Pennsylvania’s Workforce and Long-Term Care: Erasing the ‘Mob’ Mentality

I was always a big fan of The Sopranos. A New Jersey mobster battling both his professional and personal ‘family’ life? Count me in. I watched every episode, even when I was too young to understand some of the more profane words and expressions (and there were plenty).


One of the central storylines of the first two seasons involved Tony Soprano and his refusal to admit his mother into a nursing home. When he finally did (after it was discovered she may have put out a ‘hit’ on him, which is another topic entirely), he hated himself for it. How could any son, even with a severely strained parental relationship, pull his own mother out of her home and admit her into institutionalized care?


As I re-watch some of those episodes today, that sentiment hits very close to home.


I’ve spent the last five years advocating on behalf of long-term care providers, staff and residents. When I speak with family members who come to visit their loved ones in a long-term care setting, I hear some of those same concerns: how could I do this to my mom or dad? Why can’t I care for them myself? After all, on any given day, more than 125,000 Pennsylvanians are cared for in a nursing home.


My grandfather was recently one of those residents. So maybe I’m more like Tony Soprano than I thought.


Pennsylvania currently ranks fourth nationally in the percentage of people 65 and older. Our fastest growing demographic is age 85 and older. And as Pennsylvania’s baby boomer generation ages, it is estimated that nearly 70 percent of these residents will need long-term care in their lifetime — and they will receive care for an average of 3 years.


Given those statistics, would it be alarming to learn that the biggest issue facing long-term care providers is finding a trained, qualified workforce?


The issue is looming so large, in fact, that in late July, Auditor General Eugene DePasquale released a report entitled, ‘Who Will Care for Mom and Dad?’ — which largely focused on the need for more caregivers across the Commonwealth.


So it’s no wonder you might fear sending a loved one to a nursing home.


But why is it so tough to find good, qualified staff?


First, it’s not easy work. Stop by a nursing home, talk to a direct care worker and ask them about their daily routine. It takes a very special person to work in long-term care-someone who is dedicated, caring and willing to sacrifice for others.


Second, wages haven’t kept up with other sectors and service industries. Why? Two-thirds of all residents in Pennsylvania’s nursing homes have their care paid for by the state’s Medicaid program, and that rate has remained flat since 2014. So while other private businesses may be able to pass costs on to consumers to pay for the inflated cost of goods, long-term care providers can’t. Operating costs continue to rise, and state funding remains painfully stagnant.


Third, the legal climate in Pennsylvania doesn’t exactly lend itself to a ‘business-friendly’ environment. Punitive, predatory lawsuits from out-of-state attorneys make the Commonwealth one of the toughest places to operate in the nation. Long term care providers spend more than $100 million in Medicaid funding every year to defend against lawsuits, instead of investing in their residents, staff and facilities.


The Pennsylvania Health Care Association is working to address these issues, and the challenges facing our providers. We’re partnering with state government, local workforce investment boards and other community partners to improve recruitment, training, retention and career advancement.


One new and innovative initiative is a partnership with the United Way of the Capital Region. Their “Road to Success” program helps individuals ready themselves for employment by assessing their skill level, providing training and connecting participants to additional educational support. Additionally, the program provides wrap-around services, such as transportation and childcare.


We’re working with the Capital Region Partnership for Career Development to help educate school counselors and teachers on the career opportunities that exist. Efforts connected to this partnership include job fairs, networking events, ‘educators in the workplace,’ job shadowing opportunities and internships.


Finally, we’re creating a statewide provider Workforce Committee to guide our initiatives and prioritize our investments in workforce development. The objective of the Workforce Committee is to expand the pool of qualified workers and improve the retention rate of current employees within the industry through partnerships and participation, policy and program development, education and the sharing of best practices.


Without an investment in long-term care and caregivers, the Commonwealth will be ill-prepared to meet the growing needs of its aging population. We’re doing our part to ensure families can count on quality care for their loved ones, and we’re looking forward to the same level of commitment from legislators and Gov. Tom Wolf’s Administration.


And maybe, one day, we’ll prove Tony Soprano wrong. Just don’t tell him I said that.


Zach Shamberg is president and CEO of the Pennsylvania Health Care Association.   


Founded in 1916, the Pennsylvania Chamber of Business and Industry is the state's largest broad-based business association, with its membership comprising businesses of all sizes and across all industry sectors. The PA Chamber is The Statewide Voice of BusinessTM.