Billions of dollars in provider relief funding have helped offset the tremendous financial losses some nursing homes have reportedly incurred during the pandemic.

But COVID-19-associated problems run long and deep, with the potential to influence how well and for how long providers  remain financially viable. One challenge that will require immediate — and expensive — attention: Shared rooms.

“How do you make capital investments up front? Then how do you pay for the care on an ongoing basis? And pay staff a living wage and offer a non-double occupancy living environment?” asks Harvard Medical School’s David Grabowski, Ph.D. “Operators tell me all the time, if they had single occupancy, they couldn’t make this work.”

Another problem: A huge expected influx of baby boomers who could instead head toward lower-acuity settings.

“There’s great interest in the ‘less care’ driven market, whether you call it ‘active adult’ or truly independent living,” says Robert Kramer, co-founder and strategic advisor for the National Investment Center for Seniors Housing & Care (NIC).

But the mother of all challenges is a bruised and battered workforce with more support for better wages and benefits.

“Labor shortage issues continue to be a challenge throughout the industry posing pressure on operating margins,” says Bianca Andujo, senior director at Berkadia. “We expect that the recent Provider Relief Fund Phase 4 will grant some additional relief to operators. However, it will not be a permanent fix.”

Unsettled workforce crises very well could permanently alter the face of long-term care in the coming years. 

To Grabowski, labor issues and their causes are just begging to be fixed.

“Nursing home financing has long been broken and the pandemic showed just how much,” he says. “Moving forward, we need to redesign the nursing home payment system to encourage greater value, equity and accountability. Without these types of reforms, I am worried that we will see an exit of high-performing providers and a number of residents unable to obtain high-quality care.” 

From the November 2021 Issue of McKnight's Long-Term Care News