Human Resources

Discuss leader's perspective on human resource management connecting with course concepts, include citations. Reflect on what you learned, connecting with course concepts.I recommend a paragraph summarizing your leader's perspective on the topic followed by a paragraph reflecting on his/her responses, connecting with course concepts. For example, how does what your leader shared, compare or contrast with what you learned in class.

L10 Long-term Care Workforce

As we discussed in Lesson 1, the United States population is aging. By 2030, projections suggest that one in five Americans will be age 65 or older. Likewise, studies suggest that nearly 70% of older adults will require some form of LTSS for an average of three years. Therefore, to meet the demand for services, there is an increased need for a high-quality workforce. Currently, a snapshot of the LTSS industry workforce suggests the sector employs an estimated 4.7 million workers.

For simplicity sake, let's divide the workforce into four broad categories as illustrated in Figure 10.1: Categories of the LTSS workforce.

Figure 10.1. Categories of the LTSS Workforce

Direct Care Workers

Professional and paraprofessional

Administrative

Manage direct care and other workers

Other Healthcare Workers

Resident care process

Service Personnel

Behind the scenes

Direct Care Workers

A large portion of the 4.7 million workers consists ofdirect care workers.Direct care workers provide direct one-on-one care with the clients. In 2014, the LTSS sector employed more than 1.5 million nursing employee full-time equivalents (FTEs)including registered nurses (RNs), licensed practical nurses (LPNs) or licensed vocational nurses (LVNs), and aides across all five sectors as illustrated in Figure 10.2 below.

Nurse's aides provide the majority of direct care in LTSS. The industry is very labor intensive. Direct care workers, however, also include professional positions such as Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) who also serve a vital role in client care and services (Centers for Disease Control, 2016).

Figure 10.2. Percent Distribution and Total Number of Nursing and Social Work Employee Full-time Equivalents, by Sector and Staff Type: United States, 2014

Long description Figure 10.2.

Notes:FTEs are full-time equivalents. Only employees are included for all staff types; contract staff are not included. For adult day services centers and residential care communities, aides refer to certified nursing assistants, home health aides, home care aides, personal care aides, personal care assistants, and medication technicians or medication aides. For home health agencies and hospices, aides refer to home health aides. For nursing homes, aides refer to certified nurse aides, medication aides, and medication technicians. See Technical Notes for information on how outliers were identified and coded. Percentages may not add to 100 because of rounding. Percentages are based on the unrounded numbers.

Source:Adapted from CDC/NCHS,Long-Term Care Providers and Services Users in the United States: Data from the National Study of Long-Term Care Providers, 2013-2014,Figure 9 and Table 2 in Appendix B.

Administrative

Also noted in Table 10.1 is the presence of social workers. Social workers represented an estimated 35,200 FTEs across the five sectors (Centers for Disease Control, 2016). Social workers generally fall into the category ofAdministration. The administrative staff is responsible for managing the direct care and associated staff who provide the services and supports. Often, like the social worker, they serve as a department head. Other examples of administration in the LTSS workforce include the Nursing Home Administrator, Director of Nursing, Dietary Director, Environmental Service Directive and Rehabilitation Director.

Other Healthcare Workers

TheOthercategory of the workforce includes professionals, other than the direct care workers previously identified, who are involved in the resident care process. For example, physical therapists, occupational therapist, dietician, and physician would all be considered "other professionals" involved in the resident care process.

Service Personnel

A final category that is essential to LTSS operations isService Personnel.Service personnel includes those positions who operate behind the scenes and make operations run smoothly. For example, dietary aides, cooks, housekeepers, maintenance assistance, and transportation.

L10 Human Resources (HR)

The overall function of human resources management in LTC is to ensure that the organization is properly staffed with qualified personnel who can provide care efficiently and effectively.Human resources managementrefers to practices and policies that are necessary to keep the people side of an organization operating.

Before examining the key functions of HR, it is important to note that HR is responsible for operating according to legal and regulatory guidelines. HR personnel are responsible for ensuring compliance with federal labor laws. The federal laws protect workers' rights and safety and address hiring, compensation, promotion, and dismissal practices.

