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Report: 900,000 More Home Care Workers Needed By 2031
Home Health Care News
Over the course of the next decade, the direct care workforce is expected to see enormous growth.
Despite projections, low wages and other challenges continue to plague the workforce, further compounding the recruitment and retention issues seen across the home-based care space.
That’s the key takeaway from a recent report from PHI, a New York-based direct care workers advocacy organization that conducts research and analysis.
“Home care workers continue to be an essential and growing U.S. workforce,” Robert Espinoza, executive vice president of policy at PHI, told Home Health Care News. “The research shows that median wages for direct care workers are inadequate. Many of them live in – or are near – poverty, and they rely on public assistance just to survive.”
Though the direct care workforce had seen incremental wage growth due to state and federal investments in Medicaid funding, the scaling back of these supports has meant a major slowdown in wage growth, according to the report.
Specifically, wages for direct care workers went up by $0.68 per hour in 2020, but in 2021, the median hourly wage for direct care workers increased by only $0.07 per hour. It increased by $0.02 per hour in 2022.
Overall, the median annual income for these workers is $23,688. Home care workers, in particular, earn a median annual income of $20,599.
As a result, 42% of home care workers live below the poverty line, and 55% are utilizing public assistance, such as Medicaid, food assistance or cash assistance, according to the report.
In addition to the low wages, PHI also found that 16% of home care workers work over 40 hours per week.
While these challenges persist, the home care workforce is estimated to add more than 900,000 new positions from 2021 to 2031 — outpacing any other occupation in the country.
Plus, from 2021 to 2031, the home care industry will have almost 5.5 million total positions open. Roughly 2 million of these job openings are due to workers leaving and getting into other professions, and more than 2 million will leave the labor force entirely.
“In several studies, home care workers often cite inadequate compensation as one of the primary reasons they are leaving these roles,” Espinoza said. “You can see it because, oftentimes, they’re leaving for occupations that pay modestly higher wages, like fast food, like retail, etcetera. They’re leaving for McDonald’s and Macy’s, so wages are a very important piece of it.”
Espinoza noted that things like health care coverage, child care support, adequate training and advancement opportunities are also important factors in retaining and recruiting home care workers.
Home care comes in second for among all U.S. occupations for total job openings, according to the report.
Ultimately, Espinoza urged home care employers to think about compensation, but also to build a strong culture for workers.
“[They] should be thinking about how to create a culture within agencies that supports workers, centers their needs and their aspirations, and really integrates their values into all aspects of the organization,” he said. |
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Home Health Agencies Fail to Report More than 50% of Falls Leading to Major Injuries, OIG Finds
McKnight’s Home Care | By Adam Healy
Home health agencies neglected to report 55% of falls leading to major injuries and hospitalizations on their Outcome Assessment Information Set (OASIS) assessments, according to a study conducted by the U.S. Office of Inspector General.
OIG analyzed hospital claims for Medicare home health patients and identified those that included a fall. This was compared to the home health provider’s OASIS assessments and its fall rate report on Care Compare. OASIS falls reporting was worse among young home health patients, along with those who identified as Hispanic, Black and Asian. Of 39,900 falls identified that resulted in major injury, 85% led to a bone fracture and 11% led to “head injury with altered consciousness,” according to the report.
For-profit home health agencies came up worse than other agencies in reporting Medicare home health patients’ falls. During the one-year period examined between 2020 and 2021, for-profit agencies failed to report 56% of falls. That compares to the failure to report falls among nonprofit agencies (52%) and government-run agencies (38%).
A major red flag was the lack of reporting about a hospitalization related to the fall on the OASIS assessment, OIG found.
“For many Medicare home health patients who fell and were hospitalized, there was no OASIS assessment at all associated with the hospitalization, which raises additional concerns about potential noncompliance with data submission requirements and its impact on the accuracy of information about falls with major injury on Care Compare,” the report said.
Noncompliant OASIS reporting would lead to incomplete or misleading fall rate statistics on Care Compare, OIG noted.
“These patient assessments are used by CMS to monitor and provide public information about home health care quality,” said Ann Maxwell, deputy inspector general for evaluation and inspection, in the report. “Due to this high rate of non-reporting, Care Compare may not provide accurate information about the incidence of these falls.”
OIG found that that home health agencies with the lowest Care Compare major injury fall rates reported falls less often than agencies with higher Care Compare fall rates. This indicated “that Care Compare does not provide the public with accurate information about how often home health patients fell.”
