About a dozen certified nursing assistants (CNAs) gathered outside a Milwaukee-based health care management group to call attention to the crisis looming in the long-term care industry: Low wages are forcing workers out of nursing at the same time the demographic trend lines show Wisconsin’s aging population is growing and will increasingly need skilled nursing services in the years to come.
The current median starting wage for personal caregivers in Wisconsin is $10.75, according to a report compiled by industry groups. The low pay has led to workers leaving the industry for better pay and the remaining CNAs at nursing homes and other long-term care facilities struggling to make ends meet while working a stressful job tending to frail elderly and the disabled.
Just last year, an estimated 10,600 caregivers in the state may have left for better positions outside of health care, according to data analyzed by LeadingAge Wisconsin, Wisconsin Health Care Association/Wisconsin Center for Assisted Living, Wisconsin Assisted Living Association and Residential Services Association of Wisconsin.
The groups found that one in seven caregiving staff positions in Wisconsin is unfilled. Long-term care facilities and nursing homes are filling the gap by refusing to take on new patients and requiring their staff to work more hours or double shifts.
“As I’ve worked as a CNA for 20 years I find it’s gotten harder and harder due to shortage of staff,” said Milwaukee-based CNA Kent Robinson at Thursday’s rally, organized by SEIU Healthcare Wisconsin. “We have to take care of a lot of people, sometimes 13 or 14 people per shift. This means we only have 35 minutes per resident in an eight-hour shift. Thirty-five minutes is not enough to do care. It’s not enough for us. We can’t sit down and talk to the residents. We can’t take them outside and do things to make their life feel more enjoyable.”
A Looming Crisis in Long-Term Care
The shortage of skilled caregivers could become a crisis in the near future.
Currently, about one in seven Wisconsinites is over the age of 65. But that will tick up to one in four Wisconsinites in the next 30 years, leading to an increasing reliance on personal caregivers.
“It’s really important that we get a handle on this because one day there might not be health care workers to provide care to our infirm,” said Dian Palmer, SEIU Healthcare Wisconsin president.
Also putting pressure on long-term care facilities is Wisconsin’s low Medicaid reimbursement rate.
The industry groups pointed to a recent independent report for the American Health Care Association (AHCA) showing that Wisconsin’s Medicaid reimbursement system is the worst in the country. The report found that Wisconsin’s skilled nursing facilities had a Medicaid deficit of $331.8 million in 2014-2015, meaning these facilities lost that amount of money caring for their residents covered by federal and state Medicaid funds. That translates into a projected loss of $52.84 each day for each Medicaid patient in 2015. The national average is a $22.46 Medicaid shortfall per day in 2015, according to the AHCA.
The current state budget does not include a Medicaid rate increase for nursing facilities, although providers requested a 5% increase to make up for some of the Medicaid shortfall.
State Rep. Jonathan Brostoff (D-Milwaukee), a member of the Legislature’s Committee on Aging and Long-Term Care, highlighted the Medicaid reimbursement problem when speaking to the SEIU CNAs on Thursday. Brostoff is advocating for a Medicaid wage pass-through, which would designate some Medicaid funds for increasing workers’ wages.
“We need a wage pass-through so that we can have working families get taken care of so that they can take care of our working families, so that you guys are getting adequate compensation, getting paid, and also that people will want to come into the profession,” Brostoff said.
The CNAs gathered outside of Fortis Management Group in Downtown Milwaukee to call attention to the need to pay their workers a living wage. (The Fortis Management Group is in no way connected to the Shepherd’s publisher, Louis Fortis.) SEIU is currently bargaining a new contract for about 500 Fortis CNAs employed throughout the state and the workers say they would like to see a path to $15 an hour included in the new agreement.
Kim Mackle, a longtime CNA from Sheboygan, said $15 an hour would help ease the financial and emotional stress that she and her fellow workers face as they care for their frail elderly and disabled residents.
“Good happy employees make for a great work environment and a happier home for our residents,” Mackle said.
Fortis Management Group could not be reached for comment.