The research included 3 million Glassdoor reviews of 500 large employers in 25 industries to uncover which sectors have the most frustrated workers as far as wages are concerned.

Only workers in the education field are less satisfied with their pay than are workers in healthcare, according to the findings.

“This is likely one reason why education and health services have a higher-than average vacancy rate of roughly 6%, compared to about 5% across all industries, according to data from the US Bureau of Labor Statistics,” wrote Carissa Rawson, Glen Luke Flannigan and Robin Saks Frankel.

At the other end, workers in the field of pharmaceuticals/biotechnology were least likely to have complaints about the amount in their paycheck, followed by workers in food/soft beverages/alcohol/tobacco and utilities.

Help may be in sight for some healthcare workers, but optimism may be waning in California, where, in the wake of a projected $38 billion deficit, Gov. Gavin Newson (D) is reevaluating an incremental minimum wage increase to $25 an hour for workers in nursing homes, assisted living communities and other settings. He had signed it into law in October.

California has the largest number of skilled nursing facilities and assisted living communities of any state, according to SNF Data and Statista.

Overall, nursing home salaries — including those of executives — continued their upward trajectory with many facilities responding to staffing shortfalls by increasing hourly rates and offering signing bonuses, according to the industry’s largest annual salary survey released in August.

According to the results of another study, from TollFreeForwarding.com, registered nurse salaries are projected to increase over the next decade at a rate that surpasses the rate of increases for some other healthcare professions.

Meanwhile, resident assistants in assisted living communities received a 9.22% hourly rate increase in 2022, according to the 25th annual Assisted Living Salary & Benefits Report, published by Hospital & Healthcare Compensation Service. Resident assistant hourly rates increased by 10.61% in 2021 and by 9.22% in 2022. As a result of continued pay increases, turnover rates for the position began to decrease in 2022. Resident assistant turnover was 68.09% in 2021 but declined in 2022 to 49.08%. Vacancy rates for resident assistants were 19.91% in 2022.

“Despite this earlier age, emerging adults, known as GenNext for being the next generation of workers, heads of households, consumers and investors, haven’t started planning for retirement just yet,” the authors noted.

Simply put, the so-called GenNext has other financial priorities at this stage of life, including planning for a family and taking care of everyday expenses, according to the report. 

At the same time, however, Edward Jones advisers indicated that more than 40% of their younger adult clients are “thriving” (42%) and actually are in a more favorable position regarding their financial stability than people of the same age a decade ago.

“We know from our research with emerging adults ages 18 to 34 that they want to be comfortable or have enough money to have a meaningful life, but they aren’t concerned with financial accumulation or career in the same way,” said Julia Bartak, an Edward Jones financial adviser in the Kansas City area. 

But only 12% of those surveyed said they discuss their finances with a financial adviser, and one reason for the finding may be a simple one, according to Edward Jones. Sixty-eight percent of members of the generation “don’t think they have enough income or savings for professional financial advice, despite being the most educated generation in history, with one in three having some college education and access to information,” the company said.

Fifty-five percent of US CEOs surveyed cited “economic downturn/recession” as a high-impact issue for 2024.

“Both factors also topped the 2023 list of high-impact issues. While we believe a global recession is unlikely in 2024, we do expect slower growth in the wake of tighter monetary policy to tackle inflation,” the authors noted. “Adding to global CEOs’ concerns is that less than 30% believe their organizations are adequately prepared to navigate either a recession or inflation.”

Several leaders of senior living and care industry groups recently told McKnight’s Senior Living that they expect that operators will continue to face inflationary pressures and capital market challenges in 2024, but that some effects may lessen before the year is out.

The Conference Board survey, conducted between Oct. 24 and Nov. 24, asked 1,247 C-Suite executives, including 630 CEOs, for their views on top business threats and opportunities in 2024.

The top five external issues that could affect businesses, according to respondents, are an economic downturn / recession, inflation, global political instability, labor shortages, rapidly advancing artificial intelligence technology and higher labor costs.

