By JULIE MINDA
The same types of factors that have been constricting the job candidate pool for frontline positions in eldercare also have shrunk the number of prospects for top administrator roles.
In recent years, exigencies of the COVID-19 pandemic have accelerated the departure of workers from the labor pool: Baby Boomers have been retiring in large numbers, burnt out workers have joined the "Great Resignation" out of the labor market or at least
into different roles, and too few newcomers are repopulating the pipeline. Ministry eldercare leaders say they are watching these trends especially closely when it comes to the pipeline of candidates for top administrator positions in continuum-of-care
They say they are continually seeking new ways to identify prospective candidates who are the right fit for ministry leadership and to illustrate to these prospects the many rewards of being a leader in the Catholic health ministry.
"It's truly a calling to care for the aged — it's a vocation and a ministry. It is challenging but also rewarding work," says Sr. M. Peter Lillian Di Maria, O CARM. "But there are not always enough people to fill these positions. We're all vying
for the same group of people."
Sr. Di Maria is a member of the leadership team of the Carmelite Sisters for the Aged and Infirm, a congregation that sponsors, co-sponsors and serves at more than a dozen eldercare campuses in Florida, Illinois, Iowa, Kentucky, Massachusetts, New York,
Ohio, Pennsylvania and Ireland. She also directs the congregation's Avila Institute of Gerontology.
She says eldercare facilities are looking for people with a desire and passion to guide the care of the elderly and who have the skill set to do so effectively. "When we find those people, they are a treasure!" Sr. Di Maria says.
Post-traumatic stress disorder
Jenna Kellerman is director of workforce strategy and development for LeadingAge, an organization representing nonprofit aging services providers. She says it is common in nursing homes
for residents and staff to be very close — almost like family — since they spend so much time together. So, when COVID-19 took lives and impaired the health and wellness of residents and staff, the impacts hit administrators very hard.
Kellerman notes that many administrators took on additional roles to fill the gap of vacant positions. Some administrators even slept at the facilities they oversaw. The degree of many administrators' personal investment made the pandemic especially
daunting for them. Research is showing that staff who were on the front lines of COVID-19, such as aging services professionals, are at risk for post-traumatic stress disorder due to the trauma they experienced working during the pandemic, Kellerman
says. She adds this is contributing to retirements and resignations.
Sr. Di Maria says that stress among health care workers — including administrators — was a problem before 2020 but the extreme pressures brought on by the pandemic greatly increased burnout.
She adds that many of the people who have departed from such roles in the ministry were part of the first generation of laity to be formed alongside men and women religious.
Kevin Law is director of talent acquisition for Trinity Health Senior Communities, which has 24 senior living and health care campuses in Connecticut, Indiana, Iowa, Massachusetts, Michigan and
North Carolina. He says recent dramatic shifts in the eldercare job market also are due to job candidates having many choices, with the same skill sets prized in many settings. Many job seekers are opting for gig economy work, he adds. Sr. Di
Maria notes many also want a better work-life balance, remote work and reduced hours — perks often unavailable in long-term care administrator roles.
Laura Campbell, Benedictine senior vice president for people development, says given such pressures, there is a "shrinking market" of candidates, including for these positions. She says candidates qualified to apply for such positions are heavily
Kathleen Murray, Benedictine director of workforce solutions, adds that the pipeline issues are compounded because of recent shifts in eldercare: Since such organizations are adding assisted living options to campuses, administrators must be certified
to run not only nursing homes but also assisted living sites. Benedictine has more than 30 communities across Illinois, Minnesota, Missouri, North Dakota and Wisconsin.
Allison Q. Salopeck, president and chief executive of Jennings, says anticipating vacancies in administrator roles "is a topic we always have to pay attention to." Jennings has four campuses in Ohio.
Especially given the dynamics of the eldercare job market, Law says it is ideal to build the pipeline to the top administrator positions from within an organization.
Salopeck agrees. She says: "We need to always ensure we're cultivating the type of leadership in our organizations" that will build a solid pool of people who have a love of serving elders, alignment with the Catholic health mission and the capability
to guide the organization in achieving that mission.
