Despite Billions in Aid, Nursing Homes Losing Employees in Droves


Nursing homes, already strapped for employees, lost about 19,500 workers last month, according to government figures. Question: What’s happened to all the funding nursing homes have gotten because of COVID-19?

Though COVID-19 infection rates and deaths continue to fall throughout the United States, nursing homes face even more daunting problems than the decades long systemic failures that made them and other long-term care facilities (LTCFs) the nexus of the COVID-19 pandemic. The labor shortage at nursing homes keeps getting worse. According to the latest report by the U.S. Bureau of Labor Statistics, nursing homes are losing employees in droves.

“Employment in health care changed little in April (-4,000), as a job gain in ambulatory health care services (+21,000) was largely offset by a job loss in nursing care facilities (-19,000),” the report states. “Health care employment is down by 542,000 since February 2020.”

Nursing homes and LTCFs continue to be watched closely for possible COVID-19 outbreaks, such as the one that occurred at a nursing home in Kentucky in March. According to the Centers for Disease Control and Prevention, 132,293 nursing home residents and 1894 nursing home employees died from COVID-19.

LTCF officials have countered that nursing homes remain significantly underfunded compared to urgent care hospitals and other health care systems. Infection Control Today® has reported on ways nursing homes can shore up their care gaps for relatively little expenditure and presented a case study of how one nursing home used innovative techniques to hold COVID-19 at bay. Meanwhile, the Association for Professionals in Infection Control and Epidemiology (APIC) has called on states to mandate that nursing homes employ full-time infection preventionists.

Despite the uptick in employment at ambulatory care facilities, health care as a whole seems to be hemorrhaging jobs, according Altarum, a health care consulting company that focuses on Medicare and Medicaid. “Health care added 11,500 jobs in March 2021 and 25,000 jobs in February; however, a drop of more than 80,000 jobs in January puts health employment at the end of first quarter (Q1) 2021 down by 44,000 jobs compared to the end of 2020,” according to Altarum. The report adds: “Overall, nursing and residential care employment is down 38,000 jobs in Q1 2021 and has fallen by 8.6%, or 313,000 jobs, since February 2020.”

Then there’s this: Are nursing homes and other LTCFs as strapped for funding as many believe? A report by the Center for Medicare Advocacy (CMA), a not-for-profit advocacy organization for older Americans and those with disabilities, argues that LTCFs have the funds to begin rebuilding, and certainly enough money to increase wages to lure workers.

“On April 15, 2020, Arkansas announced that CMS had approved its request to use Medicaid to fund the temporary increase of wages for direct care workers, including $125 per week for designated staff (including nursing staff) who worked 20-39 hours per week and $250 per week for designated staff working 40+ hours per week,” the CMA report states. “For staff working with COVID-19-positive residents, weekly wages increased more, $125 for staff working one-19 hours per week, $250 for staff working 20-39 hours per week, and $500 for staff working 40+ hours per week.”

Nursing homes and other LTCFs have received funding from other sources such as the Paycheck Protection Program. In addition, according to the CMA report, the “Coronavirus Aid, Relief, and Economic Security Act (CARES Act), enacted March 27, 2020, created a $175 billion Provider Relief Fund. Approximately $21 billion of the $175 billion was earmarked for nursing facilities.”

In addition, nursing homes have received billions of dollars worth of non-monetary assistance including personal protective equipment, over 7 million surgical masks, more than 32 million gloves, and COVID-19 tests, according to CMA.

The headline of an article published last November by AARP puts the question directly: “Nursing Homes Are Getting Billions in COVID Aid—Where Is It Going?”

The article states that “many industry experts and watchdogs are opposed to distributing more federal aid without a better understanding of where the money’s going. Public records show aid dollars have gone to facilities that have repeatedly been cited for health violations, insufficient care or worse. An investigation by the Washington Post found that hundreds of millions of aid dollars have been sent to facilities sued in recent years for Medicare fraud. ‘I am both skeptical and concerned about where that money has gone,’says Mike Wasserman, a past president of the California Association of Long-Term Care Medicine.”

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