ST. PAUL — A coach bus full of individuals representing nursing homes and long-term care facilities in the region visited the State Capitol Monday to impress on legislatures the staffing crisis facing senior living facilities.
The bus departed Oak Hills Living Center Monday morning carrying over 30 people representing area care facilities. The bus stopped in St. Peter to pick up even more people. The bus contained representatives from Oak Hills of New Ulm, Ecumen Pathstone Living of Mankato, Divine Providence of Sleepy Eye, St. John’s of Springfield, United Hospital District of Fairmont and Kings Way Retirement Home of Belle Plaine.
Staffing shortages at nursing homes and long-term care facilities are forcing some facilities to turn away seniors. In October, over 11,000 Minnesota seniors were turned away from long-term care facilities in a single month. There are currently over 20,000 open long-term caregiver positions in the state. The problem is only expected to increase as the number of seniors grows. Minnesota will have another 50,000 residents turning 80 within the next 5 years.
Part of the reason for the shortage of caregivers is low wages. Many nursing homes cannot compete with hospitals and other industries for a supply of skilled workers. Those who continue to work at these facilities are a forced to work extra hours.
Oak Hills Board member and former medical director of Highland Manor, Dr. Ann Vogel, help organize the capitol trip. Before departing for St. Paul, Vogel expressed her disappointment that funding long-term care facilities was not one of the top priorities of Minnesota legislators.
She said at the current rate, many rural nursing homes will not be able to stay open and everyone will be suffering for it.
On the bus ride to the capitol, Vogel said elder care needs were only going to increase over the next few years. She wanted to urge state legislatures to use a portion of the $17 billion surplus to fix the crisis.
In addition, there was a need to reduce reimbursement delays to nursing homes. Nursing homes received cost of living increases from the state, but rural nursing homes are seeing delays of up to 21 months in getting their reimburse
ment compared to Twin Cities counterparts.
Rural long-term care facilities faced extra challenges not seen in the metro area. In the Twin Cities, multiple care facilities could be located within a few miles, but residents in Greater Minnesota are sometimes required to travel across the state for care. When a nursing care facility closes in rural Minnesota, families might be forced to relocate loved ones hundreds of miles away.
All those traveling on the bus to the capitol were attending a State Senate Human Services Committee hearing on the Caregivers Stabilization Act of 2023. The bill was introduced by the committee chair Sen. John Hoffman (DFL–Champlin). The bill would create new rates affecting state disability waivers, elderly waivers, home care services, nursing facilities, intermediate care facilities and emergency and non-emergency medical transportation.
Before the meeting, the bus group had a short meeting with Sen. Gary Dahms (R-Redwood Falls) and House Rep. Paul Torkelson (R-Hanska).
Dahms said the Legislature had tackled this topic a few years ago, but inflation had brought the state back to the current conditions.
Shelly Augustine, the Director of Nursing at Divine Providence in Sleepy Eye, read a letter to Dahms about the current staffing crisis. She said the current crisis was nothing compared to what came before. The low staff is causing a mental breakdown in staff who are forced to work overtime.
Dr. Aaron Johnson, Chief of Staff at United Hospital of Fairmont echoed Augustine’s concerns.
“I’ve seen cycles where we did not have enough staff,” he said. “But it has never been like this.”
Johnson said the problem went beyond elderly care. Without staffing, long-term care facilities cannot take on patients. In rural Minnesota, this means patients cannot be discharged from the hospital if no long-term beds are open. This forces some patients to remain in the hospital, increasing costs.
Dahms said the legislators could provide extra money for caregivers, but they could not create people. He said every industry was facing shortages and there would be others coming the next to request surplus money. Dahms said they could allow care facilities to compete with other employers by raising pay.
Jeanette Landsteiner told the story of her husband Paul, who is a disabled Vietnam veteran. He became 100% disabled after suffering a stroke in Georgia during a return trip to Minnesota. Landsteiner said it took months for them to return to Minnesota. He currently resides in Oak Hills and wishes to stay there for community connection. Landsteiner said they need to raise wages to keep staff and avoid turnover.
Landsteiner worries about Oak Hills closing because of inadequate staffing. She said it would be unthinkable to move Paul now.
Anna Macholda, Infection Control Nurse at Oak Hills, said patients who would build up the community deserve to stay in the community. She did not want to see anyone transferred out of New Ulm due to closure.
Macholda said that the current system in Minnesota had been cracking for some time, even before the COVID pandemic. She said it was now shattered as nursing homes could not compete with hospital pay.
Torkelson advised the group to keep putting on pressure to make sure their concerns are heard through the system. He gave assurance he would put pressure on the House.
“The needs are real and the demographics are real,” he said.
During the Human Service Committee hearing, the committee heard testimony from several individuals across the state advocating for the passage of the Caregivers Stabilization Act.
Emily Hartzog, a nurse manager from Ecumen Pathstone Living of Mankato, testified before the committee. She said her “industry was facing record-level workforce shortages in assisted living and nursing homes across the state.”
According to the Mayo Clinic, patients are traveling as for as 200 miles to find an accepting facility.
“The other option is to send patients home with home health care services, but then seeing them end up back in the emergency room because of the initial need for placement in a skilled nursing home,” Hartzog said. “Caregiving is a 24-hour per day, seven day per week commitment. Unlike other businesses, we can’t limit our hours, close our doors for a few days, or sell fewer products. We cannot accept a lower quality of service because we are caring for people.”
Hartzog closed by reminding the committee that the ability to raise wages is tied to state allocations.
The committee took no action on the bill during the hearing but expressed a desire to fix the problem. Sen. Jim Abeler (R-Anoka) described the testimony as “horribly compelling.” He was astonished that Minnesota could be facing a crisis like this despite its strong medical background.
Committee Chair Hoffman encouraged everyone to be innovative in finding solutions.