LOWVILLE — Lewis County Health System is upping its game to overcome a critical challenge in providing quality nursing home care: the chronic shortage of certified nursing assistants and licensed practical nurses.
Chief Executive Officer Gerald R. Cayer announced Friday that the health system is introducing “a new way to scale” pay that will shift compensation for CNAs to start at $20 per hour with the pay grade topping out at $23. Each pay level for LPNs will be increased by $2.50 hourly.
“We want to bring people in with some speed, so we are blending four steps of wage scale to get to $20,” Mr. Cayer said in an interview later in the day,”Existing people are already on various steps on the scale, but those on the first four steps will be brought up to $20.”
The starting step hourly wage right now that will increase is $13.98.
For practical nurses, the scale will change from steps between $19.68 and $25.00 per hour to $22.18 hourly to start with $27.58 at the top of the scale.
Mr. Cayer prefaced the announcement by saying these health care provider groups are “the backbone of long-term care” at the Lewis County Residential Health Care Facility and to long-term care in American society “as a whole.”
“It’s one of the most difficult jobs in our health system and we want to recognize it. In order to do that, we need to think outside the box.” Mr. Cayer said. “Traditional approaches to recruiting and retaining are not working and so we’re trying to do it differently.”
Redefining the wages isn’t just about better compensation in the present, but about creating a better work-life balance to improve the retention of an employee group with a notoriously high turnover rate that has only increased with the COVID-19 pandemic.
The pandemic has added a new level of appreciation for CNAs and LPNs at the nursing home, Mr. Cayer said, noting that most of the female-dominated team has a tremendous amount of caregiving to do in their own lives as often single parents, grappling with homeschooling and an urgent lack of child care that has been taxing society as a whole, while many also care for their own parents or other family members.
“Lewis County has made a very strong commitment to ... long-term care services. In order for us to be able to fulfil that commitment, we need to have the best work force that we can pull together,” Mr. Cayer said.
While up to now, the nursing home has offered wages on-par with other area facilities, the benefit package they are able to offer as a public hospital from health insurance to the state retirement system may have given them an edge, but this wage — which will mean an annual wage of at least $40,000 — could help the facility offer more flexible schedules, cut down on the overtime aids and practical nurses need to work and in some cases, eliminate the need for a second job.
In return, the facility hopes to recruit between 25 and 35 new CNAs who are compassionate, empathetic, enjoy senior citizens, are hard workers, have a work ethic — meaning, he clarified, that they actually come to work — and are team players.
According to Mr. Cayer, the staff-to-patient ratio the nursing home management team works to ensure is one-to-eight on the day and evening shifts and one-to-twenty on the overnight shift.
To date, that has been accomplished through as significant amount of staffing through agencies and, often to the detriment of the work-life balance, - through “mandating,” or requiring staff to stay late or work a double shift when other aids come in late or don’t show up at all.
Mandating staff is a common practice in nursing homes and a staff member’s refusal to fufill that mandate could lead to dismissal, even if it’s for a good reason. A number of CNAs working at nursing homes in both Jefferson and Lewis County have contacted the Times about the lack of fairness in this practice.
Mr. Cayer and his team agree. He said they are striving to have a “mandate-free” workplace at the residential center. The higher pay scale may be the key to reaching that goal if it elevates staffing levels.
Money that has been used for sign-on bonuses, the use of agencies to fill gaps at higher rates and the money made available by a decrease in overtime hours will be used to finance the wage increases, Mr. Cayer said.
Better staffing levels will also make it possible for a better revenue stream because more residents can be admitted to the facility.
“We have a waiting list, but we want to add to the team of CNAs and LPNs, and we want the right mix of seasoned, experienced people and new people to those fields,” Mr. Cayer said.
The same wage scale changes will not apply in the hospital facility or through the Healthcare System’s Home Care division, although Mr. Cayer said discussions with the local Civil Service Employees Association are ongoing through contract negotiations that will be completed in about six months.
The more immediate change for nursing home employees has been necessity-driven by the market, he said.
“If this doesn’t work then we have to re-evaluate if long-term care can be a part of our future. We think this can work,” Mr. Cayer said.
With this change, Mr. Cayer said the health system is living its values: emphasizing integrity, compassion, accountability, respect and excellence.
“We really want to support progressive actions for a liveable wage,” Mr. Cayer said.
Hospital administrators, the human resources manager, the local Civil Service Employees Association union and the Board of Managers have been working to make this change for the past five weeks, Mr. Cayer said.
“We wanted to introduce an initiative and a real commitment to fully deliver long-term care by recruiting more and retaining more quality aides,” Mr. Cayer said in an interview.
The changes in wage scale will begin June 28.