. Johnson argues that workers’ thoughts on changing the way they work is a good thing, giving workers agency to discover new aspirations and proactively seek them.
“The Great Resignation appellation is, I believe, mistaken. Most workers are not simply quitting. They are following a dream refined in pandemic adversity. They are aspiring to grow in the ways most important to them,” she writes.
Even for those who have been forced out of the workforce, like working mothers and caregivers, Ms. Johnson argues that it will lead to a boom of innovative new businesses, created by those resourceful workers who find another way to work outside the realms of traditional industry.
She also states that this “great aspiration” is beneficial for employers too, who can make the most of a fresh pool of talent, full of newly motivated employees who are dedicated and searching for meaning.
Hospital CEOs are joining the Great Resignation

The number of departing hospital CEOs is on the rise as C-level executives are grappling with challenges tied to the COVID-19 pandemic.
Twelve hospital CEOs exited their roles in January, double the number who stepped down from their positions in the same month a year earlier, according to a report from Challenger, Gray & Christmas, an executive outplacement and coaching firm.
While some hospital and health system CEOs are retiring, others are stepping down from their posts into C-level roles at other organizations. At least eight hospital and health system CEOs have stepped down from their positions since mid-February.
The increase in CEO departures isn’t unique to healthcare. More than 100 CEOs of U.S.-based companies left their posts in January, up from 89 in the same month a year earlier, according to the Challenger, Gray & Christmas report.
The uptick in executive exits shouldn’t be surprising given the challenges presented by the COVID-19 pandemic, experts told NBC News. CEOs and other executives aren’t immune to the pressures that are prompting people to leave their jobs.
“It’s many factors — the burnout, the pandemic, the school closures, the need to take stock of life,” Julia Pollack, chief economist at ZipRecruiter, told NBC News in January. “It’s a whole wide range of shocks.”
Cartoon – Recruiting an Aging Workforce

Nursing home staff shortages are worsening problems at overwhelmed hospitals
https://www.washingtonpost.com/health/2021/12/28/nursing-home-hospital-staff-shortages/

At the 390-bed Terrace View nursing home on the east side of Buffalo, 22 beds are shut down. There isn’t enough staff to care for a full house, safely or legally.
That means some fully recovered patients in the adjacent Erie County Medical Center must stay in their hospital rooms, waiting for a bed in the nursing home. Which means some patients in the emergency department, who should be admitted to the hospital, must stay there until a hospital bed opens up. The emergency department becomes stretched so thin that 10 to 20 percent of arrivals leave without seeing a caregiver — after an average wait of six to eight hours, according to the hospital’s data.
“We used to get upset when our ‘left without being seen’ went above 3 percent,” said Thomas Quatroche, president and chief executive of the Erie County Medical Center Corp., which runs the 590-bed public safety net hospital.
Nursing home bed and staff shortages were problems in the United States before the coronavirus pandemic. But the departure of 425,000 employees over the past two years has narrowed the bottleneck at nursing homes and other long-term care facilities at the same time that acute care hospitals are facing unending demand for services due to a persistent pandemic and staff shortages of their own.
With the omicron variant raising fears of even more hospitalizations, the problems faced by nursing homes are taking on even more importance. Several states have sent National Guard members to help with caregiving and other chores.
Hospitalizations, which peaked at higher than 142,000 in January, are rising again as well, reaching more than 71,000 nationally on Thursday, according to data tracked by The Washington Post. In some places, there is little room left in hospitals or ICUs.
About 58 percent of the nation’s 14,000 nursing homes are limiting admissions, according to a voluntary survey conducted by the American Health Care Association, which represents them. According to the U.S. Bureau of Labor Statistics, 425,000 employees, many of them low-paid certified nursing assistants who are the backbone of the nursing home workforce, have left since February 2020.
“What we’re seeing on the hospital side is a reflection of that,” said Rob Shipp, vice president for population health and clinical affairs at the Hospital Association of Pennsylvania, which represents medical providers in that state. The backups are not just for traditional medical inpatients ready for follow-up care, he said, but psychiatric and other patients as well.
A handful of developmentally disabled patients at Erie County Medical Center waited as long as a year for placement in a group setting, Quatroche said. Medical patients recovered from illness and surgery who cannot go home safely may wait days or weeks for a bed, he said.
“I don’t know if everyone understands how serious the situation is,” Quatroche said. “You really don’t know until you need care. And then you know immediately.”
Remarkably, despite the horrific incidents of death and illness in nursing homes at the outset of the pandemic, more staff departures have come during the economic recovery. As restaurants and shops reopened and hiring set records, nursing homes continued to bleed workers, even as residents returned.

