The coronavirus pandemic and its impact on nursings has exposed the federal government’s failure to properly invest in a “safe and effective” long-term care system, researchers argue in a perspective published Wednesday in the New England Journal of Medicine.

“More funding alone is not the answer. Nor is more regulation a sufficient response. Rather, we need a combination of funding, regulation, and a new strategy that fully supports a range of institutional and non-institutional care,” University of Pennsylvania researchers wrote. 

The authors argued that providers have seen their occupancy and federal funding decline and had “little cushion” to respond to a national emergency, like the coronavirus pandemic. 

The public health emergency has forced them to divert resources to pay for additional costs, such as COVID-19 testing, personal protective equipment and increased wages, and that will likely cause many operators to make harsh operating decisions in the near future despite recent relief packages.

“In the coming months, some nursing homes are likely to struggle to pay rent or their staff members and may be forced to close or file for bankruptcy. Hundreds of thousands of nursing home residents could be displaced, which would cause huge disruptions for them and their families during an already precarious time,” they said. 

Operators should consider models that promote smaller group care settings for residents, while the United States should consider changing its funding approach for long-term care to better meet the needs of seniors, the researchers urged. 

“The tragedy unfolding in nursing homes is the result of decades of neglect of long-term care policy,” they wrote. “But this crisis in nursing homes is not a new problem. Long-term care in the United States has been marginalized for decades, leaving aging adults who can no longer care for themselves at home reliant on poorly funded and insufficiently monitored institutions.”