MICHAEL J. MULLEN / STAFF PHOTOGRAPHER Allied Service certified nursing aide students Mary Jane Cummings, Karen Hughes and Kenesha McDaniel practice hospital bed making techniques as clinical instructor Mary Greenely prepares a mannequin for training in Allied Services Skilled Nursing Center.
Nursing homes, home health and hospice providers in Northeast Pennsylvania face massive shortages of certified nurses’ aides as the region’s aging population needs more long-term care.
Entry-level caregivers empty bed pans, help bathe and feed patients and assist with other basic care needs. Their hourly pay ranges between $9 and $15 for what is often unglamorous work.
And they are in high demand.
Compounding the problem is a high turnover rate among aides who might jump from job to job as they shop for better pay, or get fatigued from the job’s demands and leave the field altogether.
Pennsylvania has the fourth-largest 65-and-over population nationwide and is tied for the third-largest population over the age of 85, according to the state Department of Aging.
About 17 percent of Pennsylvania’s 12.8 million residents are 65 years old or older. By 2020, 19.2 percent are expected to be, and by 2030, 23 percent as the Baby Boomers age.
In Lackawanna County, 18.2 percent of its 214,000 residents are over age 65 and 3.3 percent are over age 85, according to 2014 U.S. Census Bureau figures, which are the most recent available. In Luzerne County, 18.4 percent of its 320,400 residents are over age 65; and 3 percent are over age 85, according to the Census Bureau.
The aging population will require more health care and related services.
The federal Bureau of Labor and Statistics
projects 5 million new jobs in health care nationwide between 2012 and 2022, with only about 1.3 million of them being highly-trained physicians or registered nurses, according to a January report, the most recent available. The remaining jobs will be support staff positions, including nurses’ aides.
The bureau warns that the workforce may lag behind the need.
For nurses’ aides in the region, it’s already problematic.
Short about 40 aides, Allied Services’ Skilled Nursing Center in Scranton received state approval on Feb. 3 to start a training program to entice new employees.
The classroom and lab are ready, instructors have assembled curriculum and a new-hire group will soon slide behind the work tables.
New employees go through a trial period working among the residents and other workers.
“They assist with the nurse aides on the floor just to make sure that it’s a right fit for them and it’s a right fit for us,” said Laura Piazza Smith, R.N., vice president of Allied’s Skilled Nursing Center.
Without certification, employees are limited in how they interact with residents and can do little more than push wheelchairs, make beds and serve meals.
To cover staffing needs, certified workers often take on extra hours or work inconsistent shifts. “We’re staffed 100 percent every day; we’re just paying a lot of overtime,” Mrs. Piazza Smith said.
Of about 600 workers at the Skilled Nursing Center, about 100 are nurses’ aides, some of whom fill part-time and weekend-only shifts.
Allied is not alone.
On any given day 15 to 20 percent of aide positions are open at Senior Health Care Solutions nursing homes, which include three in Scranton, one near Shamokin, and a new facility in Sayre. Like Allied, the existing staff ends up working overtime, said company president Michael Kelly.
“People aren’t choosing it as a profession,” Mr. Kelly said. “The solution to me is to get (the local hospital networks and nursing homes) into high schools, develop programs, offer scholarships, incentivize people to choose nursing as a profession.”
Needs at a nursing home are different than assisted living or personal care centers, he said.
Nursing homes offer residents an elevated level of care, and, because they are beholden to federal funds through Medicare and Medicaid, anyone who works directly with residents is required to have certification.
For a 100-bed nursing home, it is ideal to have about 100 employees, 40 of which are nurses’ aides, Mr. Kelly said. There are mandated staffing requirements, so in the midst of a shortage, workers keep long hours and nursing homes pay more overtime.
Pay for aides is a little better than other entry-level work that requires little training. On average, aides make about $12 an hour, said Susan Spry, vice president of workforce and community development at Luzerne County Community College.
The pay is much less than a registered nurse or medical technician. Retention is challenging and many aides leave the field because of fatigue.
“You’re on your feet all day, it’s a tiring job,” said Lackawanna College’s nursing aide program coordinator Laurie Mielo. “My guess is a lot of them don’t stay in it.”
Enrollment in the college’s five programs has been steady with about 45 students each year, she said. Typically 85 to 90 percent of graduates lock down jobs before they graduate, she said, but she is unsure of how many stay long-term with their employers.
Marywood University has expanded its nurses’ aide training to add an evening class and recently started offering certification testing on campus, which must be proctored by the American Red Cross, said professional continuing education Director Sue Reilly.
Allied had a training program for about a decade, but ended it about 15 years ago as colleges began to shoulder that role, said Allied’s training program director, Rose Burti, R.N.. With the growing shortages, Allied will offer free training to qualified employees.
Kenesha McDaniel, 25, of Scranton, is a trainee at Allied, preparing to enter the new nurses’ aide class.
She was bagging groceries a few years ago when a recruiter from another nursing home approached her in the checkout line and offered her a job. The higher pay — about $1.25 more an hour than her grocery store job — enticed her.
“I actually want to further it,” she said. “I actually want to be an RN.”
Often, nurses’ aide jobs allow workers to test the waters in the medical field, and can be a springboard to a career.
“I started just working in that environment and worked my way up, and I think it’s important that we foster that,” Mrs. Piazza Smith said, adding that Allied offers tuition reimbursement to encourage employees to continue their education.
With the nurses’ aide shortage, nursing homes, hospices and home health services compete for employees, said Ms. Spry, adding that employers bombard LCCC with requests for qualified help around graduation time.
“A good nurse aide is worth their weight in gold,” she said.
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