PBN Five Questions with Matthew R. Trimble

Five Questions With: Matthew R. Trimble

By Claudia Chiappa -04/02/2023


Matthew R. Trimble is the CEO and president of Saint Elizabeth Community, a nonprofit organization that provides elder care services in Rhode Island. The nonprofit has launched a training and educational program to encourage workers’ recruitment and retention, which is meeting a pressing need amid a national health care staffing crisis.

Trimble discusses the impact of workforce shortages, the company’s training program for certified nursing assistants and other financial challenges currently hurting nursing homes in Rhode Island.

PBN: How much have workforce shortages affected Saint Elizabeth Community?

TRIMBLE: Since the onset of COVID-19, the health care industry has experienced a severe loss of staffing. Many workers have retired, leaving the field permanently, while the number of new employees entering the profession cannot meet the demand. And it’s not only trained health care staff. Shortages in staffing impact every area, from dining services to housekeeping.

During a time when the population of Rhode Island is aging faster than ever before, ensuring quality eldercare in our state is becoming more challenging. Staffing is one of the critical issues that will affect the ability to maintain the levels of quality care necessary for the growing population.

PBN: You have started a couple of programs to tackle the issue of workforce shortage. One of them is a paid training program for students interested in becoming certified nursing assistants. What does this program look like? How successful has it been so far?

TRIMBLE: The training program for certified nursing assistants has been very successful. Students “earn while they learn” during the 10-week course facilitated by our clinical nursing instructor, Amy Nield. Upon graduation, they join Saint Elizabeth Community in any one of our divisions from our skilled nursing facility to adult day programs to our home health care division.

It’s a great opportunity to prepare our CNAs with the skills they need to do the job while ensuring they fit the culture of our organization as a community of caring. We’re excited to be expanding the training program by adding a new classroom and a second instructor to increase the number of participants.

PBN: What other training and educational programs does Saint Elizabeth Community offer?

TRIMBLE: We’ve been working closely with educational institutions and technical training centers to offer real-life experience in eldercare. Many health care workers often don’t consider this field as an option. We provide internships and other opportunities for them to participate and, hopefully, choose to focus their career in this area.

We’re currently developing a program with the URI [University of Rhode Island] College of Nursing where students spend part of their semester experiencing the world of eldercare.

PBN: What do you think is driving workforce shortages in nursing homes in particular?

TRIMBLE: During the pandemic, health care experienced an unprecedented labor shortage as many long-time nurses and caregivers left the industry due to stress, burnout and fear of COVID. To ensure proper staffing around the clock, we’ve had to increase overtime for existing staff and utilize external agency staffing at the highest rate we’ve seen in decades.

Staffing is now a supply and demand issue. Competition for qualified staff has reached a fever pitch. This competition quickly turned into wage wars and labor inflation. Even with significant changes to our pay scales, it is challenging to compete with larger health care institutions and hospitals.

PBN: What else can be done to address the economic challenges nursing homes in Rhode Island are facing?

TRIMBLE: In addition to increased staffing costs due to workforce shortages, nursing homes in Rhode Island have not seen an upgrade in the state’s Medicaid reimbursement rates in years. Even before COVID, Rhode Island’s nursing homes, on average, were being paid a Medicaid rate that was $30 under the cost of care.

In Rhode Island nursing homes, more than 70% of our residents are on the state’s Medicaid program. Imagine trying to run a business where you lose $30 every day on 70% of your customers? Since the pandemic, the cost of running a nursing home has risen another 30% while Medicaid payments have increased only 7.7%. The gap between cost and reimbursement has grown another 22%. This discrepancy is unsustainable. State reimbursement rates for Medicaid must be increased.

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