OIG made four recommendations to the Centers for Medicare & Medicaid Services to remediate the issue of non-reporting. These recommendations included taking steps to ensure falls are reported in OASIS assessments and using other data sources to develop more accurate reporting measures.
In a letter to OIG, CMS Administrator Chiquita Brooks-LaSure concurred with the inspector’s recommendations.
“CMS understands the importance of providing accurate quality information to home health agencies and the public,” Brooks-LaSure said. “CMS will explore opportunities to help promote the completeness and accuracy of the home health agency reported OASIS data used to calculate the falls with major injury quality measure, including additional OASIS outreach and educational opportunities.” |
Home Palliative Care Can Improve Quality of Life for Heart Failure Patients, Study Reveals
McKnight’s Home Care | By Adam Healy
Not only does home-based palliative care improve heart failure patients’ quality of life, it can do so immediately, according to new research in BMC Palliative Care.
To conduct the study, researchers surveyed 100 patients with heart failure aged 65 years and older using questionnaires to record their demographic information and determine their quality of life. Quality of life was measured by patients’ responses to questions regarding their health, socioeconomic, psychological and family satisfaction, according to the study.
These patients received palliative care in three types of settings: primary, specialty and home-based palliative care. Primary palliative care was found to be the least effective in improving patients’ quality of life. Specialty palliative care was better, particularly in improving peoples’ socioeconomic satisfaction, according to survey findings. The most effective form was home-based palliative care, which led to the greatest observed quality of life improvements in the shortest amount of time.
This is due in part to the holistic approach home-based palliative caregivers were able to take with patients. Palliative care in the home “takes more comprehensive care of the person, taking into consideration symptoms and signs related to accompanying co-morbidities, such as stroke, renal dysfunction, pulmonary disorders, anemia, and even cancer,” according to the study.
In addition to improving quality of life, palliative care lessened patients’ future symptoms of heart failure and reduced hospital admissions, the study found.
Other recent research has explored the effectiveness of in-home palliative care services. A 2022 study found that palliative care performed in the home reduces patients’ risk of dying in the hospital, while other research showed that home-based palliative care may be able to help patients live longer.
In June, senators introduced the Expanding Access to Palliative Care Act, which seeks to create a demonstration program providing Medicare coverage for community-based palliative care services. |
Popular Nasal Decongestant Doesn't Actually Relieve Congestion, FDA Experts Say
Associated Press | By Matthew Perrone
WASHINGTON — The leading decongestant used by millions of Americans looking for relief from a stuffy nose is likely no better than a dummy pill, according to government experts who reviewed the latest research on the long-questioned drug ingredient.
Advisers to the Food and Drug Administration voted unanimously on Tuesday against the effectiveness of the ingredient found in popular versions of Sudafed, Allegra, Dayquil and other medications sold on pharmacy shelves.
"Modern studies, when well conducted, are not showing any improvement in congestion with phenylephrine," said Dr. Mark Dykewicz, an allergy specialist at the Saint Louis University School of Medicine.
The FDA assembled its outside advisers to take another look at phenylephrine, which became the main drug in over-the-counter decongestants when medicines with an older ingredient — pseudoephedrine — were moved behind pharmacy counters. A 2006 law had forced the move because pseudoephedrine can be illegally processed into methamphetamine.
Does evidence show a benefit?
If the FDA follows through on the panel's recommendations, Johnson & Johnson, Bayer and other drugmakers could be required to pull their oral medications containing phenylephrine from store shelves. That would likely force consumers to switch to the behind-the-counter versions of the pills or to nasal sprays and drops that contain phenylephrine, which are not under review.
This week's two-day meeting was prompted by researchers at the University of Florida, who petitioned the FDA to remove phenylephrine products based on recent studies showing they failed to outperform placebo pills in patients with cold and allergy congestion. The same researchers also challenged the drug's effectiveness in 2007, but the FDA allowed the products to remain on the market pending additional research.
That was also the recommendation of FDA's outside experts at the time, who met for a similar meeting on the drug in 2007.
This time, the 16 members of the FDA panel unanimously agreed that current evidence doesn't show a benefit for the drug.
"I feel this drug in this oral dose should have been removed from the market a long time ago," said Jennifer Schwartzott, the patient representative on the panel. "Patients require and deserve medications that treat their symptoms safely and effectively and I don't believe that this medication does that."…
Read Full Article |
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