One Quarter of U.S. Nursing Homes Might Not be Here by Next Year

Almost half of nursing homes and assisted living facilities are operating at a loss, while 84% of nursing homes are losing revenue this year because fewer post-acute patients are coming to them from hospitals.

If anybody has any doubt that nursing homes and other long-term care facilities (LTCFs) in the United States face problems serious enough to close them down over the next year, they need only ask officials at those facilities to have those doubts challenged. That’s what the American Health Care Association (AHCA) and the National Center for Assisted Living (NCAL) did. (The NCAL is part of the AHCA.) They surveyed about 14,000 such facilities and found that only one quarter of the officials running them think that those institutions will still be here by this time next year.

In addition, a press release by AHCA/NCAL notes that 94% of nursing homes face serious staffing shortages, as has been reported by Infection Control Today® (ICT®). (This, despite receiving billions of dollars in aid, according to the Center for Medicare Advocacy; more on that below.) The AHCA/NCAL survey finds that:

  • Almost half of nursing homes and assisted living facilities are operating at a loss.
  • Eighty-four percent of nursing homes are losing revenue this year because fewer post-acute patients are coming to them from hospitals.
  • More than half of nursing homes and assisted living communities have had to make staff cuts this year because of increased expenses or lost revenue.
  • Whether the facilities have had to care for COVID-19 patients or not, the top 3 costs incurred include more pay for staff, hiring more staff, and purchasing personal protective equipment (PPE).
  • The Provider Relief Fund has provided some, well, relief during the COVID-19 pandemic, according to 92% of nursing homes and 62% of assisted living facilities. But not enough.

Mark Parkinson, the president and CEO of the AHCA/NCAL, in a statement called on Congress and state legislators to help the struggling institutions by passing the Care for Our Seniors Act. “Too many facilities are operating under shoestring budgets simply because policymakers have

failed to detect the proper resources, and this can have devastating consequences,” Parkinson said. He adds that a significant portion of whatever resources are left in the Provider Relief Fund needs to be funneled to nursing homes and other LTCFs.

The nursing home industry will lose about $94 billion from now until the end of the COVID-19 pandemic, according to the AHCA/NCAL. More than 1800 of the facilities are expected to close their doors, forcing the placement of residents into other facilities, which can be a logistical hurdle for the institutions involved and an emotional burden for the residents and their families, as well as the caregivers who will find themselves out of a job and their families.

The dire straits laid out by the AHCA/NCAL about nursing homes and other LTCFs contradicts a CMA report issued in March that contends that nursing homes have more than enough funding to fix their problems. CMA, a not-for-profit advocacy organization for older Americans and those with disabilities, ticked off several revenue sources for nursing homes and other LTCFs, including the Provider Relief Fund noted by the AHCA/NCAL. The CMA used what was going on in Arkansas as a case study.

“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.”

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.”