Nursing homes’ familiar struggles with insufficient staffing and insurance reimbursements are contributing to growing backlogs of patients awaiting throughput from hospitals to post-acute care across the US. 

Those waitlists are set to grow more congested in 2024 and cause even bigger disruption throughout the US healthcare system, according to recent state-level reports.

Hundreds of patients are currently stuck waiting for discharge from hospitals in states such as Massachusetts, where 481 have been delayed from being placed in skilled nursing facilities, according to a report from the Massachusetts Health & Hospital Association.

“Delays in patient discharges to post-acute care settings have become a growing challenge for hospitals and post-acute care providers,” the MHA report stated. It also noted that lingering effects of the pandemic had worsened already difficult winter seasons.

The trend holds true outside of Massachusetts, confirmed Jalene Carpenter, president and CEO of the Nebraska Health Care Association.

“While the seasonal impact of COVID, influenza and RSV exacerbate the transition-to-care issue, the current situation reflects long-term and ongoing insufficient resources to meet patient needs,” Carpenter told McKnight’s Long-Term Care News Wednesday.

A lack of funding and available long-term care workers are the major compounding factors in Nebraska, where more than 100 patients are waiting for access to long-term care and skilled nursing facilities according to a report by the Nebraska Hospital Association. 

Even when beds are available, facilities may simply not have enough workers and resources to care for additional residents, noted Kierstin Reed, CEO of LeadingAge Nebraska.

“They have too many patients in their hospitals, a lot of which they aren’t getting paid for,” Reed told McKnight’s. “They’re boarding and it’s because they can’t get into long-term care.”

Nursing home closures across the US have further complicated the issue. More than 500 have closed nationwide since 2017, including 35 in Nebraska, according to the NHA report. While that number is stabilizing in Nebraska — only one closed last year — the state has lost 15% of its LTC facilities in total and now has four counties with none at all.

Some states have responded by attempting to legislatively address problems, especially targeting increased Medicaid reimbursement in states like New York, Ohio and Washington. 

In Nebraska, nursing homes are now able to apply for additional state funding for incoming residents with complex needs, such as wound or end-of-life care. This measure took effect Monday and is directly intended to streamline the throughput process.

With winter’s respiratory illness season in full swing, however, slow-moving and scattered legislative solutions are unlikely to curb an expected upswing in the hospital backlog. Massachusetts, for example, saw more than 1,000 patients stuck in hospitals throughout the winter months of 2022-2023 — a high-water mark that MHA’s data suggests will be approached again in the coming year.

Meanwhile, patients awaiting post-acute care placements are already forced to wait anywhere from a week to several months for throughput. Dozens have even been in limbo for more than half a year, according to both the MHA and NHA reports. Increased waitlists will surely put even more pressure on nursing homes.