COVID-19 Labor Shortage and Costs Causing Crisis in South Dakota’s Long-Term Care Industry
The labor shortage affecting businesses in South Dakota is hitting long-term care facilities particularly hard, with the COVID-19 pandemic exacerbating the historic challenges of hiring workers in nursing homes and nursing homes. assisted living centers.
The inability to fill vacancies and keep up with patient care has led some facilities to turn away new residents, even though most have open beds. The labor shortage has caused the burnout of overworked employees and reduced the level of patient care in some facilities.
During the COVID-19 pandemic, long-term care facilities in South Dakota saw their payrolls increase by nearly $ 30 million in total, but lost about $ 60 million in revenue due to the cut of resident admissions, according to the South Dakota Health Care Association.
Faced with the need to raise wages and offer hiring bonuses to attract workers or hire expensive traveling nurses, some facilities already facing high operating costs and low profit margins could eventually close. , making it more difficult than ever for families to find housing for their loved ones. those, industry experts say.
“Access to care could be very different in the future if our funding mechanisms and funding infrastructure do not change in South Dakota,” said Nate Schema, Evangelical Lutheran Good vice president of operations. Samaritan Society, which operates long-term care facilities. . “You are going to have to move your loved ones further and further away from the communities they have called home for more than 50 years.”
The labor shortage has created new barriers and compounded current challenges for the Good Samaritan, one of the nation’s largest long-term care providers. The group, based in Sioux Falls and now operating under the umbrella of the Sanford Health Group, currently has more than 200 job openings.
The Fountain Springs healthcare center in Rapid City, part of the EmPres Healthcare group, had 15 vacancies listed on the company’s website at the end of September. (Bart Pfankuch / South Dakota News Watch)
“It stretches us and imposes on us a place we haven’t been in a while,” Schema said.
The inability to hire workers has forced The Good Samaritan to turn away some potential new residents, including at his 19 facilities in South Dakota, at a time when new income is badly needed.
“We had to limit some admissions in some communities in South Dakota and throughout our organization,” Schema said.
Schema said he was aware of about 70 long-term care facilities that have closed across the country in the past year and as many as 200 that have been closed in the past two years. South Dakota saw a handful of facilities close in 2017-19, but has not had a shutdown since.
Working in one of South Dakota’s 104 nursing homes or 163 assisted living facilities can be rewarding but also exhausting. Meeting the daily physical, mental and health needs of elderly and infirm residents has always been difficult work, but shifts have become more difficult during the COVID-19 pandemic as safety precautions have increased and the risk of illness for residents. residents and employees remains almost constant.
Meanwhile, the long-term care sector remains hampered by low wages.
Facilities in South Dakota have increased wages slightly to attract more workers over the past six months, with the salary for registered nurses increasing by 12% and the salary for licensed practical nurses and certified practical nurses by about 7%, according to a recent state investigation. health care association.
However, that same survey found that the average salary for certified nursing assistants, the most common front-line patient care position in long-term care facilities, averages only $ 14 an hour, or $ 29,000 per year.
Low pay makes it difficult to hire CNAs when the job requires training and certification, and McDonald’s restaurants in Rapid City, for example, offer inexperienced crew positions starting at $ 16 an hour.
The increasing stress of caring for residents while being almost constantly short of staff puts great strain on existing employees, said Ryan Brinkerhoff, administrator of the Five Counties Nursing Home in Lemmon, SD.
“They are tired and exhausted; their quality of life is affected, ”said Brinkerhoff. “I see it in their body language, and just looking at them you can see the stress.”
The evening nurse position has been open for nearly a year at Five Counties, a 45-bed public nursing home that has five open positions in its workforce of about 45 employees.
Brinkerhoff had to hire expensive temporary nurses from a mobile nursing agency to maintain the quality of care and this expense limited his ability to pay for certain needs within the facility.
Brinkerhoff said he was concerned the level of care for elderly or sick residents has already declined, but like other administrators, he praises his staff.
“I think in general patient care has probably suffered,” Brinkerhoff said. “But here it isn’t because my staff are amazing and stepped up and sacrificed a lot.”
Recent wage increases were necessary to compete for workers, but this expense and an increase in overtime and incentive payments to new and existing employees came at a time when fewer people were entering long-term care facilities, according to the national healthcare association. .
Some potential residents have found other options as long-term care facilities have experienced significant outbreaks of COVID-19 among residents and staff, while some facilities have turned away new residents due to a lack of staff. Spending at facilities increased to account for 192 new patient safety regulations added during the pandemic, according to the South Dakota Association of Healthcare Organizations.
Jobs in the long term care industry are available almost anywhere in the state and nation and at all skill levels.
“You’d be hard pressed to find a nursing home or assisted living facility in South Dakota that doesn’t have significant workforce issues,” wrote Mark B. Deak, director of South Dakota. Health Care Association, in an email to News. To concern.
EmPres Healthcare Management, a Washington state-based company that operates 82 properties in nine states, is one of several ownership groups offering signing bonuses of up to several thousand dollars for new hires, especially nurses.
On its website, the company lists 80 open jobs at its seven South Dakota facilities, including six openings in Flandreau, seven in Sturgis, nine in Britton, 11 in Mitchell, 13 in Woonsocket, 15 in Rapid City and 19 in Garretson. . Jobs range from nursing and cooks to janitorial.
A national survey of long-term care providers, conducted by the American Health Care Association in September, found that more than half of nursing homes turn away new residents because they cannot hire enough workers .
South Dakota has a long history of funding the Medicaid program at a low rate compared to almost every other state. The state’s Medicaid reimbursement rate falls far short of the cost of housing for each Medicaid patient.
According to the State Association of Healthcare Organizations, the money long-term care facilities lose every day for every Medicaid patient housed has increased over the past three years, from $ 47.14 lost by day in 2019 to $ 51.95 lost per day in fiscal year 2020-2021. .
South Dakota pays long-term care facilities about $ 158 per day for each Medicaid patient; for comparison, the rate is $ 174 per day in Iowa, $ 187 in Wyoming, $ 203 in Nebraska, $ 211 in Montana and $ 270 in Minnesota, according to the association.
In South Dakota in 2020, about 54% of patients in long-term care facilities were on Medicaid, according to data from the state’s Department of Human Services.