Executive Order Expanding Apprenticeships Could Ease Staffing Shortages in Nursing Homes, Assisted Living Facilities

An executive order to consolidate federal workforce programs could address workforce shortages among senior living and other aging services providers by expanding apprenticeships, according to an article penned by Kimberly Bonvissuto, writing for McKnight's Senior Living. This comes at a critical time given that Biden era staffing mandates have been stuck down by a federal court.

Trump signed an executive order, “Preparing Americans for High-Paying, Skilled Trade Jobs of the Future,” on April 23 with the goal of expanding and improving job training for skilled trades. The order directs the Labor, Education and Commerce departments to streamline and consolidate federal workforce programs, with a focus on expanding registered apprenticeships to more than 1 million annually.

Although the initiative is most directly aimed at the  administration’s goal to revive US manufacturing, LeadingAge Director of Workforce Policy Amanda Mead said in a written announcement that it could help alleviate critical workforce shortages in the aging services sector: 

“While the president’s executive order is widely seen as part of the administration’s push to revitalize US manufacturing, the initiative to expand apprenticeships could also benefit direct care workers — such as nursing assistants and home health aides — by offering enhanced training and alternative educational pathways beyond traditional four-year degrees.” 

Argentum is a national trade association representing senior living communities across the United States. It advocates for policies that benefit the senior living industry and its residents, serving companies that own, operate, and support professionally managed senior living communities. Argentum’s mission includes promoting quality care, operational excellence, and workforce development within the sector.

Back in 2020, Argentum  touted the success of the Healthcare Apprenticeship Expansion Program, which served more than 7,600 incumbent workers through a $6 million Closing the Skills Gap grant from the Department of Labor. The association also petitioned the Centers for Medicare & Medicaid Services (CMS) to include assisted living in an incentive program geared toward attracting registered nurses to skilled nursing facilities.

Since the 2020 grant, staffing challenges in the senior living industry have persisted and intensified, particularly due to the COVID-19 pandemic. In response, several efforts emerged to bolster the workforce:

• Workforce Development Initiatives: Argentum has continued to prioritize workforce development, launching initiatives such as partnerships with educational institutions in 2022. These programs aim to create career pathways, offering training and opportunities for individuals entering the senior living field.

• Legislative Actions: At both state and federal levels, there have been efforts to address staffing shortages in healthcare, including senior living. These include funding for training programs, loan forgiveness for healthcare workers, and incentives for employers to hire and retain staff. For instance, discussions around immigration reform in 2023 have explored allowing more foreign workers to fill caregiving roles, while some states have introduced minimum staffing requirements for nursing homes, potentially influencing senior living practices.

• Improved Compensation and Benefits: To attract and retain staff, many senior living providers have increased wages and enhanced benefits, recognizing the competitive labor market and the need to make these roles more appealing.

• Technological Innovations: The industry has also turned to technology to supplement staffing needs. Solutions like telehealth services and remote monitoring have been adopted to enhance care delivery and reduce the workload on existing staff.

In late 2023, a survey I conducted for an article (I never published) suggested that  38 states and the District of Columbia had established their own minimum staffing standards for nursing homes, but that figure was gleaned from internet searches; I could find no readily available source cataloguing the states and their staffing regulations.  I was surprised that the information wasn't more readily available since federal staffing mandates were then a hot topic.  

An Argentum spokesman told McKnight’s Senior Living:

“There are far too few caregivers to meet the needs of our rapidly aging population, and it will take an across-the-board approach to recruit and retain more than 20 million workers who will be needed across long-term care by 2040.” Three million of that 20 million will be needed in senior living alone, according to Argentum."

The American Seniors Housing Association (ASHA) told McKnight’s Senior Living that  the aging population demands a steady pipeline of workers to serve older adults living in senior living communities and other long-term care settings. ASHA Vice President of Government Relations Jeanne McGlynn Delgado appears optimistic:  

“Identifying and implementing federal training programs that can attract and grow this workforce, whether it be in retooling existing grant programs or expanding apprenticeships specifically for senior living workers, shows much promise,” ASHA ."

The American Health Care Association/National Center for Assisted Living told McKnight’s Senior Living that it continues to support making apprenticeship programs more available and accessible, including supporting the recently introduced American Apprenticeship Act to provide tuition assistance to fund apprenticeship programs:

“We’ve seen the value they can bring through our own apprenticeship partnership with Equus Solutions, who has supported some of our long-term care providers with the process. Apprenticeships are one of the many solutions we need to help recruit and retain more long-term caregivers, and we appreciate this effort to help address the nation’s growing caregiver shortage.”

Despite these efforts, staffing remains a critical and ongoing challenge in senior living. The effectiveness of these measures is under evaluation as needs increase, and the industry and governments continue to seek innovative and sustainable solutions to ensure high-quality care for residents. 

You can help.  Develop a plan to age in place.  To the extent possible, relegate institutional choices to "when and if it is absolutely necessary, and there is no available alternative."  You and your loved ones will likely experience better outcomes, and you will relieve an already burdened system.