“Close to 90% of CEOs see AI increasing the efficiency/productivity of labor and their firms overall. They also see gains in innovation and creativity,” according to the survey. “But there is work to be done to create an organizational culture and structure to maximize AI’s productivity. Almost 80% of CEOs say adopting AI will require new capital expenditures, and 94% say it will require new skills and training.”

Respondents said they were less concerned about the effects of industrial policy in their region, wealth or income inequality, backlash over environmental, social and governance policies, shortages of semiconductors/rare earths and shareholder activism.

Internally, the executive respondents said they mostly were concerned with attracting and retaining talent, accelerating the pace of adding AI, enhancing product and service innovation, improving customer experience, reducing costs and upskilling and reskilling talent.

Respondents said they were less concerned about focus on AI governance policy, a full-time return to offices, accelerating the shift to renewable energy sources, the increasing cost of healthcare benefits and unionization efforts.

“Amid elevated inflation and a potential downturn, CEOs’ plans to grow profits in 2024 include introducing new products/services, investing in technology, increasing sales via marketing, and entering new markets,” according to a press release issued in conjunction with the report

The bill was effective upon the governor’s signature Jan. 8.

The law empowers a labor union to file a complaint in court against a contractor or subcontractor for unpaid wages on behalf of workers in certain construction, reconstruction, demolition, alteration and maintenance projects, regardless of whether the workers belong to the union or are unaffiliated with any union.

“It is our expectation that empowering labor unions to pursue actions in court on behalf of construction workers, whether they belong to the union or to no union at all, will inure to the benefit of all workers in this industry and their families,” the governor said in a statement. 

“Every worker should be properly compensated for the work they undertake — no exceptions,” Murphy said in a press release issued in conjunction with the bill-signing. “This bill allows unions to take up for those workers without representation seeking wage claims.”

State Sen. Troy Singleton (D), Assemblywoman Annette Quijano (D) and Assemblyman Anthony Verrelli sponsored the bill.

“This bill signifies a monumental shift in protecting workers’ rights, extending the reach of unions and ensuring that no worker is left behind in the pursuit for fair wages and just treatment,” Quijano said. “Unions being able to start wage claims could encourage employer compliance and potentially lessen the state’s need to closely monitor and enforce these laws.” 

Business groups had opposed the bill, arguing that the legislation “would allow labor unions to act in the place of the state government by filing lawsuits on behalf of workers they don’t represent,” The Center Square reported. 

Labor groups, on the other hand, applauded the new law.

Laborers’ International Union of North America Vice President and Eastern Regional Manager Mike Hellstrom said that the law provides an additional layer of support to construction workers who might find themselves on the losing side of a wage dispute and denied pay they had already earned.

“It is good news for New Jersey, for law-abiding employers and, most of all, for workers,” Hellstrom said.

During our final session, we tried to help them pare back their goals, but they fell into the problem many companies are facing. They were struggling to prioritize and, against our advice, they felt that they needed to begin to address each item all at once. 

Senior living business leaders and companies are facing a very similar challenge in 2024, and should they fail to focus and prioritize addressing the greatest issues they face, they will soon find themselves asking how they didn’t make any headway in 2024 and what to do about it in 2025.

This can prove challenging, as these companies aim to meet immediate financial targets and operational goals while they also need to lay the groundwork for sustainable growth, innovation and quality improvement in the long term. To cut through the noise, leaders must strategically focus and prioritize the right challenge by determining its urgency over its relative standing in the hype cycle.

So, let me help with that. Here are the four challenges and their implications that leaders and companies could face that must be addressed if they are to not only survive 2024 but thrive.

1. Today’s trendiest AI isn’t everyone’s best tool

Senior living businesses have arrived at a crossroads in 2024. Integrating artificial intelligence into general business practices has become an imperative and an untenable obstacle course.