Generally, federal laws can be grouped into two broad categories:

• Antidiscrimination lawsthat prohibit discrimination in managing workers
• Worker safety lawsthat protect workers from unsafe work environments

Although a full discussion of these laws is beyond the scope of this lesson, Table 10.1. outlines select key HR laws and regulations for your reference.

• Employment-at-will:A doctrine of employment in which theemployer is freeto discharge individuals without cause and the employee is free to quit, strike, or cease working at any time.
• Right-to-work law:A statute thatprohibitsemployer-union agreements that require union membership as a condition of employment.
• Workers' compensation:Insurance that provides employees with medical care, rehabilitation services, and financial settlements forworkplace injuries.(McSweeney et. al, 2017, p. 296)

Table 10.1. Major U.S. Human Resources Legislation (Parts A, B, and C)

Table 10.1 A Major US Human Resources Employment LegislationEmployment LegislationDescription

Fair Labor Standards Act of 1935 Established minimum wages, overtime pay, and standard work hours; enforced by Department of Labor (DOL)

Taft-Hartley Act of 1947 Prohibits unfair labor practices and restricts political activities of unions

Title VII, Civil Rights Act of 1964 Prohibits discrimination based on gender, race, color, religion, and national origin; enforced by Equal Employment Opportunity Commission (EEOC)

Age Discrimination in Employment Act (ADEA) of 1967 Protects employees and job applicants aged 40 years or older from discrimination in hiring, firing, promotion, layoffs, training, benefits, and assignments

Pregnancy Discrimination Act of 1978 Protects female employees who are pregnant against discrimination

Americans with Disabilities Act (ADA) or 1990 Protects individuals with disabilities from employment discrimination

Table 10.1 B Major US Human Resources Compensation and Benefits LegislationCompensation and Benefits LegislationDescription

Employee Retirement Income Security Act (ERISA) of 1974 Regulates pension and benefit plans for employees; enforced by DOL

Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986 Allows employees who change jobs to obtain health insurance; enforced by DOL

Older Workers Benefit Protection Act of 1990 Amended ADEA to provide benefits to younger and older workers; enforced by EEOC

Family Medical Leave Act (FMLA) of 1993 Requires employers with 50 or more employees working more that 1,250 hours annually to provide up to 12 weeks of unpaid leave to any employee in a 12-month period for care of a family member or themselves; enforced by DOL

Uniformed Services Employment and Reemployment Rights Act (USSERA) of 1994 Allows employees serving in the military to have job protection and benefits extended while serving; enforced by DOL

Health Insurance Portability and Accountability Act (HIPAA) of 1996 Protects the privacy and confidentiality of patient information; enforced by the U.S. Department of Health and Human Services

Pension Protection Act of 2006 Strengthens employer funding requirements for pensions and pension insurance; enforced by DOL

National Defense Authorization Act of 2008 Extends FMLA to include the families of employees in military service

Genetic Information Nondiscrimination Act of 2008 Prohibits insurance companies and employers from discriminating in areas of compensation and benefits based on results from genetic testing; enforced by EEOC

Patient Protection and Affordable Care Act (ACA) of 2010 Requires individuals to obtain health insurance and allows children of employees to remain on their parents' health insurance up to age 26

Table 10.1 C Major U.S. Human Resources Safety and Work Environment LegislationSafety and Work Environment LegislationDescription

Occupational Safety and Health Act of 1970 Requires employers to provide a safe and healthy work environment for their employees; enforced by the Occupational Safety and Health Administration (OSHA)

Worker Adjustment and Retraining Notification Act of 1989 Requires employers with 100 or more employees to give employees 60 days' notice of layoffs and closings

Administrators in all sectors are strongly encouraged to have an understanding of all antidiscriminatory and worker safety laws. As the Latin saying goes, "ignorantia legis neminem excusat" translated, "ignorance of law excuses no one" (U.S. Legal, 2016).

