Sources of New Workers and Job Mobility in Long-Term Care

Background: In the past decade, there has been substantial job growth in the health care industry overall and in the LTC sector in particular. Despite the substantial role of CNAs, HHAs, PCAs, and other workers in LTC settings, limited research is available as to where the LTC industry draws its supply of workers and the pathway by which workers enter the industry. The characteristics and experiences of LTC workers after they leave LTC jobs also are unknown. In addition, there are high rates of turnover in LTC jobs, and there is little knowledge about the characteristics that make people more likely to leave LTC positions or what happens to them after they leave. 

Objectives: The study objective is to examine the pipeline of workers into the LTC industry, and the factors associated with workers leaving LTC employment. The specific aims of this project are to: (1) Describe the demographic and socioeconomic profile of entrants into LTC occupations and settings; (2) Determine from which industries and occupations LTC draws workers; (3) Analyze the wage impact of entering LTC jobs; (4) Describe the demographic profile of people who leave LTC jobs; (5) Identify the industries and occupations to which LTC workers go; and (6) Examine the wage impact of leaving LTC jobs. 

Data and Sample: This project will use 12 years (2000 to 2011) of the publicly-available Current Population Survey (CPS) Annual Social and Economic Supplement (“March Supplement”), which is an annual cross sectional survey of approximately 100,000 households, or 200,000 individuals.

Methods: We will begin with descriptive statistics on the percentage of workers whose previous-year occupation was in a non-LTC industry, unemployed status, or out of the labor force; the percentage of workers with the same versus different occupations within the LTC industry; the percentage of workers with increased/same/decreased level of employment; and average hourly wage rates for those who changed occupations/industries versus those who did not. We will then use multivariate logistic regression to estimate the predictors of individuals leaving LTC occupations. The main outcome variables will include current and previous year occupation and industry codes, unemployment, labor force participation, hours worked, hourly wage rate, and fringe benefits. Demographic and socioeconomic predictors of job changes include education level, gender, age, race/ethnicity, immigrant status, rural residence, marital status, and presence of children in the home. All data will be analyzed using weights to ensure statistics represent the full LTC workforce. 

Results and Conclusions: Results are still too preliminary to report. It is important to understand the characteristics of people who enter LTC jobs – especially entry-level occupations such as CNAs, HHAs, and PCAs – to ensure that an adequate supply of workers will be available to meet the projected need for LTC in the future. An understanding of the demographic characteristics that are associated with individuals being more likely to stay in LTC, and the industries they go to when they leave, will provide guidance in designing retention strategies.