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Learn to care Nursing homes grow their own LPN staffs (DS)

WORCESTER —  When Hannah M. Afiadata started her career in long-term care, she knew she had to move up, but wasn’t quite sure how to do it.

“I came to the United States in 2006 and I started asking everyone ‘What do you do to make life easier? How do you make it in America?’ So, I started as a CNA,” said Ms. Afiadata, 44, of Milford, referring to her first job as a certified nursing assistant.

She now works at Notre Dame Long Term Care Center, a member of the Intercare Alliance of long-term nursing care providers, which helped Ms. Afiadata pay for a nursing degree to get a better job. She is now a licensed practical nurse.

Through the “Grow Your Own Nurses” program, 11 nonprofit and independent Worcester-area facilities that make up Intercare Alliance are working to address the shortage of licensed nurses by helping full-time nursing home employees earn degrees.

“We basically take people with caring and compassionate work ethic and help them advance in their career,” said Dean Messier, director of human resources at Holy Trinity Eastern Orthodox Nursing and Rehabilitation Center in Worcester, a member of Intercare Alliance.

The program started in 2004 in response to vacant nursing positions the centers had trouble filling, a national problem. In 2005, 96,000 nursing positions were vacant in U.S. long-term care facilities and the overall staff turnover rate exceeded 50 percent, according to the National Commission on Nursing Workforce for Long-Term Care. The number of vacancies was expected to increase to 434,000 by 2010.

“We had many nursing vacancies and the positions took a long time to fill. Now we have little to no vacancies and if we have them, they’re easy to fill,” said Katherine Lemay, Notre Dame’s chief executive officer and administrator.

Karen Laganelli, executive director of Holy Trinity, said the program benefits many stakeholders.

“I see it as being twofold. The employer finds a way to increase licensed nursing staff and eliminate the nursing agency, which is costly and makes it harder to deliver high quality care. For work force development, we do as much as we can to provide opportunities to the staff. Then there are the unintended effects that change lives along the way. It’s like a ripple effect that changes families,” Ms. Laganelli said.

In partnership with Quinsigamond Community College, Intercare Alliance selects employees who want to earn nursing degrees. They begin formal education at the Notre Dame Educational Bridge Center at Notre Dame Long Term Care Center in Worcester, and then take nursing degree classes at QCC.

“The key is the bridge center. That’s where diverse educational backgrounds come together and succeed here,” said Ms. Lemay of Notre Dame. The students work part-time hours, but receive full-time benefits in the nursing home while they take their prerequisite classes at the Educational Bridge Center and their course requirements at QCC, which grants mostly Licensed Practical Nurse degrees and some Registered Nurse degrees. The program helps the employees bypass a waiting list for nursing students at QCC that could keep them out of school for years.

“A lot of our students have been away from school for a long time. It’s local, easy to get to, welcoming and an easy transition,” said Patricia Campbell, director of the Notre Dame Educational Bridge Center.

The nursing homes pay all the program costs — $10,500 per student — as long as employees agree to stay after they’ve earn their degrees for a minimum of two years. The students also keep their health insurance premium contribution and employee benefits at the same levels they were before joining the program.

According to Mr. Messier, the program has helped the nursing homes retain staff. “There’s always a risk with taking on a new employee, but when you take someone who is already employed and bring them through the system, the retention rates are a lot higher,” Mr. Messier said.

Of students whose two-year agreement has expired, 60 percent remain at their place of employment. The Intercare Alliance is content with the number, but hasn’t set an expected retention rate.“Sixty percent isn’t 100 percent, but it’s not 12 or 20. It’s a good number. Would we like it to be better? Yes. But we had no preconceived percentage. We figured if we help people have life-changing experiences, in the long run, they’d want to stay,” Ms. Laganelli said.

Since its start, the program has had 134 graduates; 18 more students will begin in the fall.

“I couldn’t afford to finish school. I didn’t know how I could pay the bills and pay for classes. Then I heard about this program, and I was thrilled when I was accepted,” said Maritzabel Vidal of Southbridge, who graduated from the program in June. Ms. Vidal, 26, worked at the front desk at Holy Trinity for two and a half years before entering the program. Now, she is looking forward to helping the center care for its patients as an LPN.

“I definitely wouldn’t have gotten my degree this fast if it weren’t for this program,” Ms. Vidal said.

Reimbursements are also offered for any college prerequisite classes the students take toward their nursing degree on their own. Because of this, Ms. Afiadata opted for more schooling.

“It pushes you a lot when you get the 100 percent reimbursement back and the encouragement is very helpful,” Ms. Afiadata said.

The program is designed to be flexible so students can work and go to school. Students are only required to work 16 hours a week while they attend classes.

“We don’t want them to work more hours, we want all the time to go to their clinical (training) and studying,” said Ms. Laganelli. “We’re flexible around needs to achieve positive outcomes. It’s a win-win situation for everyone.”

Contact Danielle Kahn by e-mail at