PreviousNext

1. I understand that attracting and retaining talented nurses and assistants in the home healthcare market can be quite challenging due to the high level of competition in the healthcare industry. Would you be able to suggest some effective strategies that have helped your organization overcome this challenge?

Virginia explained that when working with a national company, they recruit on different levels. The corporate recruiting department runs ads through platforms like Indeed, ZipRecruiter, and other similar sites. On a local level, the HR managers attend job fairs and corporate events. Sometimes, they also host a local hiring event to draw in more candidates.

She shared an experience where they were trying to start a new office, and they held a hiring event at a local Dunkin' Donuts, where they served coffee to nurses and spoke with them about their offerings. Additionally, Virginia had a magnet on the side of her car that advertised job openings, and she has done presentations at schools to attract potential hires.

Virginia acknowledged that it can be frustrating when planning an event and not getting the desired turnout. However, she shared an example where she had no one show up to an event she planned, but met a potential hire in the parking lot who had missed the event but was interested in the position. Virginia emphasized that retention is the best recruitment tool as it helps to keep the nurses and aides they have, so they are not always in need of new hires. She noted that there is no such thing as hiring too many, as there is always a need for care.

2. As a clinical manager responsible for overseeing a team of nurses and assistants, I am interested in learning how to make a positive work environment and encourage professional growth among staff. This will help minimize employee turnover and ensure continuity of care for patients. Could you kindly share any successful strategies or methods that you have used or recommend?

This is what Virginia said: One of my favorite parts of this role is working with nurses, especially new grads. I share a lot of myself when I'm talking with them and doing training. I talk about mistakes I've made so that they can learn from them and know that it's okay to make mistakes. I want them to feel comfortable coming to me if they need help and not be embarrassed about it.

For coaching, I observe what they're doing and offer suggestions on how to improve. As a new manager, I learned that it's important to address problems early on, instead of letting them go and hoping they'll fix themselves. I make sure to correct mistakes right away and show them the correct way to do things.

I also believe in treating everyone with respect, regardless of their job title or level of education. I communicate with people in a way that they will understand without being condescending. If someone is not doing their job properly, I give them corrections and document everything. If the problem persists, termination may be necessary, but I make sure to do it respectfully.

Overall, it's important to be approachable, respectful, and clear in communication. Everyone is needed in the team, and every job is important.

L10 Summary and ReferencesHuman Resources

Discuss leader's perspective on human resource management connecting with course concepts, include citations. Reflect on what you learned, connecting with course concepts.I recommend a paragraph summarizing your leader's perspective on the topic followed by a paragraph reflecting on his/her responses, connecting with course concepts. For example, how does what your leader shared, compare or contrast with what you learned in class.

L10 Long-term Care Workforce

As we discussed in Lesson 1, the United States population is aging. By 2030, projections suggest that one in five Americans will be age 65 or older. Likewise, studies suggest that nearly 70% of older adults will require some form of LTSS for an average of three years. Therefore, to meet the demand for services, there is an increased need for a high-quality workforce. Currently, a snapshot of the LTSS industry workforce suggests the sector employs an estimated 4.7 million workers.

For simplicity sake, let's divide the workforce into four broad categories as illustrated in Figure 10.1: Categories of the LTSS workforce.

Figure 10.1. Categories of the LTSS Workforce

Direct Care Workers

Professional and paraprofessional

Administrative

Manage direct care and other workers

Other Healthcare Workers

Resident care process

Service Personnel

Behind the scenes

Direct Care Workers

A large portion of the 4.7 million workers consists ofdirect care workers.Direct care workers provide direct one-on-one care with the clients. In 2014, the LTSS sector employed more than 1.5 million nursing employee full-time equivalents (FTEs)including registered nurses (RNs), licensed practical nurses (LPNs) or licensed vocational nurses (LVNs), and aides across all five sectors as illustrated in Figure 10.2 below.

Nurse's aides provide the majority of direct care in LTSS. The industry is very labor intensive. Direct care workers, however, also include professional positions such as Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) who also serve a vital role in client care and services (Centers for Disease Control, 2016).

