The long wait for hiring new employees due to waiting on provisionals from the background check unit is causing great hardship and staffing issues in assisted living homes and other health care facilities. To support staffing and quality of resident care, we need to shorten the time it takes to receive a provisional status for new hires of health care workers.
 
During the COVID pandemic, the BCU process was adjusted to accommodate the difficulties presented by the pandemic. The adjustments during this time enabled new hires to begin work within a day or two. This was an eye-opening experience for me, as I soon discovered that the shorter process solved the majority of our staffing issues! As an administrator for 11 plus years of two 12-bed facilities, I can say that for the first time in my career we were rarely short staffed and I was not working 60 to 80 hours 7 days a week.  During this time, staff turnover was at the lowest it had ever been, critical incidents were at the lowest they had ever been, staff burn out was at an all-time low, quality of life for residents was at an all-time high.
 
Since the delayed process has started again, we are again having difficulty in maintaining adequate staffing leading to an increase in staff burn out, manager burnout due to the stress of needing to cover shifts, incidents with residents, and overall lower employee morale. Despite the many improvements we’ve tried over the years to better support our staffing, it has been and continues to be the greatest difficulty in our ALHs, EXCEPT when the BCU could clear staff to provisional same day or next. Many state agencies (APS, ombudsman, Cert. and Licensing) have shared over the years that there are widespread issues in staffing and bed shortages in ALHs across the state. I know we can fix this issue IF we make the appropriate changes. 
 
If we don’t make changes now, I believe we will continue to experience staffing issues and even see more assisted living homes close, leading to more loved ones being sent out of their local area or the state for housing. ALL THIS CAN BE PREVENTED! 
 
HERE ARE THE CONFLICTS WE EXPERIENCE WITH LONG HIRE WAITS:
 
·      Applicants often cannot financially afford to wait 2-3 weeks to start work. As a result, they will find other employment while waiting on the background check clearance.
·      Waiting extended periods of time for new hires can and will increase employee burnout when short staffed. Due to the burnout, some staff may quit while new hires are waiting to start, which leaves us even more in a bind.
·      When new staff finally arrive, there may be limited staff to train and training can be rushed and not adequate.
·      Management step down due to the stress of having to continually pick up shifts and cannot fulfill their managerial responsibilities with so many shift openings.
·      Applications may be rushed due to the urgency of staff needed, due to the long waits for new hires.
·      Staff may look great on paper and for the interview, but the true interview happens during training.  Many new hires do not work out during training; this results in an additional 2 to 3 weeks wait to find new staff to replace inadequate hires which again further compounds the problem (this one can be one of the worst situations and happens often). 
·      OT increases causing a financial burden on the home.
·      Quality care for residents go down due to staff fatigue. Critical incident reports increase for falls, med errors, etc.
·      Families (husbands, wives and their children) of staff suffer due to their family member being called upon to help fill shortages (family vacations cancelled, time with loved ones cancelled, etc). Myself, my wife and 5 children feel the stress of this continually.
·      New residents are not accepted into homes at times due to low staffing. 
 
With the BCU returning to the “old normal” we have seen the same issues quickly return and even more so with COVID here to stay. I believe we will see an increase in CIR’s, an increase in staff turnover, and possibly more homes closing if we don’t make changes for the future of the healthcare field. An administrator called me just 2 weeks ago, saying “I don’t think I can do this anymore, it’s just too hard to maintain the staffing”. They shared they plan to close their home soon. Fairbanks Memorial Hospital, the Fairbanks Pioneer home, and every ALH I know in the interior are currently struggling with low staffing.  
 
This cannot continue.  If we are to be successful in this field of service, I KNOW THE ANSWER.  It was revealed through the tragedy of COVID, and for the first time in 10 years I could easily maintain adequate staffing most of the time. COVID has imposed a “new normal” for many areas of our lives and we need to discover the “new normal” for the BCU process to support better staffing, especially with COVID.  When provisionals are issued through doing checks on courtview, APSIN, Prober, OIG, JOMIS, Alaska Professional Licenses, and the National Sex Offender Registry to determine whether a provisional background clearance can be given, clearance can be given in hours instead of weeks. COVID does not appear to be going away.  It is currently increasing again, and we need to make changes now before it’s too late. If a facility experiences a COVID outbreak, staffing is one of the scariest issues as you may lose a large portion of your workforce and cannot adequately provide for the residents’ needs. We need a system that works with us and not against us. We need decreased wait times for new hires. 
 
We can do this! Only if we work together for a better community and for the future generations of healthcare workers who will carry the torch in the medical field.  We can fix this issue, but we must let our government agencies know what we are struggling with!