Even prior to the COVID-19 pandemic, a March 2020 report to Congress showed the nation's average nursing home operating at a loss (a -.3% margin) due to state Medicaid under-funding. New Hampshire has New England's worst under-funding. And yet, prior to the pandemic, New Hampshire's nursing homes had the nation's best rate of "substantial compliance" with federal health survey standards.
The COVID-19 pandemic has proved to be especially lethal to the elderly and medically-compromised population that nursing homes, and many assisted living facilities, care for.
The state recognized the crisis with $300 weekly stipends for all front-line long-term care workers serving the state's own Medicaid clients. But that program ended July 31.
The pandemic didn't end July 31. Nor did the heroism of long-term care workers. The state continues to give hazard pay to liquor store workers.
Providers are hard-pressed to keep staff, with Medicaid wage and benefit costs already unpaid by the state.
According to a May 17 Union Leader story, Governor "Sununu approved $30 million in relief for nursing homes.” Those who could apply was broadened to include all long-term care providers. Only 17 of 74 N.H. nursing homes received help during the 2nd round of state grants, with even a small 40-bed Catholic nursing home denied. There simply isn't enough funding to go around.
Alabama has provided significantly more funding to save nursing home care (boosting its Medicaid rates for nursing homes by $20 per day, and also giving $68.27 million in federal CARES Act funds to the Alabama Nursing Home Association Education Foundation to additionally assist nursing homes with personnel and other costs). In Georgia, October 2020 reporting states "$113 million in federal coronavirus relief funds will be made available to nursing homes and long-term care facilities." This was on top of "$36 million the state has provided to nursing homes and long term care facilities in staff augmentation since April[.]" And South Dakota legislators reportedly allocated $115 million to long-term care facilities. South Dakota has a population roughly 2/3 the size of New Hampshire.
We congratulate Gov. Sununu on his re-election, and long-term care providers appreciate many of his efforts to date, including the workforce stipends while they lasted, and especially value the work of his Dept. of Health & Human Services, its nation-leading testing approach, and its efforts to supply personal protective equipment when obtaining it was nearly impossible. Providers simply respectfully ask the state to better assist the lifesaving work going on in nursing homes and other long-term care settings. This is not a partisan issue. It's a life-or-death issue. We're asking this of both parties.
It would help New Hampshire if Senate Majority Leader Mitch McConnell would stop killing bills like the House-passed HEROES Act, which would provide "$150,000,000 . . . through September 30, 2022, to prevent, prepare for, and respond to coronavirus, for State strike teams or resident and employee safety in skilled nursing facilities and nursing facilities, including activities to support clinical care, infection control, and staffing" and also provide hazard pay to our essential workers. And in the latest Trump Administration distribution of federal aid, New Hampshire nursing homes fared 3rd-worst proportionately among all states. For example, each Florida nursing home received over 6X more funds than a N.H. facility.
We're in it for a long haul. As Harvard Professor David Grabowski notes, "The amount of fatigue that the direct caregivers are feeling right now is going to begin to manifest itself in individuals leaving the workforce, choosing a different profession." And who will fill the vacancies? In just one year's time New Hampshire reportedly suffered the net loss of 709 licensed nursing assistants.
Looking for a job? Long-term care staff are our heroes, and facilities are hiring heroes!