Figure 10.2. Percent Distribution and Total Number of Nursing and Social Work Employee Full-time Equivalents, by Sector and Staff Type: United States, 2014

Long description Figure 10.2.

Notes:FTEs are full-time equivalents. Only employees are included for all staff types; contract staff are not included. For adult day services centers and residential care communities, aides refer to certified nursing assistants, home health aides, home care aides, personal care aides, personal care assistants, and medication technicians or medication aides. For home health agencies and hospices, aides refer to home health aides. For nursing homes, aides refer to certified nurse aides, medication aides, and medication technicians. See Technical Notes for information on how outliers were identified and coded. Percentages may not add to 100 because of rounding. Percentages are based on the unrounded numbers.

Source:Adapted from CDC/NCHS,Long-Term Care Providers and Services Users in the United States: Data from the National Study of Long-Term Care Providers, 2013-2014,Figure 9 and Table 2 in Appendix B.

Administrative

Also noted in Table 10.1 is the presence of social workers. Social workers represented an estimated 35,200 FTEs across the five sectors (Centers for Disease Control, 2016). Social workers generally fall into the category ofAdministration. The administrative staff is responsible for managing the direct care and associated staff who provide the services and supports. Often, like the social worker, they serve as a department head. Other examples of administration in the LTSS workforce include the Nursing Home Administrator, Director of Nursing, Dietary Director, Environmental Service Directive and Rehabilitation Director.

Other Healthcare Workers

TheOthercategory of the workforce includes professionals, other than the direct care workers previously identified, who are involved in the resident care process. For example, physical therapists, occupational therapist, dietician, and physician would all be considered "other professionals" involved in the resident care process.

Service Personnel

A final category that is essential to LTSS operations isService Personnel.Service personnel includes those positions who operate behind the scenes and make operations run smoothly. For example, dietary aides, cooks, housekeepers, maintenance assistance, and transportation.

L10 Human Resources (HR)

The overall function of human resources management in LTC is to ensure that the organization is properly staffed with qualified personnel who can provide care efficiently and effectively.Human resources managementrefers to practices and policies that are necessary to keep the people side of an organization operating.

Before examining the key functions of HR, it is important to note that HR is responsible for operating according to legal and regulatory guidelines. HR personnel are responsible for ensuring compliance with federal labor laws. The federal laws protect workers' rights and safety and address hiring, compensation, promotion, and dismissal practices.

Generally, federal laws can be grouped into two broad categories:

• Antidiscrimination lawsthat prohibit discrimination in managing workers
• Worker safety lawsthat protect workers from unsafe work environments

Although a full discussion of these laws is beyond the scope of this lesson, Table 10.1. outlines select key HR laws and regulations for your reference.

• Employment-at-will:A doctrine of employment in which theemployer is freeto discharge individuals without cause and the employee is free to quit, strike, or cease working at any time.
• Right-to-work law:A statute thatprohibitsemployer-union agreements that require union membership as a condition of employment.
• Workers' compensation:Insurance that provides employees with medical care, rehabilitation services, and financial settlements forworkplace injuries.(McSweeney et. al, 2017, p. 296)

Table 10.1. Major U.S. Human Resources Legislation (Parts A, B, and C)

Table 10.1 A Major US Human Resources Employment LegislationEmployment LegislationDescription

Fair Labor Standards Act of 1935 Established minimum wages, overtime pay, and standard work hours; enforced by Department of Labor (DOL)

Taft-Hartley Act of 1947 Prohibits unfair labor practices and restricts political activities of unions

Title VII, Civil Rights Act of 1964 Prohibits discrimination based on gender, race, color, religion, and national origin; enforced by Equal Employment Opportunity Commission (EEOC)

Age Discrimination in Employment Act (ADEA) of 1967 Protects employees and job applicants aged 40 years or older from discrimination in hiring, firing, promotion, layoffs, training, benefits, and assignments

Pregnancy Discrimination Act of 1978 Protects female employees who are pregnant against discrimination

Americans with Disabilities Act (ADA) or 1990 Protects individuals with disabilities from employment discrimination

