HP 626 week 6 discussion 6 1 management challenges in operating long term care discussion questions

Sample Answer

Discuss challenges that long-term care communities face. What makes these challenges more prevalent in long-term care?

According to White et al. (2019), the work environment, burnout of registered nurses and job dissatisfaction, are presented as challenges faced in long term care centers.

In a cross-sectional study of work environments, it was found that those which function well, are adequately staffed, have strong leadership, policies, and relationships with colleagues (White et al., 2019).

Additionally, those with positive work environments were offered opportunities for advancement as well as the privilege of contributing to affairs of the organization (White et al., 2019). Overwork, understaffing and job dissatisfaction seem to be the key factors in nurse burnout, inability to keep staff retained. All of this contributes to poor quality care.

I think these challenges are more prevalent in long term care due to the increased aging population. Nursing homes are at their limit with admissions, and the medical acuity of the patients is increased, as they are being discharged from the hospital to long term care facilities sooner and sooner after illnesses and surgeries.

Identify trends and root causes of these challenges. Are there possible solutions to these causes?

According to American Health Care Association & National Center for Assisted Living. (2020), one of the root causes of the challenges faced by long term care facilities is driven by Medicare underfunding. Following the pandemic, these strains have become exacerbated.

It is important that Medicare reimbursements are congruous with the actual cost of care. The exodus of nursing home staff in the last 3 years is related to the onset of Covid-19, which placed the workers at high risk of contracting the illness, as well lack of payment for needed time off due to the pandemic.

This lead to a significant level of burnout among support staff, and thus left the nursing homes with a staff shortage. It is reported that lack of interest is at the top of scale of reasons why the nursing homes are not recovering post Covid (Heiks & Sabine, 2022).

Financial concerns loom heavily as the cost of agency nurses and support staff have higher rates; they have either doubled or tripled since the pandemic (Heiks & Sagine, 2022).

As far as solutions, an increase in Medicare and Medicaid reimbursement from the government would be advantageous. Additionally, I think that there should be a cap on the hourly pay of nurses and support staff who are agency personnel or travelers.

This practice reminds me of selling tickets to a sold out concert for an inflated price, it isn’t fair, and it isn’t just.

Analyze labor challenges within long-term care and possible causes of the challenges.

I have spoken about the labor challenges above in terms of nursing and support staff above. The causes tend to lie in the working conditions within the facilities and lack of funding to improve the conditions, it is a double-edged sword.

The involvement of the government with increasing reimbursements will be helpful. As this population ages, there will be exponentially more people requiring long term care and less and less institutions to provide if nothing is done.

According to Amirkhanyan et al. (2008), it seems that the status of ownership has a bearing on the quality of care. The for-profit agencies have been notably poorer in performance than public and nonprofit agencies. Perhaps the difference in approaches should be examined more closely to make detailed comparisons in an effort to raise for-profit agencies to a higher level of care.

Explain federal policy gaps for addressing disparities among long-term care organizations.

Federal policy is such that it supports minority health and protects the well-being of long- term facility residents. According to Mauldin et al. (2020), revisions need to be considered for The Patient Protection and Affordable Care Act of 2010, as well as updated requirements in the Long- Term Care Ombudsman Program, to require data collection that includes racial, ethnic, and demographic information (Mauldin et al., 2020).

An ombudsman is a representative advocate for those individuals living in nursing homes and assisted living residences with a goal to promote quality care (Commonwealth of Massachusetts, 2024).

Are there solutions you would implement as a leader in a long-term care facility? Provide examples of how you would lead an aging service organization through these challenges.

As a leader in a long -term facility, these challenges can be far reaching. Since there is a major issue with funding, I believe that I would become active in the political arena, contacting my state Senators as to the crisis that is being faced by the long -term care industry. I would collect pertinent data supporting the claims of shuttered long term care establishments due to lack of funding.

In terms of job retention, there would need to be a total makeover of the amenities that are offered to staff in terms of benefits and performance bonuses. I believe that a solid assessment by an outside source would be advantageous in terms of the feasibility of providing these opportunities, in terms of economic feasibility.

Some incentives can simply be time off for performance as well, perhaps just 2 hours once in a while, to get out earlier as a recognition of exemplary care and service. Due to the budget constraint, the rewards cannot be lavish, but recognition and respect, no matter how small, go a long way in the eyes of the worker who feels appreciated. With all of this, perhaps retention, morale, motivation and pride in the company would ensue, resulting in a solid, happy, workforce.

References

• American Health Care Association & National Center for Assisted Living. (2020). Financial challenges continue to affect nursing homes, emphasizing need for higher Medicaid reimbursement rates. https //www.ahcancal.org/News-and-Communications/Press-Releases/Pages/Financial-Challenges-Continue-To-Affect-Nursing-Homes,-Emphasizing-Need-For-Higher-Medicaid-Reimbursement-Rates.aspx
  
• Commonwealth of Massachusetts. (2024). Massachusetts long-term care ombudsman program. Mass.gov. https //www.mass.gov/orgs/massachusetts-long-term-care-ombudsman-program
  Heiks, C., & Sabine, N. (2022). Long term care and skilled nursing facilities. Delaware journal of public health, 8(5), 144–149. https //doi.org/10.32481/djph.2022.12.032
  
• Mauldin, R. L., Lee, K., Tang, W., Herrera, S., & Williams, A. (2020). Supports and gaps in federal policy for addressing racial and ethnic disparities among long-term care facility residents. Journal of gerontological social work, 63(4), 354–370. https //doi.org/10.1080/01634372.2020.1758270
  
• White, E. M., Aiken, L. H., Sloane, D. M., & McHugh, M. D. (2020). Nursing home work environment, care quality, registered nurse burnout and job dissatisfaction. Geriatric Nursing, 41(2), 158–164.