Many companies are moving forward with the misguided hope that the benefits will outweigh the upfront costs, and that can be true. AI can personalize care, customize resident plans, provide predictive analytics and tell you what your budget could be next year.

Companies, however, will need to make smart choices, as not all AI models are built and, more importantly, trained, equally. Choosing the wrong model means a potential for a closed-loop input system where the model does not consider outside needs of potential future customers other than what it was trained on.

To make the most of AI, businesses should prioritize models that have transparency and ones that can help them fix their fragmented data. Siloed records, notes, charts and schedules in multiple platforms that lack interoperability means there will be limited value in the analytics from a model only able to pull from one source of data. The integration challenges are real, but the potential is transformative.

2. The demographic cliff

It’s not news to you that senior living businesses are facing the stark reality of the increasing number of potential residents and a lack of talent to care for them. As baby boomers continue to age and look to move into active-adult or various other tiered classes of caregiving, not only are the communities lacking or nonexistent, but so are the caregivers. Flexible working options and higher pay elsewhere are fueling resignations.

To address those challenges, businesses need to consider new development routes for staff and properties. Considerations for creativity in how administrative roles are staffed and developed through training and upskilling local community members is one way to start.

Long term, the labor shortage may mean rethinking on-demand workers over full-time hires. Also, there is the potential for modular construction, and investors looking to be recession-resilient could mean new forms of capital that could allow for the right-sizing of the units and technologic improvements needed.

3. Transparency versus personalization versus privacy

Senior living companies have leaned heavily on personalization to drive engagement. Data collection can provide unique offerings, especially with the advent of wearables, which can help customize meal plans, activities, amenities and medicine, but consumers and clients have begun to demand more privacy and protection of their data.

Businesses must become more transparent about where they collect data, where outside data are being used and what is done with them. If done successfully, the transparency can bolster engagement and increase communication between the residents and the communities, another potential data perk.

Equally important will be open communication on issues such as sustainability, social responsibility and employee well-being. Today’s residents and families expect more transparency. Companies that honestly address their practices and shortcomings will build trust. 

4. Inflexibility in your future direction

Operators facing these pressures often suffer from a lack of agility and flexibility in their planning. Anticipating future challenges in healthcare and demographics is crucial yet challenging, especially with limited resources, as those challenges constantly move.

Even with prioritized challenges to address, however, leaders must be open to being nimble enough to adapt their hardened three- to five-year plans while also realizing that type of planning needs to shift to become 10- to 15-year planning. This change will allow them to be ready for shifts in behaviors, to grow as digital health evolves, residents’ preferences morph and staffing dynamics shift.

Allowing for re-perception of the challenges and trends that are faced throughout the year will allow companies to be proactive instead of responsive. Most companies lack this flexibility, which ultimately means they stay the course when they need to pivot and, in doing so, become obsolete to the whims of their clients and residents.

In 2024, these challenges and trends are not just obstacles but also catalysts for innovation and improvement. For business leaders, particularly in the senior living industry, addressing these challenges head-on is not just about survival but also about thriving in an ever-changing landscape. By doing so, you can ensure sustained growth, improved service quality and enhanced operational efficiency, ultimately leading to long-term success and a positive impact on your communities.

Mark Bryan is the senior foresight manager at the Future Today Institute, an advisory firm specializing in strategic foresight aimed at driving corporate strategies that lead to long-term success and resilience. The institute partners with leaders of Fortune 500 companies, world governments and other major organizations to help them pivot, adapt and thrive in the face of disruptive change.

The opinions expressed in each McKnight’s Senior Living guest column are those of the author and are not necessarily those of McKnight’s Senior Living.

Have a column idea? See our submission guidelines here.

California has the largest number of skilled nursing facilities and assisted living communities of any state, according to SNF Data and Statista. 

The current minimum wage increase plan would affect approximately 400,000 workers in the Golden State. It is meant to increase the state’s hourly minimum wage from its current $15.50 for healthcare-related workers. The incremental wage increase for covered workers would be $23 per hour from June 1, 2024, to May 31, 2025; $24 per hour from June 1, 2025, to May 31, 2026; and $25 per hour from June 1, 2026.

