News and Notes

UCSF Health Workforce Research Center on Long-Term Care

October 2025

Director's Note

The 13^th year of the UCSF Health Workforce Research Center on Long-Term Care has begun, with the arrival of a new post-doctoral scholar and a visiting professor (see below for introductions) and a flurry of activity as we launch new projects.

In collaboration with the U.S. Bureau of Health Workforce, we are starting four new projects this year:

The Licensed Practical/Vocational Nurse Workforce in Long-Term Care – this study updates reports published in 2015 on this important group of licensed professionals
The Influence of Clinician Training and Involvement in Medicare Advantage Plans on Dementia Care Pathways – this project will use the new National Dementia Workforce Study Community Clinician survey
State Assisted Living and Nursing Home Training Requirements, Staff Training, and Staff Outcomes – we will combine policy data from the AWARD Network Data Compendium on training requirements with nursing home and assisted living staff data from the National Dementia Workforce Study for this project
Menopause Training Standards – this study will examine the literature and education accreditation standards on primary care and reproductive health clinicians’ knowledge about menopause care

You can read more about these projects, as well as our past work, on our newly updated HWRC website.

Joanne Spetz, PhD, FAAN

Director

Highlighted Stories

New Members of the HWRC Team!

Jenny Kwon, PhD, is a T32 postdoctoral scholar affiliated with the Philip R. Lee Institute for Health Policy Studies and the Department of Epidemiology and Biostatistics at UCSF. Her research focuses on understanding and measuring multiple aspects of long-term quality in the U.S., with a particular focus on leadership turnover, nursing staff retention, person-centered care, the neighborhood deprivation surrounding nursing home locations. Prior to joining UCSF, Jenny completed her PhD in Social Gerontology at Miami University in Ohio where her dissertation examined how retention of nursing staff and individualized care practices affect nursing home consumers’ satisfaction.

Aoife McDermott, PhD is Professor of Human Resource Management at Aston University, UK. She joined the Healthforce Center as a visiting scholar and splits her time between the Bay Area and the UK where she teaches and delivers executive education for healthcare leaders. Her research explores how to organize work and the influence of management roles on employee experiences and outcomes in healthcare. She recently edited a Research Handbook on Contemporary Human Resource Management for Healthcare and is completing a Special Issue on HRM in Social Care. She draws on management and organizational theories and especially enjoys qualitative research.

HWRC and the National Dementia Workforce Project

The leadership of the UCSF Health Workforce Research Center on Long-Term Care (HWRC-LTC) is deeply involved in the National Dementia Workforce Study (NDWS), bringing their extensive expertise in health workforce policy and long-term care delivery. Joanne Spetz, Director of the UCSF HWRC-LTC, and Laura Wagner, Associate Director, serve as key members of the NDWS research team.

Their contributions have been instrumental in shaping the study’s research design, survey methodology, and analytic framework—advancing national understanding of the clinicians, direct care workers, and care settings that support people living with dementia. Their work is highlighted in several new articles featured in the Journal of the American Geriatrics Society special issue on the NDWS.

HWRC at the Gerontological Society of America Conference this November!

A number of HWRC researchers will be presenting at the Gerontological Society of America Conference this November in Boston, MA.

See below for the impressive list!

Awards

Thursday, November 13, 6:30 PM — 9:00 PM

Dying with Dementia: Is Hospice the Answer

Lauren Hunt - Recipient of the 2025 Terrie Fox Wetle Rising Star Award in Health Services and Aging Research https://www.afar.org/fox-wetle-award

Presentations

Wednesday, November 12, 8:00 AM – 9:30 AM

Session: Amplifying Voices: Workforce-Related Barriers and Facilitators to Person-Centered Care in LTSS

Presentation: Strengthening Long-Term Care Workplace Culture and Worker Voice Through the Coach Approach Intervention

Kezia Scales, Emily Dieppa Colo, McKayla Brady

Wednesday, November 12, 12:00 PM – 1:30 PM

Session: Health Care and Nutrition Policy and Practice

Presentation: Role of the Community Health Representatives in Caring for Older People in Tribal Communities

Susan A. Chapman, PhD, MPH, FAAN

Thursday, November 13, 10:00 AM — 11:30 AM

Session: Direct Care Staff Training Standards and Educational Interventions in Long-Term Care

Presentation: A Comprehensive Review of PCA Training Standards Across the United States

