Community Health Centers Faced Hefty Workforce, Nursing Shortages

Better financial opportunities and pandemic-related stress were driving factors behind workforce shortages at community health centers, with nursing shortages a top concern, a report from the National Association of Community Health Centers (NACHC) found.

Community health centers are an essential part of the healthcare industry and provide primary care services to nearly 30 million patients across the country. However, these organizations have not been immune to the workforce shortage the industry has been experiencing throughout the COVID-19 pandemic.

NACHC surveyed 263 federally qualified health centers (FQHCs) on the state of their workforce, what factors are driving staff to leave their positions, and what policies would help support employee retention and recruitment.

Nearly 70 percent of health centers reported losing between 5 and 25 percent of their workforce in the last six months. Fifteen percent reported losing between 25 and 50 percent of their workforce. Urban health centers and large health centers saw higher turnover rates compared to their rural and smaller counterparts, the report noted.

Community health centers ranked nurses as the top category where they saw workforce loss. Administrative staff, such as financial services, scheduling, and front office staff, followed. Behavioral health staff and dental staff were tied for third place.

According to the report, better financial opportunities at larger healthcare organizations was the most common reason for staff members leaving. Half of the health centers estimated that their employees who left for this reason were accepting wage offers that were 10 to 25 percent higher. The figure increased among urban and larger health centers, suggesting greater competition between other large healthcare organizations.

Pandemic-related stressors were also a common reason for staff departure. Healthcare workers have faced high levels of burnout during the pandemic due to increased COVID-19 patient volumes.

Community health centers also cited a lack of professional growth and difficulty securing childcare as reasons for staff departure.

Several respondents also said resistance to complying with the COVID-19 vaccine mandate was a reason for staff leaving. Notably, rural health centers ranked this reason nearly a point higher than urban health centers. Some staff left their current position to relocate, with a handful leaving rural health centers to work in a more urban setting, the report stated.

Certain federal and state policies offer community health centers some relief from workforce shortages by improving employee recruitment and retention.

For example, 92 percent of respondents said they would have experienced more turnover without funding and other benefits provided through the American Rescue Plan.

“The future of the community health center workforce and our readiness to meet public health challenges is uncertain. We must immediately invest in policies that will retain current health center staff, broaden the pipeline for the future workforce, and foster creative strategies at the community level for short and long-term solutions,” Rachel Gonzales-Hanson, interim president and chief executive officer of NACHC, said in a press release emailed to RevCycleIntelligence.

“There are programs that will augment the health center workforce to ensure we can meet the demand for care, as well as provide boosters, testing, and treatment if another COVID surge in the pandemic is ahead.”

The majority of health centers (97 percent) said that additional federal funding would allow them to provide salaries comparable to those offered by competing employers to retain employees who want to leave for better financial opportunities.

Six in ten respondents said that recognizing additional billable providers to expand medical services would help mitigate staffing shortages. Meanwhile, 59 percent of health centers noted that investing in employee wellness programs and interventions would help by alleviating pandemic-related stress.

Community health centers also reported that more generous loan repayment terms and improvements to loan forgiveness programs would help organizations retain employees.