The unprecedented workforce shortage caused by the COVID-19 pandemic continues to severely affect nursing homes across the United States, and Colorado is no exception.
Between February 2020 and December 2022, nursing homes lost 210,000 jobs, according to an analysis of year-end data from the Bureau of Labor Statistics released by the American Health Care Association (AHCA) and the National Center for Assisted Living (NCAL) on Thursday.
According to the report, the last time the number of people working in nursing homes was this low was in 1994.
At the current rate of job growth, these facilities won’t reach pre-pandemic levels until 2027 — slower than a previous model that estimated recovery by 2026.
Filling open positions was not an easy process.
About 96% of nursing homes have had a problem with staffing, according to an AHCA survey of 500 providers in the country published Jan. 10. About half said their workforce situation has been declining since May 2022. That continues to be an issue. In spite of incentives such as wage increases and bonuses.
The survey also found the following:
- 84% of nursing home providers are currently experiencing moderate to high levels of staffing shortages
- 96% of aged care providers have difficulty hiring staff
- 97% of aged care providers said that the lack of interested or qualified candidates is a major obstacle to hiring new staff
- 78% of aged care providers have hired temporary agency staff to cope with the shortage
- More than nine out of 10 Aged care providers have increased wages and offered bonuses to try to recruit and retain staff
- 54% of nursing home providers say they have to turn away potential residents
- 67% of aged care providers are concerned that their facilities may have to close due to workforce challenges
- 52% of nursing home providers say they may not be able to continue operating for more than a year at the current pace
The report found that of any health care sector, nursing home providers experienced the worst job losses and continue to suffer as most other industries bounce back. This has led to some facilities restricting entry to residents or, in some cases, closing their doors permanently.
“The data doesn’t lie. This is not just an overblown call for help, and this labor crisis is not going away on its own or through government enforcement. Our nursing homes are struggling to hire caregivers, and if they don’t We get meaningful help soon, the result will be the displacement of hundreds of thousands of elderly people.”
This includes financial support because many facilities have very tight budgets because Medicaid reimbursement rates are often lower than the actual costs of care, according to the Jan. 19 report. Add rising labor costs and inflation to that, and there are fewer resources to help — and hire — employees.
Colorado is seeing evidence of this happening. Residents whose Medicaid benefits pay for their stay in assisted living facilities and nursing homes are receiving troubling news: Several facilities throughout the Denver metro area are either reducing Medicaid populations, laying off Medicaid altogether or closing them entirely.
Colorado has about 400 assisted living communities and 64% of them are Medicaid certified. About a quarter of the population relies on Medicaid for long-term care.
Read moreAs assisted living centers switch, Medicaid residents are looking for new homes
A big problem, explained Nicole Schiavone, president of the Colorado Assisted Living Association, is the reimbursement rate these facilities receive from Medicaid. She said private paying residents often pay more than $2,000 per month than the center paid Medicaid residents over the same period.
As assisted living centers switch gears, Medicaid residents are looking for new homes
“For those facilities that cancel Medicaid as a payer and tell residents they will need to relocate, we have case management agencies and our responsible regional entities there to help members find new facilities,” said Mark Williams, a Colorado spokesperson. Department of Healthcare Policy and Financing. “The challenge is often finding a place that can accept them close to their family or loved ones.”
People stuck in this position in Colorado are encouraged to contact the Colorado Department of Health Care Policy and Financing, which is assisting with this transition. The email for this department is firstname.lastname@example.org.
At the federal level, the Biden administration is considering implementing a minimum federal staffing limit for nursing homes, which the AHCA and NCAL have claimed “will only exacerbate the crisis.”
In a statement released on February 28, 2022, the Biden administration said “setting a minimum staffing threshold ensures safe, high-quality care is provided to all residents of nursing homes, and that workers get the support they need to provide quality care. Nursing homes will be held accountable if they fail to meet this standard.” This can include a minimum of 4.1 hours worked per day per resident.
Deb Emerson, director of accounting and advisory firm CLA (CliftonLarsonAllen LLP), which is used by AHCA, said in December that this additional burden — without financing — will increase the number of facilities operating at negative margins.
“Despite improvements in workforce availability in some areas of the country, nationwide, nursing homes continue to face a challenge in finding the right workforce,” said Emerson. “If nursing homes are unable to increase their workforce, hundreds of thousands of residents could be affected by census cuts.”
In mid-December, the CLA finalized an updated report released by the AHCA describing the need for more funding for workers to meet a potential minimum mandate for nursing home staff set by Biden.
“Because of rising labor costs and widespread workforce shortages across the country, the CLA now estimates that more than 191,000 nurses and nurse aides are needed at an annual cost of $11.3 billion in order for nursing homes to meet a minimum staffing of 4.1 hours per day. Evaluator,” a report reads about the proposal from the Biden administration.
This is an increase from July 2022, when the CLA estimated that 187,000 additional caregivers were needed at an annual cost of $10 billion.
The report also found that 94% of nursing homes in the country would not be able to comply with the potential minimum of 4.1 hours per resident day.
The CLA estimates that about 450,000 people could be at risk of displacement if facilities are unable to increase their staffing to meet staffing minimums proposed by the Biden administration.
Parkinson said: “Nursing homes have done everything they can to recruit and retain staff – including increasing wages – but it hasn’t been enough to stem the tide. Their money is where their mouth is. Otherwise, we will fail to address the fundamental problem here, and our residents will have Fewer options for long-term care.”
This problem will continue to grow in the United States and Colorado as the population over the age of 65 grows.
As of December, Colorado was second only to Alaska in the United States for its fastest growing population over the age of 65. Over the past decade, that group in Colorado has grown by more than 317,000 to more than 800,000 people.
Between 2010 and 2020, the 65-74 demographic was the fastest growing demographic in the state. In the next decade, the age range will be 75-84. Meanwhile, the number of people entering the 65+ range is expected to slow slightly.
Overall, Colorado still has the sixth lowest number of people over the age of 65 compared to other states.
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