Yet another sign that New Hampshire employers are hurting for workers was put into focus by the decision of a popular chain of restaurants to close Mondays to give its workers a reprieve. As representatives for long-term care providers, we can relate.
However, nursing homes and assisted living facilities cannot limit hours or close on certain days. Instead, facilities are struggling to make do. That can mean denying admission to someone who needs a bed because the facility cannot responsibly staff to meet that person’s needs.
Even as New Hampshire joined a handful of states in achieving a national goal of having 75% of nursing home staff vaccinated, those staffing facilities are exhausted. They made it through the worst of the COVID-19 pandemic, but it took an emotional toll. Facilities have dramatically increased pay in the effort to recruit and retain staff, but do so beyond the limits of the Medicaid payments that are responsible for the care of most residents. If you are a nursing home looking to compete with a restaurant hiring dining staff, for example, that restaurant is not being limited in its hiring ability by government funding.
To the credit of legislators and Gov. Sununu, the state budget improved nursing home funding. Yet, for reasons too technical to explain, that did not translate into an immediate rate increase for care. Meanwhile, we are over seven months into the year with no federal payments having been made in 2021 from the COVID-19 Provider Relief Fund that Congress had established. New Hampshire facilities were disadvantaged by the prior federal distributions and could desperately use new federal aid. Instead, even as the Delta variant surges, some D.C. policymakers have toyed with the idea of using the unspent provider funds as a “pay-for” to offset new program costs like infrastructure.
We are all for infrastructure, but it would be unseemly to effectively pave roads with dollars meant to make up for the devastating toll of COVID-19 upon health care providers and their workers. A national survey of providers only found confidence that a quarter of long-term care facilities could last a year or more unaided.
It’s a perfect storm. We have a red-hot service economy, great for New Hampshire, and yet those serving our most vulnerable citizens lack the means to compete amidst a shortage of workers that is besetting everyone. It’s enough to make one cringe every time you see the “help wanted” signs that are now as familiar a part of our landscape as our famous autumn leaves.
In the long run, we must continue the state’s admirable progress in improving Medicaid funding for all long-term care settings.
In the near term, there are one-time investments that can be made through the American Rescue Plan Act of 2021 dollars the state received that can help shore up our long-term care system and grow the number of licensed workers available to them. The opportunity exists for innovation, just as Gov. Sununu deployed Coronavirus Aid, Relief, and Economic Security Act funding in 2020 in ways that quite literally saved long-term care that year. Time is of the essence, as the future of facility-based care has never been more tenuous.
(Tom Blonski is president and CEO of Catholic Charities New Hampshire. Brendan Williams is president and CEO of the New Hampshire Health Care Association.)