Table 10.1 B Major US Human Resources Compensation and Benefits LegislationCompensation and Benefits LegislationDescription

Employee Retirement Income Security Act (ERISA) of 1974 Regulates pension and benefit plans for employees; enforced by DOL

Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986 Allows employees who change jobs to obtain health insurance; enforced by DOL

Older Workers Benefit Protection Act of 1990 Amended ADEA to provide benefits to younger and older workers; enforced by EEOC

Family Medical Leave Act (FMLA) of 1993 Requires employers with 50 or more employees working more that 1,250 hours annually to provide up to 12 weeks of unpaid leave to any employee in a 12-month period for care of a family member or themselves; enforced by DOL

Uniformed Services Employment and Reemployment Rights Act (USSERA) of 1994 Allows employees serving in the military to have job protection and benefits extended while serving; enforced by DOL

Health Insurance Portability and Accountability Act (HIPAA) of 1996 Protects the privacy and confidentiality of patient information; enforced by the U.S. Department of Health and Human Services

Pension Protection Act of 2006 Strengthens employer funding requirements for pensions and pension insurance; enforced by DOL

National Defense Authorization Act of 2008 Extends FMLA to include the families of employees in military service

Genetic Information Nondiscrimination Act of 2008 Prohibits insurance companies and employers from discriminating in areas of compensation and benefits based on results from genetic testing; enforced by EEOC

Patient Protection and Affordable Care Act (ACA) of 2010 Requires individuals to obtain health insurance and allows children of employees to remain on their parents' health insurance up to age 26

Table 10.1 C Major U.S. Human Resources Safety and Work Environment LegislationSafety and Work Environment LegislationDescription

Occupational Safety and Health Act of 1970 Requires employers to provide a safe and healthy work environment for their employees; enforced by the Occupational Safety and Health Administration (OSHA)

Worker Adjustment and Retraining Notification Act of 1989 Requires employers with 100 or more employees to give employees 60 days' notice of layoffs and closings

Administrators in all sectors are strongly encouraged to have an understanding of all antidiscriminatory and worker safety laws. As the Latin saying goes, "ignorantia legis neminem excusat" translated, "ignorance of law excuses no one" (U.S. Legal, 2016).

PreviousNext

1. I understand that attracting and retaining talented nurses and assistants in the home healthcare market can be quite challenging due to the high level of competition in the healthcare industry. Would you be able to suggest some effective strategies that have helped your organization overcome this challenge?

Virginia explained that when working with a national company, they recruit on different levels. The corporate recruiting department runs ads through platforms like Indeed, ZipRecruiter, and other similar sites. On a local level, the HR managers attend job fairs and corporate events. Sometimes, they also host a local hiring event to draw in more candidates.

She shared an experience where they were trying to start a new office, and they held a hiring event at a local Dunkin' Donuts, where they served coffee to nurses and spoke with them about their offerings. Additionally, Virginia had a magnet on the side of her car that advertised job openings, and she has done presentations at schools to attract potential hires.

Virginia acknowledged that it can be frustrating when planning an event and not getting the desired turnout. However, she shared an example where she had no one show up to an event she planned, but met a potential hire in the parking lot who had missed the event but was interested in the position. Virginia emphasized that retention is the best recruitment tool as it helps to keep the nurses and aides they have, so they are not always in need of new hires. She noted that there is no such thing as hiring too many, as there is always a need for care.

2. As a clinical manager responsible for overseeing a team of nurses and assistants, I am interested in learning how to Make a positive work environment and encourage professional growth among staff. This will help minimize employee turnover and ensure continuity of care for patients. Could you kindly share any successful strategies or methods that you have used or recommend?

This is what Virginia said: One of my favorite parts of this role is working with nurses, especially new grads. I share a lot of myself when I'm talking with them and doing training. I talk about mistakes I've made so that they can learn from them and know that it's okay to make mistakes. I want them to feel comfortable coming to me if they need help and not be embarrassed about it.

For coaching, I observe what they're doing and offer suggestions on how to improve. As a new manager, I learned that it's important to address problems early on, instead of letting them go and hoping they'll fix themselves. I make sure to correct mistakes right away and show them the correct way to do things.