Jessica King, Kezia Scales, Susan Chapman

Thursday, November 13, 10:00 AM — 11:30 AM

Session: COVID Changed Everything, Everywhere, All at Once

Presentation: Shelter-in-Place Policies, Proximity, and Changes in Caregiving for Older Adults During the COVID-19 Pandemic

Lei Chen, Joanne, Spetz

Friday, November 14, 4:30 PM — 6:00 PM

Session: Making Home Care Work for All: Real-World Considerations for Effective, Affordable Care Policies

Presentation: Benefits Cliffs and Financial Stability for the Direct Care Workforce

Sarah Angell, Susan Chapman, Jiyeon Kim, Stephen McCall

Joanne Spetz (Discussant)

Saturday, November 15, 12:00 PM — 1:30 PM

Session: Long-Term Services and Supports Workforce: Policy and Practice

Presentation: Registered Nurse Employment and Earnings in Long-Term Care

Joanne Spetz, Timothy Bates

Posters

Chen, L., Maust, D., Spetz, J. Characteristics of the Dementia Care Workforce in Nursing Homes and Assisted Living Communities in the U.S.

Chen, L., Wang, Q., Kietzman, K. How Financial Challenges Affect the Health and Lived Experiences of Adults With Long-Term Services and Supports Needs.

Lane, S., Yoon, C., Basrai, Z., Maren, Y.P., Farnham, T., Scales, K., Tanner, G., Boucher, N. Using Communities of Practice in the Home and Community-Based Service Workforce

Recent Publications

Angell, S., McCall, S., King, J., & Scales, K. (July 2025). Tipping point: Exploring the risk of benefits cliffs among direct care workers in Virginia. PHI. https://www.phinational.org/resource/tipping-point-exploring-the-risk-of-benefits-cliffs-among-direct-care-workers-in-virginia/

PHI. (September 2025). Direct care workers in the United States: Key facts 2025. https://www.phinational.org/resource/direct-care-workers-in-the-united-states-key-facts-2025/

Dawson, W. D., Stodola, A., Carder, P., Cellarius, K., Smith, L., Brandis, L., Oschwald, M., Totten, A. M., Womack, D., Aga, V., Unsworth, J., Carney, M., Byerly, L. K., Spetz, J., Nash, M., Dhar, N., Wilson, K. B., Hogue, T., Sulick, B., Stone, R., Blow, R. C., Lewis, J. P., Chan, K., Emery-Tiburcio, E. E., & Lavretsky, H. (September 2025). Supporting older adult behavioral health: Building the first state center of excellence for behavioral health and aging. Health Affairs Scholar. Advance online publication. https://doi.org/10.1093/haschl/qxaf175

Cajavilca, M., Chen, L., & Spetz, J. (September 2025). Policy initiatives regarding the long-term care immigrant workforce and associated outcomes: A scoping review. Journal of the American Medical Directors Association. Advance online publication. https://pubmed.ncbi.nlm.nih.gov/41022143/

Spetz, J., Chen, L., Ross, L., & Maust, D. (September 2025). Geographic proximity of family members and the provision of unpaid and paid care for unmarried older adults. Health Science Reports. https://doi.org/10.1002/hsr2.71258

Bates, T, Miller, J, Mendez, X, Spetz, J. 2025 (October 2025). Investing in the Direct Care Workforce: Lessons from the CalGrows Training and Stipend Initiative. Journal of the American Medical Directors Association. https://doi.org/10.1016/j.jamda.2025.105923

About UCSF HWRC

The UCSF Health Workforce Research Center on Long-Term Care (UCSF HWRC) is a dynamic hub of policy-oriented research and investigation, established through support from the National Center for Health Workforce Analysis in the U.S. Bureau of Health Workforce. UCSF HWRC closely examines the health care workforce and helps shape policies to meet expanding LTC needs. Our research includes the workforce in nursing homes, home health care, adult day care, community-based settings, and home settings, and includes all LTC occupations.

Director: Joanne Spetz, PhD, FAAN

Deputy Director: Laura Wagner, PhD, RN, FAAN

Visit: https://healthworkforce.ucsf.edu/about

Follow on Twitter: @ucsfhwrc or Bluesky: @ucsfhwrc.bsky.social

This newsletter highlights new HWRC publications, as well as workforce-related research conducted by our team at the Institute for Health Policy Studies and Healthforce Center at UCSF, UCSF School of Nursing and other research partners.