The impending closure of Pioneer Health & Rehab, Prairie Farm, is an example of a series of challenges facing nursing homes and elderly care facilities across the state, according to two sources representing the nonprofit nursing home industry.
They include John Sauer, who heads LeadingAge Wisconsin, a statewide group that represents nonprofit long-term care providers, and Amy Duhr, chief executive officer with the Eau Claire-based Grace Lutheran Foundation, which has operated the Prairie Farm facility since 2015.
In a Jan. 31 press release announcing the closure at Prairie Farm, Duhr cited two issues that pose a challenge to her organization:
• Medicaid reimbursement rates, which the press release said do not cover the cost of long-term care.
• A shortage of qualified certified nursing assistants to staff the facilities and provide adequate care for elderly residents.
Sauer said his organization represents Wisconsin “nursing homes, assisted living (facilities), senior housing, hospice, and adult day care (organizations).
“We have tracked facility closures since 2016,” he added.
In that time, some 60 nursing homes in Wisconsin have closed.
“In the past 14 months, we’ve averaged one closure per month,” Sauer said.
The string of closures isn’t limited to smaller communities like Prairie Farm, Sauer added.
LeadingAge tracked other recent closures in Whitewater, Viroqua, Ladysmith, Dodgeville, Mellen, Kenosha, Wittenberg, Walworth, Altoona, Phillips, Cuba City, Portage and Sheboygan.
While the communities listed vary greatly in population, Sauer added that “Medicaid pays rural facilities a lower amount compared to the rest of the state.”
There was a time when Wisconsin’s Medicaid reimbursement rate was last in the nation, Buhr and Sauer said.
“We’ve begun to make some inroads since then,” Sauer added. “The governor and the Legislature have supported helpful increases, but not enough to save the challenged facilities.”
Twenty-six residents currently live at Pioneer Health & Rehab, according to Duhr.
“A significant number of (the Prairie Farm residents) are on Medicaid,” she said.
Grace Lutheran Foundation operates many facilities across the state, and “at least 80 percent is our average” when it comes to Medicaid-funded residents, she added.
Sauer said that across Wisconsin, “about two-thirds of nursing home residents receive medical assistance or Medicaid.”
The crisis in the nursing home workforce is the second primary challenge listed by both Grace Lutheran and LeadingAge.
Sauer said that the problem was already severe before the COVID-19 pandemic and has only worsened since then.
The shortage has forced many facilities to operate below their licensed number of beds, which “means (that the nursing home industry) has to manage admissions to its facilities, and that further jeopardizes financial viability,” he added.
As long-term care facilities seek to compete with other healthcare sectors for a dwindling number of workers, they have raised wages and increased benefits, which dramatically increases operating expenses, according to Sauer.
“Secondly, inflation is beyond what we’ve dealt with in the past, and has hit hard,” he added. “Fuel and utilities are significant costs, along with the food budget, medical supplies and maintenance supplies.”
LeadingAge members and other long-term care providers are trying to call attention to streamlining other ways to help ease the job shortage. They include:
• Streamlining the process of employing legal immigrants.
• Offering free CNA training and testing for economically-disadvantaged citizens.
Sauer noted that in 2022, the Wisconsin Community Action Program was awarded a $4 million grant “to connect (economically disadvantaged) people who want to work in long-term care (to jobs in the industry).”
Successful candidates can get their tuition paid for, he added.
“We have another program called WisCaregivers Careers, funded by a grant that provides free training, testing and mentoring for CNA candidates,” Sauer said. “It will pay for the 75-to-120 hour training, pay (candidates) to sit for the exam, and pay providers to mentor the individuals.”
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