The Newsom administration was opposed to the dramatic wage increase at the onset of discussions. Other opponents included the California Assisted Living Association, the California Association of Health Facilities, LeadingAge California and the California Chamber of Commerce, which argued that the “astronomical increase in labor costs that will result from SB 525 is simply not sustainable.”

According to KFF Health News, “the governor’s latest budget asks the state legislature to add an annual trigger making the minimum wage increases contingent on state revenues and to clarify which state employees are included, citing ‘the significant fiscal impact’ of the law.” 

Newsom told reporters Wednesday that he had been assured that such triggers would be forthcoming, “even though it wasn’t in the bill,” multiple media outlets reported. 

“We’re confident all parties that committed to that agreement are going to meet it and do so very shortly,” the governor said.

But other dangers exist, too; the process of hiring can consume substantial amounts of time and resources. Failing to identify unsuitable candidates in a timely manner will result in malinvestment, even if the candidate is never hired.

And yet, hiring remains a top priority. As disconcerting as the stakes may be, properly carrying out background checks is a necessary and ultimately rewarding effort.

To help senior living communities navigate this process successfully, I’ll discuss the three most common errors organizations make.

1.  Ignorance-induced legal risks

Litigation is a top concern for any senior living employer conducting background checks. Employers should ensure full understanding and compliance with both local and federal legislation long before even designing their policy, not to mention running an actual check.

Laws governing the hiring process will vary widely based on location and the nature of the position. They tend to specify certain aspects of the procedure, such as information that must be communicated to candidates throughout the screening process. Restrictions and regulations on using acquired data also are common, with consideration of marijuana use or criminal backgrounds being notable examples.

Whatever the particulars may be, any given organization will be subject to a specific, often unique, set of laws. Failure to adhere to such legislation may expose a company to potential lawsuits, which can easily cost millions of dollars in settlements and legal fees. When it comes to the law, due diligence is always due.

2. Flexibility without framework

Oftentimes, approaching the screening process on a case-by-case basis is the path of least resistance. Although each position should be given unique consideration, improvisation always will land a company in hot water.

The underlying factor here is that lack of consistency increases the likelihood of legal negligence. Without a pre-decided policy, it is much easier for an employer to disregard certain legal guidelines or restrictions that otherwise might be detailed in a well-prepared plan. Once such a policy has been created, staying aligned with the law is merely a matter of ensuring that it remains up-to-date. 

Another serious concern is that an unorganized background check always will lack the efficiency of a carefully designed workflow. Organizing how screenings and communications, among other things, will take place ensures that a company’s background check does not waste resources.  

3. Using unclear criteria

Finally, senior living organizations often try to speed up the screening process by sending all candidates through a single filter. The faults with such an approach, however, are obvious. Unclear criteria consistently will deny competent workers where parameters are too strict and allow unsuitable workers where parameters are too loose. For this reason, companies must establish job-specific criteria.

The first criteria to consider are criminal backgrounds, because — yet again — the law must be considered first and foremost. Legislation often will regulate which workers can be employed in certain fields, such as working with older adults, based on criminal records. Although background checks in this industry are more extensive than in most other industries, some offenses should not disqualify candidates for certain positions.

Non-criminal criteria like work experience, licensing, references, and referrals should also be job-specific. While there is not much flexibility here, organizations must decide for themselves where to set the bar for each position — something that may change with the job market. 

Bottom line

The process of screening candidates for hire is not simple for senior living employers. After all, it is a matter of life and death. With legal and economic concerns around every corner, it is easy to feel overwhelmed. When taken into account, those mistakes cannot only be carefully avoided but can guide a company in executing robust background checks that offer peace of mind and allow its workforce, and living community, to prosper.

Jeff Ernste is chief sales and marketing officer with Minneapolis-based Orange Tree Employment Screening. For more than 30 years, Orange Tree has provided technology-enabled background screening, drug testing and occupational health services for clients nationwide.

