Dear Friends,

We are in the midst of a caregiver crisis, and the consequences are dire. Since January 2020, an alarming 400,000 nursing home and assisted living staff have left their positions. They cite exhaustion from the ongoing pandemic, coupled with the low pay and lack of advancement opportunities characteristic of the field. This exodus of caregivers arrives at a time when America is already grappling with a shortage of caregivers for its aging population. Every day, 10,000 individuals in the United States turn 65, and birth rates are on the decline. The impact of the nationwide labor shortage is most acutely felt in home health care, a sector that is projected to grow by 33 percent in the next decade, significantly faster than most other occupations. Despite this growth, there are simply not enough workers to meet the ever-increasing demand.

The numbers alone indicate the urgent need for more caregivers in the sector. However, the solution to the crisis is not merely a matter of quantity; it's also about quality. Higher wages and opportunities for career advancement are critical for retaining caregivers. In reality, the root of the issues facing the long-term care industry is not a shortage of workers but a shortage of wages. Most direct care aides are compensated at rates equivalent to fast-food workers, earning between $13 to $15 per hour, often living below the federal poverty line and frequently lacking access to health insurance.

The workloads of caregivers are excessively heavy, with many being responsible for far more patients than they can reasonably manage. For instance, a Certified Nursing Assistant (CNA) should typically be responsible for seven residents, but many are expected to care for 12 or even as many as 25 individuals. The resulting burnout leads to high turnover rates, as employees seek less stressful work elsewhere, even if it pays similarly.

The onus is not solely on the industry to self-correct. Government intervention is also vital in instigating these much-needed changes. The Biden administration has proposed a series of executive reforms aimed at addressing these issues, such as increased oversight of nursing home ownership, greater financial transparency, and the establishment of minimum staffing standards, which have been found to be lacking in nearly every state. It's a sobering fact that 75% of all nursing homes have inadequate staffing, a reality that research has indicated for two decades but became glaringly obvious during the pandemic. Lower RN staffing levels during the pandemic correlated with increased nursing home COVID-19 infections and deaths.

While federal efforts are commendable, more needs to be done to rectify the situation. Many promising initiatives are emerging from states, which have the flexibility to regulate how nursing homes allocate their funds. States like New York, New Jersey, and Massachusetts have set "direct care ratios," limiting profits to direct more funds toward care, especially important in an industry where 70% of nursing homes are for-profit. Since the pandemic's onset, five states have permanently increased nursing home staffing requirements, while four have enacted laws or regulations for higher nursing home wages.

The responsibility also falls on nursing homes to provide decent wages and benefits, as changes are unlikely to occur without external pressure. In the absence of policy changes, America will become a country where its seniors do not live or die with dignity. The quality of care will deteriorate, with fewer baths, less assistance with daily activities, and more transmission of disease. The workforce will become understaffed and demoralized, resulting in more bedridden seniors, increased falls, and general neglect.

The McKinsey report paints a grim picture of the nursing shortage. As early as 2025, it predicts that there could be a shortfall of 200,000 to 450,000 nurses available for direct patient care, representing a 10 to 20 percent gap. The report emphasizes that the situation will only worsen without immediate action.

The solution is multi-faceted. We need to attract more individuals to the nursing profession, making it an attractive and appealing career choice. Nursing schools should be expanded, and there must be more educators, clinical rotation spots, and mentors available for the next generation of nurses. Innovative arrangements need to be forged, connecting potential candidates with employers and creating new pathways into the profession. Furthermore, healthcare providers need to innovate their care delivery models to maximize nurses' time and energy.

The time to act is now. Our elderly population deserves care with dignity and respect. The caregivers who provide this care deserve fair compensation, decent working conditions, and opportunities for advancement. We must push for meaningful policy changes at both the federal and state levels and advocate for a more equitable and sustainable caregiving system.

We invite you to sign and share our petition to support family caregivers and the entire long-term care industry. Together, we can create the change we so desperately need.

Please sign and share the petition, for the future of caregiving in America and the well-being of our loved ones.