Director: Staff shortage severe at nursing home

As national numbers show impending elder care troubles, the Tri-Lakes area is already experiencing them

Veronica Rivers, an 84-year-old resident of Mercy Living Center in Tupper Lake, watches as Norah Dew-Pratt, 2, gets glitter on an ornament, and herself, at an inter-generational craft event in December 2019. (Enterprise photo — Aaron Cerbone)

TUPPER LAKE — It’s a problem that’s getting worse by the day, and the generation.

Nursing homes are in a race against time to find staff as the “elder support ratio” is getting increasingly lopsided. These facilities are facing understaffing as more and more members of the baby boomer generation are reaching retirement age.

Madeline Toliver, the director of Mercy Living Center, said the elder care facility is in need of home aides and certified nursing assistants. She said there are currently five people in training, but there are still lots of openings for jobs at every level.

Toliver said while there is a nationwide shortage of CNAs, it is worse in the North Country, and still worse in the Tri-Lakes area.

“This is a major crisis here,” Toliver said. “It is very difficult to get people to work in health care.”

Toliver said health care is a “niche” profession and that elder care is even more niche. It requires a lot of hard work for low wages, she said; not just anyone can do it. But she said anyone with the “caring gene” looking to get into the field is in a good position to find a job if they are qualified.

“Scary” numbers

Toliver said the elder support ratio — which compares the number of 18-to-64-year-olds who can provide services to those 64 and older — had changed drastically in the last century. In 1900 it was 13.6 to 1, but by 1960 the number of eligible providers had been cut in half. In 2014 the ratio was 4.3 to 1, and by 2030 it is projected to be 2.8 to 1.

Toliver said that the Tri-Lakes area already is operating under the 2.8-to-1 ratio projected nationwide in 2030.

“That’s scary. There’s going to be nobody around when everybody gets older,” Toliver said. “I sort of fear what is going to happen.”

This shortage is only going to get more severe as more members of the baby boomer generation — those born between 1946 and 1964 — continue to retire. Toliver said while 35.1 million Americans turned 65 and became eligible for Medicare in 2000, it is projected 69.7 million Americans will reach that in 2030.

Working hard

She said the local elder care industry has heavily tapped its hiring resources.

Mercy Living Center has around 100 staff members currently. Around two-thirds of those are care staff. Toliver said when staff levels are low, managers and administration fill in on the floor to help get the work done.

“Periodically, that’s not a terrible thing. But (not) on a regular basis.” Toliver said. “Then who is doing their jobs?”

She said low staffing also results in higher fatigue and burnout, physically and mentally.

“That’s the problem … that we are overutilizing good people,” Toliver said.

“A great place to be”

Veronica Rivers, an 84-year-old Mercy Living Center resident, said employees work hard every day just to get the residents to the table three times a day, as well as doing essential health care.

“It’s not easy. It’s hard work,” Rivers said.

Despite this, Rivers said the staff at Mercy Living Center provides service for which she is thankful.

“This is a great place to be,” Rivers said.

Toliver said the center has openings for registered nurses, licensed practical nurses and certified nursing assistants. She is looking for people both young and old to fill those spots.

“CNAs are the bedrock of what we do,” Toliver said.

But they are the lowest-paid profession of the three, she said.

To make up for the hard work and low pay that comes with the industry, Toliver said she needs to be able to offer a workplace that is, as Rivers said, “a great place to be.” She wants to develop programs to make the work environment better and to ensure a job with her company can support employees fully.

The fingerprinting cliff

Toliver said one of the major obstacles to making new hires is that not all young people are passing fingerprinting tests — that is, that they have been arrested for some crime that shows up in a background check.

At a Tupper Lake town board meeting in November, Toliver warned attending students, “Be careful what you do in your private life.”

Tupper Lake High School students attend town board meetings during the school year for Linda Sexton’s social studies class, and Toliver pitched health care work to them, saying Mercy hires 18-year-olds and offers flexible hours to work around school schedules.

Mercy will also hire BOCES or North Country Community College students.

Toliver said employees at Mercy need to be able to pass a background check including fingerprinting to see if they have been arrested. She also warned the kids, “Be careful what you post.”

Toliver and others running nursing homes in the area are looking for ways to find people passionate for elder care in the face of an incoming wave of retirees. This type of job will not appeal to everyone, Toliver said. But for those with a passion for it, it can be a rewarding career.


The Enterprise plans to continue covering the elder support gap as it affects other local facilities and services.


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