Home health workers are quitting in droves. What gives?

A survey of 140 home health agencies in Maryland and Virginia says that droves of home care workers have quit in recent years to work at hospitals and nursing homes. The question comes amid…

Home health workers are quitting in droves. What gives?

A survey of 140 home health agencies in Maryland and Virginia says that droves of home care workers have quit in recent years to work at hospitals and nursing homes.

The question comes amid concern that a shortage of available home health care workers could cause delays in patients’ discharge from the hospital, damage patient outcomes and ultimately impact the health of states and the country.

The survey, based on interviews with about 100 workers who responded to a survey from the National Association of Home Care and Hospice, found that nearly a quarter of those surveyed had left the home health care industry in the past four years for employment at facilities other than their own. About 8 percent had left to work for other home health care agencies, for-profit or nonprofit.

It’s not clear whether the people who have left home health agencies are leaving because they were unsatisfied with their jobs or whether they’re choosing a different career. But the researchers cited data suggesting that leaving a job in the home health care industry is similar to quitting a job in the professional or managerial industries, such as investment banking or medicine.

“When you’re saving a patient in their home, you’re saving a patient’s life,” said Kamel Jemaa, research director at the Center for Public Health Advocacy, which coordinated the survey. “And when you do have this situation where you can’t continue to treat people, it’s a crisis for home care.”

Home health agencies are at a critical point: The U.S. unemployment rate has reached its lowest point in nearly four decades, which is enticing workers in other fields to seek out jobs in home health care agencies.

As home health care workers leave, family members typically take on the work in the home. About three-quarters of respondents to the survey said they were willing to do so. But the survey showed that about a quarter of workers, based on the most recent data from the Bureau of Labor Statistics, said that their family members were not willing to do the work.

The survey found that home health agencies have a core group of employees who stay for the long haul. In the Maryland and Virginia regions, home health care agencies reported that 80 percent of staff were in their positions for at least four years.

Although there has been some increase in vacancies from 2014 to 2016, home health agencies’ staffing is still far from being enough.

John McDonough, who was laid off in July after working for 10 years at the Nashville-based Home Care Association of Virginia, said that both of his children have been diagnosed with HIV. One of his children receives treatment from an out-of-state doctor.

“The nurse that I used to see wasn’t up to the task of taking care of that,” he said. “I did my best to keep it on the up and up and maybe even get them in a bed, but they’re still needing medications at this point.”

Because of the lack of additional staff at his office, the home health workers were working too many overtime hours to keep up with the more complex care. His organization has been able to attract new staff, McDonough said, but the local economy isn’t helping.

“The Affordable Care Act is definitely affecting the number of employed people in nursing homes,” McDonough said. “They don’t want to fire somebody and let them go and say, ‘Sorry. We don’t have anybody here.’”

Increasing the size of the workforce to solve the problem could be tricky.

In some places, for example, that increase in workers could hamper the quality of care provided to the patients. At the same time, the United States is aging and will soon have a need for more caregivers. If home health care remains an important part of this sector of the health care industry, the sector will need to raise its standards and keep up with a demand for workers that is likely to increase for the foreseeable future.

At the same time, it will be difficult to compete with other jobs on the market, said Jonathan Tamari, an economist at the University of Texas at Austin.

“The market is starting to devalue home health care,” he said. “So wages are falling and the overall quality of service is being affected.”

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