To do this at Trinity Health Senior Communities, Law says that organization focuses on understanding what it is about the culture that makes people want to stay and then investing in and bolstering those areas. The organization also pays constant
attention to succession planning. And it remains in communication with all staff about their job satisfaction, so it can quickly identify issues that could spark an exodus. It addresses problem areas right away, Law says.
All the ministry eldercare leaders who spoke to Catholic Health World say their organizations are very intentional about keeping an eye out for mission-minded staff with leadership potential. The organizations have — or are in the process
of developing — formal programs to help those staff build up leadership capabilities so they can advance if they wish to. The programs include formation in the organizations' spiritual heritage. Jennings' program is "Reach"; Trinity Health
Senior Communities, "Emerge"; and the Carmelites, "Roots of Caring."
Many of these organizations also have developed mentorship programs to give budding executives support.
LeadingAge offers multiple programs for people aspiring to executive positions in eldercare. It is developing a fellowship to increase diversity in eldercare administration.
The eldercare organizations also work to develop the external pipeline, including by countering misconceptions about working in eldercare and building awareness of the positives of a career in that
field. LeadingAge's Kellerman says such education of the public is needed because long-term care is not generally seen as an on-the-radar, highly desirable career path, in part because of U.S. society's focus on youth over old age.
Salopeck says Jennings has established programming to expose students from high school up to the many types of job opportunities at continuum-of-care sites.
She notes that Jennings is fortunate to be in a state where multiple top universities have developed curriculum and programming around long-term care career preparation. Jennings takes part in internship and administrator-in-training partnerships
with the universities. Those programs have steered multiple people with an interest in eldercare administration to Jennings. Other executives say their systems have forged similarly effective educational partnerships. Some say they are looking
to expand the partnerships significantly.
Law says beyond those educational partnerships, Trinity Health Senior Communities is working on other ways of building awareness of and interest in ministry eldercare roles. The organization is attuned to how it and its leadership are interacting
with the community.
"We don't just sit back, we need to be constantly innovating our processes," Law says. "This includes projecting our values and culture to the market and making sure we have a strong employment brand."
He says the organization uses its marketing and social media to tell the stories of the important work that goes on at Trinity Health Senior Communities. It also encourages employees and executives to be ambassadors for the system's sites. Those relationships
between the informal ambassadors and people in the community can be leveraged to attract candidates into the pipeline to top positions.
Murray too says it's vital that people outside the organization know the powerful work going on inside facility doors. "Our faith-based work is definitely a selling point for us," she says. "People join and stay for the right reasons and it's a beautiful
culture and people do purpose-driven work here."
Sr. Di Maria says if more people were aware of the life-changing vocations available to them in long-term care, "they'd be banging down the doors to work here."
Studies show staffing shortages, pressures remain in eldercare, including for administrators
Research is bearing out that considerable staffing challenges continue for eldercare systems and facilities, and this includes when it comes to top leadership at those organizations.
- According to a poll the LeadingAge nonprofit conducted among its membership of eldercare sites
in February and March, 64% of the nearly 900 respondents said the workforce crisis had not improved since LeadingAge last queried on the subject in June 2022.
- That same poll found 92% of nursing home respondents and nearly 70% of assisted living respondents report significant or severe workforce shortages.
- In the poll 78% of respondents said staff were leaving eldercare for better pay; 53% said they were leaving for better schedules; and 73% said staff were leaving because of burnout.
- An analysis of Bureau of Labor Statistics data by the American Health Care Association and National Center for Assisted Living showed that nursing homes have lost 210,000 employees over the course of the pandemic. The AHCA/NCAL released this analysis in January.
- In that reporting, AHCA/NCAL said that at the current rate of hiring, nursing homes would not return to pre-pandemic staffing levels until 2027.
- McKnights Long-Term Care News found in its 2022 Mood of the Market survey that about 52% of long-term care facility administrators had considered leaving their jobs in the three months prior to the survey.
- According to March 2022 reporting in Skilled Nursing News, in a survey the publication conducted, 58.6% of respondents said they expected the administrator hiring climate to get harder. About 32.5% of respondents said hiring administrators
has been increasingly challenging because there are not enough qualified applicants. The total respondent count for the survey was 116 operators of small, midsized and large nursing homes.
- In the same survey, 65.2% of respondents said they expected administrator retention to get harder. More than 48% of those surveyed said retention had gotten harder due to pandemic-related burnout and current operating challenges.