I also believe in treating everyone with respect, regardless of their job title or level of education. I communicate with people in a way that they will understand without being condescending. If someone is not doing their job properly, I give them corrections and document everything. If the problem persists, termination may be necessary, but I make sure to do it respectfully.

Overall, it's important to be approachable, respectful, and clear in communication. Everyone is needed in the team, and every job is important.

L10 Summary and References

In looking ahead, the long-term care sector is faced with a tremendous challenge of meeting the growing demand for long-term care services and one chronic shortage is the supply of a qualified workforce. Human resource professionals are tasked with developing a strategy aimed at recruiting and retaining qualified staff.

Although HR professionals are charged with the task, it is important to note that, as a future administrator, you too play a vital role in supporting HR professionals and providing them with the resources to be successful.

References

Center for Disease Control. (2016). Long-Term Care Providers and Services Users in the United States: Data From the National Study of Long-Term Care Providers, 2013-2014. Retrieved from https://www.cdc.gov/nchs/data/series/sr_03/sr03_038.pdf

Eldercare Workforce Alliance. Geriatrics Workforce Shortage: A Looming Crisis for Our Families. (n.d.). Retrieved from https://eldercareworkforce.org/research/issue-briefs/research:geriatrics-workforce-shortage-a-looming-crisis-for-our-families/

McSweeney-Feld, Molinari, C., & Oetjen, R. (2016).Dimensions of long-term care management. Chicago: Health Administration Press

Redfoot,D., Feinberg,L, & Houser, A. (2013). The Aging of the Baby Boom and the Growing Care Gap: A Look at Future Declines in the Availability of Family Caregivers. Public Policy Institute. Retrieved from https://www.aarp.org/home-family/caregiving/info-08-2013/the-aging-of-the-baby-boom-and-the-growing-care-gap-AARP-ppi-ltc.html

Seavey, D. (2004). The cost of frontline turnover in long-term care Better Jobs Better Care https://phinational.org/wp-content/uploads/legacy/clearinghouse/TOCostReport.pdf

U.S. Legal. (2016). Ignorance of law. Retrieved from https://definitions.uslegal.com/i/ignorance-of-law/

PreviousNext

In looking ahead, the long-term care sector is faced with a tremendous challenge of meeting the growing demand for long-term care services and one chronic shortage is the supply of a qualified workforce. Human resource professionals are tasked with developing a strategy aimed at recruiting and retaining qualified staff.

Although HR professionals are charged with the task, it is important to note that, as a future administrator, you too play a vital role in supporting HR professionals and providing them with the resources to be successful.

References

Center for Disease Control. (2016). Long-Term Care Providers and Services Users in the United States: Data From the National Study of Long-Term Care Providers, 2013-2014. Retrieved from https://www.cdc.gov/nchs/data/series/sr_03/sr03_038.pdf

Eldercare Workforce Alliance. Geriatrics Workforce Shortage: A Looming Crisis for Our Families. (n.d.). Retrieved from https://eldercareworkforce.org/research/issue-briefs/research:geriatrics-workforce-shortage-a-looming-crisis-for-our-families/

McSweeney-Feld, Molinari, C., & Oetjen, R. (2016).Dimensions of long-term care management. Chicago: Health Administration Press

Redfoot,D., Feinberg,L, & Houser, A. (2013). The Aging of the Baby Boom and the Growing Care Gap: A Look at Future Declines in the Availability of Family Caregivers. Public Policy Institute. Retrieved from https://www.aarp.org/home-family/caregiving/info-08-2013/the-aging-of-the-baby-boom-and-the-growing-care-gap-AARP-ppi-ltc.html

Seavey, D. (2004). The cost of frontline turnover in long-term care Better Jobs Better Care https://phinational.org/wp-content/uploads/legacy/clearinghouse/TOCostReport.pdf

U.S. Legal. (2016). Ignorance of law. Retrieved from https://definitions.uslegal.com/i/ignorance-of-law/

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