November 4, 2019; New Hampshire Union Leader

When a whole system is experiencing a problem, you often have to step out of the usual solution bank to address it. As we have recently noted, this has led more and more to nonprofits stepping into roles previously held primarily by for-profits when the profit motive is found to be warping the system. For instance, nonprofits are inserting themselves into pharmaceutical production after the cost and availability of regularly needed drugs were repeatedly limited by the “business decisions” of pharmaceutical companies.

NPQ’s regular readers know we have often discussed over the years the employment issues in health care, including the issues of pay, hours, benefits, and training. This labor pool problem is particularly visible in a high-employment market, causing problems of coverage and sustainability for nonprofit health organizations all around the country. We have seen a number of different kinds of responses to this, including home-care co-ops, labor actions, and advocacy for rate hikes, but it will take all of those and more to tackle the problems growing in the realm of home and senior care.

In New Hampshire, Catholic Charities has elected to act in partial response by launching St. Jacinta Healthcare Staffing, an agency whose efforts are concentrated on nurses and meant to cut the costs of contracting for per diem care. In the process, this will cut the excess costs generally charged by for-profit employment agencies.

“There is a perfect storm hovering over New Hampshire skilled nursing facilities,” said Tracey Lane, executive director of St. Jacinta:

Not only are they staring down a barrel of unfavorable reimbursement rates, deficits and negative margins, but the staffing dynamics are also shifting statewide. Among the shrinking talent pool, more nursing professionals are opting for higher flexibility and pay through staffing agencies, versus traditional direct hire roles. For nursing homes, this means more variability and uncertainty in aligning their staff with resident and patient demand.

But every time you fill a shift with agency staff, a significant piece of that cost goes back to the employer agency. These costs continue to add up, and over time, they will no longer be practical or sustainable. Establishing a nonprofit internal agency to serve a large network of care facilities is our proactive solution to the problem.

“We want our staff to feel heard, respected and valued,” Lane said in the news release. “This is a unique opportunity to not only grow careers and learn from some of the best in the business, but also work for a nonprofit where staff is not aggressively recruited or owned by contracts.”—Ruth McCambridge