A prominent front-page story in Monday’s New York Times confirms what many industry insiders have dreaded for years: Rural nursing homes hanging on by a thread are closing in waves across the country.
The high-profile report notes that more than 440 rural nursing homes have either closed or merged the past decade, citing data from the Cowles Research Group. Often, that has forced frail nursing home residents with few options into facilities that are miles away from friends and family.
Most industry watchers are familiar with the culprits — including inadequate Medicaid reimbursements, dwindling small-town populations and crippling labor shortages. The story highlights some of the small town lives affected by these big-picture issues.
LeadingAge CEO Katie Smith Sloan said her group has personally heard the stories at town hall meetings in communities across the U.S.
“If nursing homes shut down in rural areas, there is no place for residents to go,” she told McKnight’s on Monday. “The workforce issues faced by all our members across the country are magnified in rural and frontier areas where the working-age population is declining, the aging population is growing, and health and long-term care resources are few and far between. In so many of these communities, after young people graduate from college, few want to go back home.”
She said the trade group, whose members include not-for-profit nursing facilities, is pushing several legislative changes to help rural providers. Those include exploring the feasibility of amending the Rural Health Care Connectivity act of 2016 to include home health providers, and supporting the reintroduction of the CONNECT for Health Act, which would expand Medicare coverage to telehealth services, “which are especially crucial to high-quality health and long-term care in rural areas.”
She added that LeadingAge continues to work with stakeholders and CMS to implement provisions of the CHRONIC Care Act, aimed at expanding Medicare coverage of telehealth tech in Medicare Advantage and accountable care organizations.
Reports from the Medicare Payment Advisory Commission have consistently demonstrated the skilled nursing industry’s thin margins, and providers have continually voiced concerns about funding shortfalls, said Beth Martino, the American Health Care Association’s vice president of public affairs
“There is no question that the financial instability facing our sector has the potential to have a dire impact on America’s senior population,” she told McKnight’s. “We are now seeing the effect across the country, especially in rural areas. It’s time to address the inadequate Medicaid funding that leaves many of our providers struggling to keep their doors open.”
Several local reports this week further highlighted these trends. The Massachusetts nursing home industry, for one, says inadequate state funding caused 20 facilities to close last year, and it’s putting another 39 at risk of doing the same in 2019. Maine has seen a spate of closures, too, losing 3,000 beds since 1995, the Ellsworth American noted Sunday. And elected officials in South Dakota continue to seek solutions to address a “crisis” of long-term care facility closures in recent years, the Daily Republic reported.