WAWCON, Iowa — Last fall, Marjorie Kruger was stunned to find out she had to leave the nursing home she had lived in comfortably for six years.
The Good Samaritan Society facility in Postville, Iowa, will be closed, administrators told Kruger and 38 other residents in September. Joined the list of closed retirement homes.
“The rug was removed from under me,” said Kruger, 98. “I was meant to be there for the rest of my life.
Her son found a room for her at another Good Samaritan center in Waukon, a small town eighteen miles north of Postville. Kruger said the new facility was a comfortable place, but she misses her friends and longtime staff at the old facility.”We were close like a lovely family,” she said.
Former residents of the Postville facility are scattered across northeastern Iowa. The nursing home that they first moved into also closed, and some people were forced to move twice.
The owner said the closure was primarily due to a shortage of workers, including nurses, nursing assistants and kitchen workers.
Industry leaders and analysts predict the problem could deepen as pandemic-era government support dries up and nursing homes struggle to match wage increases offered by other employers. increase. Many of the care centers that have managed to stay open are keeping some beds vacant because they don’t have enough workers to responsibly care for more residents.
The pandemic has brought billions of extra federal dollars to the long-term care industry, inundated with covid-19 infections and more than 160,000 resident deaths. At many facilities, business has declined amid lockdowns and outbreak reports. Staff faced additional danger and stress.
The industry is still feeling the impact.
According to the Federal Bureau of Labor Statistics, between February 2020 and November 2021, the number of workers in nursing homes and other care homes fell by 410,000 nationwide. Since then, staffing has only recovered to about 103,000.
According to the Iowa Health Care Association, Iowa will have 13 out of 15 nursing homes that will close in 2022 in rural areas. Association president Brent Willett said, “In sparsely populated areas, it is becoming increasingly difficult to staff facilities. I pointed out that there is
Due to the shortage of available beds in nursing homes, some patients are confined to hospitals for weeks while social workers look for placements. More and more people are ending up in care facilities far from home, especially if they have dementia, obesity, or other conditions that require special attention.
Kim Bimestefer, Colorado’s executive director of health policy and funding, said at a November conference that the state recognizes the need to help strengthen care facilities, especially in rural areas. . “More nursing homes went bankrupt last year than in the last decade combined,” she said.
In Montana, at least 11 nursing homes, representing 16% of the state’s facilities, will close in 2022, the Billings Gazette reports.
Nationally, the Centers for Medicare and Medicaid Services recently reported that 129 nursing homes will close in 2022. Mark Parkinson, president of the American Health Care Association, said the real number was significantly higher, but said federal reports tended to lag behind what was happening in the world. ground.
For example, a recent KHN review found that of the 11 Montana nursing home closures reported by Montana news outlets in 2022, only one was tallied by federal agencies, and only one reported in Iowa. It was shown that only 8 of the 15 identified were aggregated.
Demand for long-term care is expected to grow over the next decade as the baby boom generation ages. Willett said his industry supports reforming immigration laws to bring in more workers from other countries. “It has to be part of the solution,” he said.
The Postville, Iowa, nursing home was one of 10 care centers that closed last year by the Good Samaritan Society, a large chain based in South Dakota.
The company’s CEO, Nate Schema, said:
The company’s full name, Evangelical Lutheran Good Samaritan Society, is affiliated with the giant Sanford Health Network, serving 12,500 customers, including residents of nursing homes and those receiving services at home. I’m here. About 70 percent of them live primarily in rural Plains and Midwestern areas, Schema said.
Many frontline nursing home workers have found less stressful jobs after going through the worst days of the coronavirus pandemic, Schema said. They had to wear additional protective clothing and undergo regular infection screening in the face of ongoing risk.
Lori Porter, chief executive of the National Association of Health Care Assistants, said nursing home staffing issues have grown over the years. “No one in the industry is shocked by the current situation,” she said. “The pandemic put it in the spotlight.”
Porter, who has worked as a certified nursing assistant and nursing home administrator, said the industry has seen how rewarding the job is and how working as an ancillary leads to higher paying jobs, including as a registered nurse. He said that it is necessary to emphasize that
Care industry leaders have raised wages for frontline workers but say they can’t always keep up with other industries. It relies on payments from Medicaid, a government program for low-income Americans that covers more than 100% of the bill.
In recent years, most states have increased how much Medicaid programs pay for nursing homes, but these rates are still lower than what facilities receive from other insurance companies or are paid out-of-pocket by residents. . In Iowa, Medicaid pays nursing homes about $215 per resident per her day, according to the Iowa Health Care Association. This equates to her about $253 a day for out-of-pocket people. When nursing homes provide short-term rehabilitation for a Medicare patient, they receive about $450 per day for her. However, that federal program does not cover long-term care.
According to Willett, a recent survey found that 72% of the remaining nursing homes in Iowa are either frozen or restricted to under-capacity.
Prairie View, a nursing home in Sanborn, Iowa, is one of them. Owned by a local nonprofit, the facility is licensed for up to 73 beds. It can only handle about 48 residents these days, according to manager Wendy Nelson.
“We were able to take in more patients, but we weren’t able to give them the care they deserve,” she said.
Prairie View’s tough choices included closing its 16-bed dementia care unit last year.
Nelson has worked in the industry for 22 years, including 17 years at Prairie View. It was never easy, she said, to keep the nursing home fully staffed. But the COVID-19 pandemic has added stress, danger, and hassle.
“It drained the dirt off some people. They just said, ‘It’s over,'” she said.
Prairie View has repeatedly raised salaries and now starts at $21 an hour for certified nursing assistants and $40 an hour for registered nurses, Nelson said. However, she is still looking for more workers.
She recognizes that other local employers are also burdened.
“I know we all struggle,” said Nelson. “The Dairy Queen is also struggling, but the Dairy Queen can change the time. I can’t.”
David Grabowski, a professor of health policy at Harvard Medical School, said some of the closed medical facilities had poor safety records. In urban areas, it may not look like a tragedy.
“We might say, ‘Maybe the market is working. Bad restaurants and bad hotels are closing,'” he said. But in rural areas, even the closure of poor quality care facilities can leave holes that are difficult to fill.
For many families, home care is the preferred alternative, but workers to provide those services are also in short supply, he said.
This may result in longer hospital stays for patients who could have been served in care facilities instead.
Rachel Olson, a social worker at Pocahontas Community Hospital in northwestern Iowa, said some of the patients were 10 years old at her hospital while trying to locate them in a nursing home after they were stabilized enough to be transferred. Some patients have waited months or more, he said.
She said certain types of patients are particularly difficult to place, such as those with dementia and those who require special attention because they need intravenous antibiotics.
Olson begins calling nursing homes closer to the patient’s home, then calling nursing homes farther away. She had to place some people up to 60 miles from her hometown, she said her family hoped she would find a closer place. . “But you can’t when you can’t, right? Your hands are tied.”