The opinions expressed in each McKnight’s Senior Living marketplace column are those of the author and are not necessarily those of McKnight’s Senior Living.

Have a column idea? See our submission guidelines here.

Tuesday’s release of a final rule on worker classification standards surely will trigger many a call to HR for a policy rewrite. And perhaps to legal counsel for advice on how to react.

According to federal regulators, the updated standards promise to bring clarity to the often murky distinction between independent contractors and employees.

Clearly, regulators feel that too many senior living operators — and employers in general, for that matter — are using the “independent” label to identify workers who should rightfully be considered employees.

Specifically, the new rule adjusts the method of analysis and adds criteria for determining which bucket a worker should be placed into.

The Labor Department asserts that the new rule will take a more “holistic” approach that encompasses additional factors and weighs them more evenly in the decision-making process.

But as so often is the case, operators are pushing back against an official narrative that seems to promise help while ignoring burdens.

“We are concerned that the rule, coupled with other proposed federal regulations, will only serve to exacerbate the workforce shortage and wipe out some of the recent modest gains communities have made in recruiting individuals to help care for our seniors,” Argentum Senior Vice President of Public Policy Maggie Elehwany told McKnight’s Senior Living.

Additionally, the changes may place greater legal and financial burdens on senior living operators, suggested Gerald Maatman Jr., partner and chair of the class action practice group at legal firm Duane Morris.

Maatman suggests that implementation of the rule may well prompt more wage and hour misclassification class action litigation in the sector.

Remember that famous line: “I’m from the government and I’m here to help you”?

I guess you could say it took on a whole new meaning this week. Or that at the very least, the old meaning was freshened up.

John O’Connor is editorial director for McKnight’s Senior Living and its sister media brands, McKnight’s Long-Term Care News, which focuses on skilled nursing, and McKnight’s Home Care. Read more of his columns here.

The FTC issued a proposed rule in January 2023, and attorneys from Polsinelli Law Firm said they expect a final rule to be released in April.

Increasingly, states also are banning such agreements. Three states — California, North Dakota and Oklahoma — banned noncompete agreements in 2023, and last month, New York Gov. Kathy Hochul (D) vetoed a bill that would have banned most noncompete agreements in the Empire State.

“What the stance of the governor is, is that noncompetes are inappropriate for low- and middle-wage workers,” Eric Packel, chair of Polsinelli’s restrictive covenants and trade litigation unit, said Tuesday during a webinar.

Packel said he was caught “a little off guard” that Minnesota now also is thinking of banning noncompetes.

“I can’t say that Minnesota was on my radar as being the state that was going to have a noncompete ban, but I think it further highlights that there is this growing hostility towards noncompetes,”  he said.

What employers need to know, Packel said, is that “You can still protect your confidential information, you can still protect your trade secrets, you can still take these measures, but we have to be more strategic now more than ever and more thoughtful about how we do it now more than we ever have before.”

The rule proposed by the FTC doesn’t prohibit nonsolicit clauses, but some “gray area” exists, noted Emma R. Schuering, a shareholder in Polsinelli’s Kansas City, MO, office. 

“But it does have a carve-out that says that … if it acts like a noncompete, it looks like a noncompete, it is a noncompete, even if you don’t call it a noncompete,” she said. “So the proposed rule has this functional test language that gives whatever organization or entity would be evaluating the application of the proposed rule the ability to review things like a nonsolicit or [a nondisclosure agreement] … to see if it is effectively operating like a noncompete even if you don’t call upon it.”

The bottom line, according to Packel, is that companies use noncompetes and nonsolicits to cover ground that is not typically covered by statute. “But one of the things for employers to focus on is that trade secrets still are protected, both under federal law and, I think, in almost every state,” he said.

Employers must take steps to articulate the trade secrets or “secret sauce” that gives the company a competitive advantage, in order to protect it, Packel said.