Long-term care (LTC) facilities have historically faced staffing shortages, and the COVID-19 pandemic only exacerbated such shortages across the entire long-term care system. According to the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) analysis of the Bureau of Labor Statistics (BLS) year-end data, many employment sectors have recovered to prepandemic employment levels. On the other hand, long-term care facilities continue to face the worst job loss of any health care sector.
Long-term care caregivers are burned out and leaving the sector in droves, either entirely or for other health care facilities, such as hospitals. Many of these other health care providers have the resources to offer higher wages and more attractive benefits. Because of the chronic underfunding for long-term care facilities, they cannot fairly compete for the limited health care workforce, leaving long-term care facilities with staff vacancies that are almost impossible to fill.
Nationwide, low staffing levels have given long-term care facilities no choice but to limit resident admissions and, in some cases, close their doors for good. Since the start of the COVID-19 pandemic, two rural long-term care facilities have closed, and continued staffing shortages have resulted in existing facilities closing entire wings and limiting admissions. This has a major impact on the health care sector at large, as hospitals are experiencing significant patient backlogs because they are unable to discharge patients to nursing homes. Regrettably, this gap in the continuum of care creates additional stress on staff in hospitals and other health care settings.
The Biden administration’s solution to the staffing shortage in long-term care is to implement a mandatory staffing minimum. Unfortunately, this approach is a Band-Aid over a gaping wound. A federally mandated staffing minimum will be extremely harmful to nursing homes, hospitals and especially to New Mexicans who need services from these providers. Health care workforce levels in New Mexico are nowhere near what is needed to fill current job openings. As a result, mandating minimum staffing levels in nursing homes will not serve to improve the quality of care for residents but will instead limit the number of people receiving such care while also having a domino effect on the entire health care system.
Nationwide, this mandate is projected to cost nursing homes billions of additional dollars each year to hire tens of thousands of caregivers. In New Mexico, a vast portion of the nursing home model of care relies on nursing home providers being price takers. This is because approximately 70% of New Mexico’s nursing home residents rely on state established Medicaid reimbursement rates to pay for their care. On average, 2021 New Mexico nursing home Medicaid reimbursement rates were $55 below the cost of resident care per day. Layering the cost of a minimum staffing mandate on top of the current cost of resident care would only widen that gap beyond what facilities can absorb for any length of time. At the bare minimum, nursing facilities need additional funding in order to close this gap and continue to operate. In the long term, nursing facilities want to partner with lawmakers to create solutions that address the underlying workforce challenges.
New Mexico facilities are doing everything they can to hire more caregivers, but they cannot do it alone. They need policymakers in New Mexico and Washington, D.C., to address the root cause of our workforce shortages instead of implementing an unfunded mandate.