coronavirus pandemic

Staffing Shortages Pave Uncertain Future for Nursing Homes

Like everything else, the pandemic and the staffing shortages this past year are taking the long-term care profession down an uncertain path

NBCUniversal, Inc.

Nursing homes across the country are in trouble.            

Many are facing closures due to staff shortages and higher operating costs from inflation and the pandemic.

These closures have been growing over the last few years.

But like everything else, the pandemic and the staffing shortages this past year are taking things down an uncertain path.

A recent survey by the American Health Care Association is highlighting these issues. It found more than half of nursing homes in the U.S. are operating at a financial loss. Many more are struggling to find staff.

Key findings from the report include:

  • More than 1,000 nursing homes have closed since 2015, including 776 closures before the pandemic and 327 closures during the pandemic.
  • Since 2015, nearly 45,000 nursing home residents have been displaced due to closures.
  • More than 400 nursing homes are projected to close in 2022 based on current financials.

The report found nursing homes that close tend to be smaller facilities in urban settings where the majority of residents rely on Medicaid. Federal policymakers are considering potential cuts to nursing homes in 2022, such as a reduction to Medicare payments and ending the public health emergency (PHE), which offers enhanced Medicaid funding.

Leading Age Texas, a nonprofit advocating for senior care communities across the state, said the same issues are reflected in Texas.

President and CEO George Linial said according to the Bureau of Labor Statistics, 12% of the long-term care workforce disappeared during the pandemic in Texas, which is worse than the national average.

"Without enough staff, places have had to close wings to reduce admissions, and that has an effect on the total healthcare system because hospitals usually discharged to nursing homes for rehab. And some of them have been unable to find spots for people. So they stay in the hospital and that just adds to the cost,” said Linial. "We usually talk about nurses. There's a huge shortage of RNs and LVNs. But there's openings in all parts of all parts of the system, including maintenance, housekeeping, accounting. You name it, there, there's opportunities for people to work in the field."

There's been dozens of nursing home closures across the state in the last two years including a few in North Texas. And there's a concern for more as the staffing crisis continues.

Right now, there's a push to increase state funding for nursing homes.

Groups are also lobbying for a tuition reimbursement program for those that follow a career in long-term care.

"We've actually run this bill twice. In the last two sessions, it never quite made it. But we continue to advocate for it. And hopefully, it will gain some traction this upcoming legislative session,” said Linial.

Local senior care facilities tell me retaining people is key.

“There have been about 20 nursing homes that have closed in the last year. And several more are sort of on the brink just because they can't afford the staff pay increases,” said Linial. “About two-thirds of nursing homes have residents that are on Medicaid. So they rely on state funding and those state rates have not increased in a long time. So it has really put a real strain on the system, in terms of how do you figure out how to keep staff?”

Dallas-based Manchester Care Homes and Cambridge Caregivers are doing everything they can just to do that, so far successfully avoiding staffing issues.

“We have a philosophy: pay attention to the employees that pay attention to you,” said Brian Levy, director of marketing and business development. "When your employees understand your values and your culture, and they're portraying that in the field, that's the perfect match."

Their own CEO, Adam Lampert, recently started paying money out of his own pocket to help cover gas for every employee.

"He is very generous with our staff. We just moved our gas stipend from $25 per child per paycheck to $30 per paycheck. For everyone, anybody full time whether you're the admin or you're a caregiver or a house manager,” Levy said. "We do IRA match, we pay health benefits, flexible schedules, PTO, quarterly and discretionary bonuses, end of year rev share."

But not everyone has the ability to offer those perks.

"We're fortunate that we're locally owned and operated. And when we want to do something like a gas stipend or PTO...We can do it," Levy said. "A franchise or a corporate owned company, they can't do those things."

Levy hosts a podcast helping families trying to navigate the complex maze of challenges facing the aging community.

He added it's important for families to be aware of what's going on and to ask lots of questions if they have a loved one currently staying in or going into senior care.

Contact Us