nursing shortage update

nursing shortage update

Government and Private Initiatives Seek to Address Nurse Aide Retention and

Recruitment, but Few Have Been Evaluated

Most initiatives and research efforts to address nurse aide recruitment and retention have been undertaken by states and provider groups. In 1999, 30 states indicated that they were addressing nurse aide recruitment and retention, primarily in nursing homes and home health care agencies, through task forces, initiatives, and research. HHS has also recently begun to focus on the supply and demand of this workforce through research and planning efforts.

Initiatives intended to improve nurse aide recruitment and retention can be categorized under three major themes:

1. improved wages and benefits;
2. the development of additional training and opportunities for career advancement; and
3. additional employee supports, including improved work environments, job skills, and social supports.

In addition, many initiatives are multifaceted, addressing two or more of these areas.

The programs discussed below illustrate the types of initiatives under way.

States have taken steps to improve the wages or benefits of nurse aides by increasing reimbursement rates, primarily for aides working in nursing homes and home health care. As of 2000, 26 states had established some form of a wage pass-through, wage supplement, or related program for nurse aides and other direct care staff.

Methods of wage pass-throughs vary from state to state; participation by providers can be voluntary or mandatory, and states use different formulas to calculate the amount of money provided. According to the 2000 North Carolina Division of Facility Services survey, 4 out of 12 states that had implemented a wage pass-through reported that it had had some positive effect on recruitment and retention of nurse aides, although little data exist to substantiate this view.

While some states have reported that they are satisfied with their accountability procedures to ensure that pass-through dollars are reaching aides, concerns have been raised that funds may not always be used as intended.

Few states have addressed the issue of benefits for nurse aides. According to a 1999 study, only three states had considered or taken action to require any form of benefits for nurse aides and other workers.

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