Nursing homes, care centers say they face staffing crisis without higher pay

LINCOLN — Words like “crisis,” “dire” and “desperate” were used Monday to describe the shortage of workers in the state’s nursing homes, as well as in programs serving the developmentally disabled.

An advocate for senior care facilities said that their workforce is down 10% and that hiring replacements is getting harder because other entities, including the state’s 24/7 care facilities and prisons, have been able to offer generous wage hikes for nurses and other health care staff.

Skilled nursing centers also get outbid by other facilities for the services of temporary nurses, who can make two to three times as much as regular staff.

“We just do not have enough staff. We can’t compete to hire them,” Jalene Carpenter of the Nebraska Health Care Association told a panel of state lawmakers.

The Legislature’s Appropriations Committee took public comment Monday on Gov. Pete Ricketts’ budget proposals, including those to increase provider rates temporarily to facilities that care for seniors on Medicaid and providers of services for the developmentally disabled.

Carpenter, as well as an advocate for care providers for the developmentally disabled, thanked the governor for his proposals but said they don’t go far enough to resolve the current staffing crisis. 

Four skilled nursing facilities in Nebraska closed in 2021, along with five assisted living centers, Carpenter said. Another nursing home, in Hooper, Nebraska, just announced it was shutting its doors. It’s all because they lack enough staff to care for residents, she said.

Carpenter said the governor’s budget proposal to increase funding for provider rates by 2% to care for Medicaid patients is helpful but falls short, in part because the rate increase lasts only until June 30.

She said she knows of nursing home administrators who are working nights and filling in as cooks on the weekends due to staffing shortages. Some facilities have halted admissions because they lack enough care workers, Carpenter added.

Lower pay, she said, is just one of the factors causing the workforce shortage. Burnout is another reason, Carpenter said, because of the need to work overtime to cover shifts. COVID-19 outbreaks in facilities have added extra stress, she said, as do school shutdowns for workers with children.

The situation is even worse for those who provide care for the state’s developmentally disabled, members of the Appropriations Committee were told, with the number of direct care workers down 30%.

Alana Schriver, executive director of the Nebraska Association of Service Providers, said Ricketts’ proposed 15% hike in provider rates for these workers was a “lifeline” but only a “temporary fix,” since the increase also expires at the end of June.

Schriver called on senators to support a proposal by State Sen. John Stinner of Gering, Legislative Bill 893, that would make the 15% rate hike permanent for providers of services for the developmentally disabled.

Another proposal deserving support, she said, is LB 1172 from Omaha Sen. Robert Hilkemann. It would set aside $37 million in federal American Rescue Plan Act (ARPA) funds to boost provider pay.

Stinner, who chairs the Legislature’s budget-writing Appropriations Committee, said he is making an increase in provider rates a top budget priority.

He said he wants to set aside $70 million to $75 million for that purpose, which would be on top of the $61 million proposed by Ricketts through the end of the 2021-22 fiscal year.

“It is a desperate situation,” Stinner said.

Stinner has two proposals, LB 989 and 1089, that would boost reimbursement for skilled nursing facilities that care for Medicaid recipients. Those account for about 55% of all nursing home residents.

Ricketts, during a budget briefing with reporters earlier this month, said he realized his proposed increases would expire June 30. But he said the provider rate situation would be revisited at that time.

The Appropriations Committee took no action on the governor’s budget proposals after Monday’s hearing. The panel will take testimony Tuesday on Ricketts’ proposals for spending ARPA funds.