As nursing homes limit admissions due to ongoing labor challenges, residents can expect a mounting access crisis, with some U.S. counties being turned into “nursing home deserts.”
This is according to a report released Wednesday by the American Health Care Association (AHCA), which notes that nearly 450,000 residents will be displaced if a potential minimum staffing mandate were to be enacted. These estimates are based on if SNFs had to comply with a 4.1 hours per resident day staffing minimum.
“Too many of our nation’s seniors are having to look farther and wait longer for the long-term and post-acute care they need. These are sobering numbers and should serve as a wake-up call to policymakers to help nursing homes rebuild,” said Mark Parkinson, president and CEO of AHCA/NCAL.
Federal policymakers are at a crossroads, Parkinson noted, in terms of how federal agencies can address the care crisis. Comprehensive policies and investments need to address the caregiver shortage while protecting access to high-quality nursing home care, he said.
“If they proceed with unfunded staffing mandates, this situation will only get worse,” added Parkinson. As it stands, the mandate is lacking resources or workforce development programs to support its implementation.
Meanwhile, nursing home closures accelerated by four times during the pandemic, according to the report.
From 2020 to the present, 579 nursing homes have closed, and more than 21,000 residents have been displaced by closures. Moreover, 30 additional counties have become what AHCA calls “nursing home deserts.” That means 45,217 fewer nursing home beds were available to prospective residents due to downsizing.
And the current crisis did not spare the best nursing homes. Two out of five nursing homes that closed during this time had four- or five-star ratings, AHCA found.
Meanwhile, the closures have not been replaced by new openings. Only three new nursing homes have opened this year, compared to an average of 64 per year between 2020 and 2022.
Nursing homes forced to close their doors tended to be smaller facilities in urban settings, where the majority of residents rely on Medicaid, according to the report. Three in 10 of the closures were not-for-profit nursing homes.
Coupled with these recent findings are labor shortage data points collected in June that also point to a grim story. And add to this a workforce analysis completed by CliftonLarsonAllen in December 2022, which found that about 15%, or 250,000 workers, left their nursing home positions during the pandemic.
Workforce levels aren’t due to rebound at a national level until 2026, CLA said back in December.
Among other findings pointing to a worsening of access to care – 55% of SNFs are turning away prospective residents, 44% have waitlists spanning a few days, 21% are downsizing beds or units and 24% have closed a wing, unit or floor because of labor shortages.
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