Nearly 237,000 workers left during the recovery, data through November show. No other industry suffered anything close to those losses over the same period, according to the Bureau of Labor Statistics.
Workers in the broader health-care industry have been quitting in record numbers for most of the pandemic, plagued by burnout, vulnerability to the coronavirus and poaching by competitors. Low-wage workers tend to quit at the highest rates, Labor Department data show, and nursing home workers are the lowest paid in the health sector, with nonmanagerial earnings averaging between $17.45 an hour for assisted living to $21.19 an hour for skilled nursing facilities, according to the BLS.
Nursing home occupancy fell sharply at the start of the pandemic, but inched back upward in 2021, according to the nonprofit National Investment Center for Seniors Housing and Care. One major force that held it back was worker shortages.

“Operators in the business have said we could admit more patients, but we cannot find the staff to allow that to happen,” said Bill Kauffman, senior principal at the organization.
Shortages have spawned fierce talent wars in the industry, Brookdale Senior Living Chief Executive Officer Cindy Baier said in a recent earnings call. When they don’t have enough workers, restaurants can reduce service hours and hospitals can cut elective surgeries, but nursing homes don’t have the option of eliminating critical services, she said. They must close beds.
“We are in the ‘people taking care of people’ business around-the-clock, 365 days a year,” she said.
Nursing homes tend to gain workers during a recession but can struggle to hire during expansions, according to an analysis of county-level data from the Great Recession recently published in the health care provision and financing journal Inquiry.
Steady income from their resident population and government programs such as Medicaid makes them recession-proof, and their low pay and challenging work conditions mean they’re chronically understaffed, said one of the study’s authors, Indiana University health-care economist Kosali Simon.
When recessions occur, nursing homes go on a hiring spree, filling holes in their staff with qualified workers laid off elsewhere.
“People during a recession may lose their construction jobs or jobs in retail sectors, and then look for entry-level positions at places like nursing homes where there is always demand,” Simon said.
Now, amid the “Great Resignation” and the hot job market, the opposite is happening. In sparsely populated areas and regions where pay is lower, the problem is even worse.
The Diakonos Group, which operates 26 nursing homes, assisted-living facilities and group homes in Oklahoma, closed an 84-bed location for seniors with mental health needs in May “simply because we couldn’t staff it any longer,” said Chief Executive Officer Scott Pilgrim. Patients were transferred elsewhere, including Tulsa and Oklahoma City, he said.
The home in rural Medford, which depended entirely on Medicaid payments, “was never easy to staff, but once we started through covid and everything, our staff was just burned out.”
Diakonos boosted certified nursing assistants’ pay from $12 an hour and licensed practical nurses’ pay from $20 an hour, used federal and state assistance to offer bonuses and employed overtime, but workers kept leaving for better health-care jobs and positions in other industries, he said.
“I’ve never been able to pay what we ought to pay,” Pilgrim said. Eventually he began to limit admissions and eventually was forced to close.
“The hospitals are backed up,” he said. “They’re trying to find anywhere to send people. We get referrals from states all around us. The hospitals are desperate to find places to send people.”
In south central Pennsylvania, SpiriTrust Lutheran is not filling 61 of its 344 beds in six facilities because of the worker shortage, said Carol Hess, the company’s senior vice president.
“I have nurses who went to become real estate agents,” she said. “They were just burned out.”
Pay raises of $1 to $1.50 an hour and bonuses brought the lowest-paid workers to about $15 an hour, Hess said, and the company is planning a recruiting drive after Jan. 1. But the prognosis is still grim.
“We’re competing with restaurants for our dining team members,” Hess said. “We’re competing with other folks for cleaning and laundry and others.” In the area around Harrisburg where SpiriTrust employees live, some schools that turned out certified nurse assistants closed during the pandemic and haven’t reopened.
The nursing homes have begun borrowing licensed practical nurses from WellSpan Health, the nearby hospital system that discharges many of its patients to SpriTrust after they recover. About 15 have began their orientations this month, she said, and the two systems are collaborating to pay them.
The bed shortage is causing backups that can average several days in the hospital, said Michael Seim, the hospital system’s chief quality officer. That gives the hospitals an interest in helping any way they can, he said.
“We have between 80 and 100 patients waiting for some type of skilled care,” Seim said this month. The hospital has begun caring for more people at home, enrolling 400 people so far in a program that sends clinicians to check on them there. More than 90 percent have said they are happy with the program.
“I think the future of hospital-based care is partnerships,” Seim said. “It’s going to be health systems partnering across their service areas … to disrupt the model we have.”