Photo of two seniors. sitting on a park bench, surrounding by green trees
Due to long-term care facility closures, some seniors have been forced to find new residences. Photo courtesy of Good Samaritan Society.

Five nursing homes and four assisted living facilities shut down in 2021. According to the Nebraska Health Care Association, all but one of them were in rural towns.

According to Jalene Carpenter, the CEO and president of NHCA, 54% of residents in long-term care facilities are on Medicaid, which means the state is paying for their care. The reimbursement rate the state pays for Medicaid patients means the facilities are losing about $40 per resident on Medicaid each day.

Correne Adams, administrator at the Good Samaritan Society in Beatrice, said that this can be especially hard on rural nursing homes, because they rely on Medicare and Medicaid for the majority of their residents. 

The pandemic has exacerbated this financial crisis, because the costs of personal protective equipment, testing and employee wages are increasing, she said. 

“It has created a staffing crisis, because it’s incredibly difficult to attract and retain employees when, in the marketplace, there is such a high demand,” Carpenter said. “Wages have increased at such a high rate, and what we get paid from the state has not increased.”

Rural nursing homes often have an especially hard time with staffing, because as their populations age, there are less people to care for those entering the nursing homes.  

When there is not enough staff, a facility has to rely on agency staffing. Adams said agency staffing is more expensive, so relying on it strains the facility’s wallet even further.

Last week, Gov. Pete Ricketts announced a request for an additional $20 a day for each Medicaid resident at long-term care facilities over the next six months. The funds would be allocated toward pandemic costs.

“We are incredibly grateful for the governor and his requests for that,” Carpenter said. “It really is a good step in the right direction so we can have that conversation. But, from a staffing perspective, it really is just a bandaid.”

The 2022 legislative session began in January, and Sen. John Stinner of Gering introduced LB988 and LB989  on Jan. 12, which, if approved, would appropriate federal funds toward increasing the rates assisted-living facilities and nursing homes receive for Medicaid patients. He also introduced LB1089, which would allocate funds for the Department of Health and Human Services to grant toward licensed and medicaid-certified nursing facilities.

In addition to funding, Carpenter said attracting more people to work in long-term care is an important step in finding a solution.

“It’s such a rewarding profession. I just don’t think people understand what joy it is to work in a facility,” she said. “The people that are currently working in the facilities are amazing heroes, and they provide such an honorable service.” 

Carpenter said it is time for Nebraskans to come together and have a conversation regarding what we want long term care to look like in the state.

Long-term care is a necessary service, and having fewer long-term care options creates a strain on Nebraskans. Folks may have to move farther from home than they would like and therefore be farther from their families.

“Every elderly rural Nebraskan that I know is fiercely loyal to their community,” Carpenter said. “The last thing we want is for them to have to receive care somewhere else.”

Nursing homes shut down in 2021:

  • Belle Terrace (Tecumseh)
  • Good Samaritan Society (Arapahoe)
  • Good Samaritan Society (Ravenna)
  • Good Samaritan Society (Valentine)

Assisted Living Facilities shut down in 2021:

  • Becky’s House (Omaha)
  • Good Samaritan Society (Arapahoe)
  • Good Samaritan Society (Valentine)
  • Parkside Manor (Stuart)
  • Westside Regency (Stanton)