ZUMBROTA, Minn. – The Zumbrota Health Services building is significantly less full than it once was. Rooms located in a hallway are mostly unoccupied. Residents sit in the common areas, but it feels empty.
About four years ago, the aged care center was a 50-bed facility. Now there is a capacity of 40 beds, but only 32 beds are full.
But the vacuum is not only due to the lack of inhabitants. Note that the staff is quite small. And that’s not exclusive to the Zumbrota facility: There are 23,000 open positions for caregivers across the state.
The staff shortage is a domino that has fallen as a byproduct of the biggest struggle facing long-term care facilities today: the financial crisis.
Long-term senior care industry leaders are strongly advocating that the Minnesota Legislature, before the session ends on Monday, May 23, 2022, use some of the budget surplus to ease the financial burden faced by so many institutions.
It is important to note that the financial crisis within the industry was not created by the pandemic, but the costs associated with protective equipment and the operation of COVID-19 units suddenly pushed onto facilities have exacerbated the fight. . The crisis even led to the closure of five nursing homes in the first five months of 2022. Twelve establishments have closed since 2020.
Before the pandemic, nursing homes in particular operated on narrow margins. And, according to Kari Thurlow, president and CEO of LeadingAge Minnesota, reimbursement rates set by the state legislature were a major reason for the financial crisis.
Retirement homes are reimbursed for residents through a daily rate set by the legislator. In Minnesota, the Medicaid rate and the private pay rate must be the same, according to state law. Institutions submit a cost report with their total operating costs to be reimbursed.
The problem is that expenses are not reimbursed until 27 months after cost reports are submitted, so care homes are currently paid based on 2020 cost reports.
“Most of those costs are before the pandemic gets really bad,” Thurlow said. “If you think about everything we’ve been through since, like the huge inflationary increases, the extra cost of testing and vaccines and all those things, none of that has been covered by the cost reimbursements.”
Nursing homes, assisted living facilities and other long-term care facilities operate on impossibly thin margins because the costs they face far exceed the reimbursements they currently receive from the state.
Lack of money is the reason why there is also a shortage of staff in Minnesota. Thurlow and other long-term caregivers are advocating for an increase in the reimbursement rate not to alleviate the costs of running facilities, but to increase caregiver wages to retain current workers and attract new ones.
“One of the biggest challenges we have, and you see it all over the state, is that due to inflation and wage inflation, we’re losing caregivers because we can’t keep up. wages. And when we lose caregivers, we can no longer admit residents. And that creates a financial problem,” Thurlow said. “So our theory is that by immediately investing in base salaries this term, we are able to recruit carers and increase occupancy of our premises to help deal with the financial crisis.”
That would help facility managers like Sue Knutson, who operates Samaritan Bethany in Rochester with about 200 staff, up from 440 five years ago. Operating with half the staff means they “just don’t get people to move in”.
“It’s hard because we don’t normally say no,” she said.
Cami Peterson-DeVries, vice president of senior services at St. Francis Health Services, the parent organization of Zumbrota Health Services, said that due to staffing shortages, the Zumbrota Care Center has been “very selective about who comes because we want to make sure we have enough staff to prepare them and take care of them.
“It’s really a sadness in the sense that we are not able to take care of all the people that we would like,” she said.
Some care centers have overcome staff shortages without closing and without compromising the care of residents who need the facilities in which they are located. But funding is desperately needed to keep many facilities running.
“We need funding. We need funding,” Peterson-DeVries said. “As an organization, we worked together to say, ‘Okay, how can we tighten our belts? What are we doing?’ But there are some things you can’t compromise on. You cannot compromise on resident care. You simply cannot.