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RTI analysis finds direct care workers earn lower wages than entry-level workers in other industries

The findings have informed a proposed rule from the federal government to establish comprehensive staffing requirements for nursing homes

RESEARCH TRIANGLE PARK, N.C. — A new analysis from RTI International, a nonprofit research institute, has found home health aides, personal care aides and nursing assistants, also referred to as direct care workers, earn lower wages than entry-level workers in other industries.

“Our analysis identified a wage gap between direct care workers and workers in other entry-level jobs,” said Denise Tyler, Ph.D., a senior research public health analyst who led the analysis. “Put simply, for the long-term care sector to be competitive and successfully recruit and retain workers, it will need to improve compensation.”

Direct care workers are typically employed by nursing homes and home health or home care agencies. They assist older adults and people with disabilities in completing self-care and other daily tasks.

The research team used state-level wage data from the Bureau of Labor Statistics to obtain hourly median wages for home health and personal care aides and nursing assistants in 2019. They also obtained hourly median wages from BLS for other entry-level jobs as defined by the U.S. Department of Labor Occupational Information Network (O*NET) OnLine.

Median wages of home health and personal care aides were lower than the wages of entry-level workers in all states and the District of Columbia with an average difference of $3.15 per hour. They earned $0.78 for every $1.00 made by other entry-level workers, the analysis found.

Similarly, it revealed that nursing assistants earned lower wages than entry-level workers in 40 states and the District of Columbia, making on average $0.76 less per hour or 95% of wages of comparable workers. Their wages were the lowest in Missouri and Louisiana (81% of other entry-level jobs) and the highest in Nevada and New York, where nursing assistants out-earned entry-level peers on average.

The analysis only examined wages and did not consider employment benefits such as paid time off, retirement benefits or health insurance. But the authors note that past research has found that direct care workers rarely receive these benefits.

The research was funded by the Assistant Secretary for Planning and Evaluation (ASPE) in the U.S. Department of Health and Human Services (HHS) and summarized in an issue brief published by the agency.

The findings were recently cited by HHS as part of proposed rules to establish comprehensive staffing requirements for nursing homes, which would include a requirement for states to collect and report on compensation for workers as a percentage of Medicaid payments for those working in nursing homes and other long-term care facilities.

Read the full issue brief

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