With each passing day, providers across the nation are transitioning more fully into a new reality that has been deeply formed and altered by the COVID-19 pandemic. This new existence will continue to take shape as providers, regulators, and industry advocates like the American Health Care Association/National Center for Assisted Living (AHCA/NCAL ) learn the lasting impacts of the past two years. New challenges await and it’s essential that providers feel prepared for what’s next.

Dr. David Gifford, Chief Medical Officer and Director of the Center for Health Policy Evaluation in Long Term Care at AHCA/NCAL, summarized his outlook on the three most pressing issues facing providers.

1. The Workforce Crisis: Providers are experiencing a loss of staff due to pandemic impacts and lack of supply/availability of staff to fill vacancies.

A recent report from AHCA/NCAL summarized Bureau of Labor Statistics (BLS) data showing that that long term care facilities have lost more than 400,000 caregivers since the beginning of the pandemic, more than any other health care sector. According to the BLS, overall long term care workforce levels are the lowest they have been in 15 years.

In addition, the issue of potential anti-competitive practices by temporary staffing agencies is a concern in nursing homes and assisted living communities. At a time when long term care facilities are struggling to make sure they have enough staff to serve their residents and keep their doors open, staffing agencies are charging exorbitant rates and giving only a fraction to their clinical personnel. AHCA and the American Hospital Association (AHA) recently sent a joint letter to White House COVID-19 Response Team Coordinator Jeffrey Zients to bring attention to the matter.

While areas of bipartisan agreement in Congress are all too rare, the scope of this workforce challenge is too big to ignore. With a growing elderly population, lawmakers must prioritize the recruitment and retention of our health care workforce, especially in long term care.

2. Continued COVID-19 Pandemic Complexities: Operations will be strained due to continually changing guidance, extensive reporting burdens, and inconsistencies in approaches on local/state/federal levels.

AHCA/NCAL has made repeated requests to federal policymakers to prioritize long term care for essential resources, such as tests, testing equipment, and a separate allocation of COVID-19 treatments for long term care pharmacies. In a recent letter to the administration, the association urged the federal government to prioritize long term care for access to urgently needed resources, such as COVID-19 testing and treatments, since at this time, long term care providers are left to compete on the open market for tests. AHCA/NCAL specified the need to increase the number of shipments with tests and testing equipment supplied to long term care providers as well as ensure our staff and residents remain the utmost priority for testing.

Additionally, association leaders have said the federal government should set up a separate allocation of COVID-19 treatments that long term care pharmacies can access to supply our settings. At present, long term care providers must navigate the various cumbersome ordering process for treatments that each state has set up. This has resulted in delays in accessing life-saving treatments. Establishing a separate process for long term care pharmacies to order treatments directly and increasing the availability of testing in long term care would help our settings identify the virus quickly and save precious lives.

3. Rising Costs: With census down and occupancy issues on the rise, issues such as agency price gouging and COVID-related costs (PPE/testing) will exacerbate the existing funding crisis.

A report from AHCA and Clifton Larson Allen provided insights into the economic crisis long term care providers across the country are facing. Main drivers of the crisis include:

• Increasing Costs Due to Labor and Inflation: The report found that the average increase in wage rates for nurses at all levels doubled from 2020 to 2021. Rates for contracted and agency nurses are also two to three times higher than pre-pandemic rates.
• Challenges with Access to Resources: Medicare and Public Health Emergency-related funding provided help and support throughout 2020 and early 2021, but potential cuts to these programs pose risk to nursing homes as they continue to face financial challenges such as occupancy decline, staffing shortages, and increased labor costs.

Watch for updates from Provider as the sector addresses these issues and works on behalf of providers everywhere. Tune into ProviderTV or check back here to get the latest information. ​