Research from the Institute for the Future of Aging Services indicates that annual staff turnover levels in home health care companies can vary between 60 and 100 percent across the nation. An article appearing in USA Today last week reflects on the issue, pointing out that turnover can have a significant impact on the quality of care received by clients. It's these hands-on caregivers who are interacting with patients day in and day out, learning specific wants and needs and forming relationships.
So when these front-line staff are like a revolving door, seniors lose the feeling of security that comes with consistency. High turnover rates also impact the frequency of errors, as it often takes several months on the job to get a firm grasp on daily routines and procedures.
Is pay the problem?
Part of the problem, according to some, is the low pay common to home health aides in these settings. In December, the U.S. Department of Labor issued new rules requiring home health care agencies to pay their employees minimum wage and overtime. Currently, the federal minimum wage is just $7.25 an hour.
Still, some employees are making less than $7.25 per hour. Twenty-one states have regulated the industry requiring agencies to comply with the minimum wage, yet those who have not still frequently encounter pay less than the federal minimum wage. Further, the concept of time-and-a-half for hours worked over 40 per week causes further complications. According to Catherine Ruckelshaus of the National Employment Law Project, agencies will typically enlist several workers to fulfill client needs when they exceed the 40-hour threshold. This avoids the necessity of paying overtime, yet creates inconsistency for the seniors being cared for.
The Center for Business and Economic Research at Ball State University found that since 2000, employment in the home health care sector has increased 23 percent, yet salaries have remained stagnant. Another study conducted by the Carey Institute at the University of New Hampshire finds that the average hourly wage for home health care workers in New Hampshire is $10 per hour. More shocking is that 70 percent receive no paid leave and a mere 20 percent receive healthcare through their employers.
Better pay for better care
Kristin Smith, a University of New Hampshire family demographer, notes that research has shown a clear link to higher wages and higher quality of care. Yet agencies fight against regulations requiring overtime and other benefits, pointing out that those increased costs would have to be passed on to seniors, making home health care considerably more expensive.
So what's the solution? An already struggling healthcare system can't realistically alleviate more of the cost burden than it currently does through programs such as the Medicaid Waiver. Yet as more seniors require in-home care, the industry must adapt to changing economic demands to hire qualified caregivers.