December 2, 2021

Lots of work, little pay

Nursing homes, care agencies struggle to keep aides

Joe McIntyre/staff photographer

Certified nurse’s assistant Heather Thompson tells a resident it is time for lunch Thursday at Northwoods Rehabilitation and Nursing Center in Moravia.

Cayla Catalano, a certified nurse’s aide at Northwoods Rehabilitation and Nursing Center in Moravia, loves her job. Whether it’s helping to feed the elderly residents or helping to bath them, she enjoys helping people.

But the career is much harder than she expected.

Some residents require more care and attention than others, and depending on their condition could be difficult to work with. The work is demanding and nonstop with little time between duties, she said.

And the pay isn’t great.

About this time every year, nursing homes and home aide agencies are able to fill their vacancies with an assortment of recent graduates eager to begin their career as a nursing aide.

But by this time next year, they’ll have to do it all over again, because few stick with the job.

“The turnover rate is high, somewhere around 75 percent,” said Deb English, administrator for the Northwoods. “It is not just here. It is the whole industry.”

Shortages like that are leaving some in Cortland County unable to get the care they need.

Elizabeth Haskins, director of the county Area Agency on Aging, said the agency provides a service where aides will go to an elderly person’s house and help for two to four hours with nonmedical aide services, such as helping them bath and get dressed. The agency contracts with other agencies to get the aides, but Haskins said there has been a struggle to get them.

Due to that, the agency can’t get aides to elderly people around the outlying areas of the county.

“It has been a huge issue around the state,” Haskins said.

The industry is growing, too, needing more people to fill the open positions.

The United States has about 3 million home health aides and personal care aides, according to the federal Bureau of Labor Statistics. By 2026, expect that number to expand 41 percent, adding another 1.2 million jobs. It is by far one of the fastest-growing professions in America, as the average growth rate for all other occupations is just 7 percent.

The need stems from the aging Baby Boom generation and growing elderly population, the bureau reports. However, the need doesn’t change anything about the low pay and high emotional demands that may cause many to leave the job.

A recent report by Mercer, a global consulting firm and health care adviser, stated there would be 423,200 job openings for home health aides by 2025, yet a projected 446,300 vacancies for the position.

English said there is no simple answer to why many leave the job. But she acknowledged pay is an issue for many.

Catalano said she feels aides across the industry are not paid enough for the work they do. Especially when there are workers in the fast food industry making 20 cents more every hour.

In 2017, the median pay for the profession was $11.12 per hour and the median annual salary was $23,130, according to the Bureau.

At Northwoods, English said the base pay ranges from $11.25 to $12.50 an hour. “There is a lot of demand for time,” English said, as the 36 resident in Northwoods need to be taken care of all day.

Someone hired for a day shift may get asked to work late at times, especially if the center is short staffed, she said.

“No facility doesn’t want to pay its workers what they deserve,” English said.

The state is looking to gradually increase minimum wage to $15 an hour –– still leaving aides to make as much as a fast food worker. And the pay increase could be a burden on nursing homes that would have a hard time covering the pay hike.

She said it seems like the industry can’t get the state to recognize it and reimburse health care facilities to be able to better pay their workers.

“Low pay is a direct result of substantial and persistent cuts in payment rates to providers, which were low to begin with,” said Tom Threlkeld, deputy director of policy and communication for the National Association for Home Care and Hospice. “The overall profit margins at home health agencies is close to 2 percent. Many agencies often lose money on Medicaid and Medicare Advantage patients.”

Agencies tend to lose workers to other professions that pay better. The profession of a social and human service assistant, which has the typical entrylevel education requirement of a high school diploma or equivalent, has a median hourly pay of $15.92 and median annual salary of of $33,120.

In New York, the median annual entry-level pay for a retail sales clerk is $22,300, according to the state Department of Labor. But an experienced retail worker could make $31,930. According to the department, a home health or personal care aide has an experienced median pay of about $26,000 to $28,000 in New York.

“These folks work really hard,” Haskins said. “It is an important job.”

She would like to see the pay for the profession increase somehow.

While Northwoods has a turnover rate of 75 percent, English said she has a group of aides who are dedicated to the profession. One has worked for the center for eight years.

Catalano has worked there for three years and she said plans on staying for a while. That Northwoods is a small facility allows her to get to know all the residents and their needs well.

With some students who come out of school and begin working for the center, English said she thinks some find the tasks of working with the elderly people more difficult than they expected. Some residents at the center can be difficult to deal with, she said. Some aides can’t handle that.

At the moment, the number of beds and number of aides needed at the center has stayed steady, English said.

But as regulations change, the number of vacancies for aide positions could increase.

Filling them may not get any easier, as English acknowledged the profession is “demanding and does not pay great.”

But there are some like Catalano who are passionate enough about the work they want to stick with it.