Health and Fitness : VGH Nursing & Rehab Voice Concerns

Nationally Long-Term Care Facilities are struggling due to low reimbursement payments and recent pandemic. Editorials from Jessica Henkle, VGH Nursing & Rehab Administrator and Michele Schoonover, CEO, Virginia Gay Hospital provide insights to the increasing difficulties and search of resolutions. Our community can make a difference by contacting our legislators for support: House Representative Thomas.Gerhold@legis.iowa.gov and Senate Representative Charlie.McCintock@legis.iowa.gov. More insights available at: https://www.keepltclocal.com/.

Over the last 60 years, Virginia Gay Nursing and Rehab has provided care to the elders of our community. They are your parents, grandparents, aunts, uncles, doctors, friends, neighbors-the people you love. We have been privileged to share in the lives the residents and their loved ones. However, we find ourselves in unprecedented times in long-term care. We have been plagued with the loneliness, isolation, and danger of the COVID-19 pandemic. During this time, we experienced "The Great Resignation" where staff were leaving faster than they could be replaced, causing us to rely on travel and agency staff to continue caring for residents. Supply shortages inflated the costs of goods and supplies required to keep our staff and residents safe, housed, fed, and cared for. These costs, paired with low Medicaid reimbursement have ravaged the budgets of long-term care facilities, forcing 23 facilities in Iowa to close in 2022.

The cost of care per resident per day at Virginia Gay Nursing and Rehab went from $238.88 in 2018 to $488.73 in 2022. In 2018 (prior to COVID-19), 53% of our residents had Medicaid as their primary payer source; they paid between $194 and $219 per resident per day-up to $45/day less than it cost to care for the residents. Today, nearly 69% of our residents have Medicaid as their primary payer source, but our Medicaid reimbursement is only $236.63/day. Our average Private Pay rate is $264/day. As you can see, these numbers are not sustainable. We need to work as a community to improve the reimbursement from Medicaid to pay what it costs to provide the care team and environment the residents deserve. It all starts with each one of us that represent the interests of these older adults reaching out to legislators to let them know they need to advocate for those that advocated for us in our homes, lives, and communities. It is our turn to make sure our residents get the care and services they deserve.

Jessica Henkle, Virginia Gay Nursing & Rehab Administrator

VGH Nursing & Rehab has provided long-term care services to the community for over sixty years. The last few years have extremely impacted this industry and future sustainability.

The fastest growing age groups in Iowa are over age 65, and the 85+ population, which is the age group most likely to need aging services such as nursing homes-is forecast to grow 90% by 2040.

While I am proud of our staff's work to keep our residents safe during the COVID-19 pandemic, our workforce has shrunk as employees have retired, left the healthcare field entirely or joined travel agencies. This critical staffing shortage, especially nurses and certified nurses' aides has increased our staffing costs by 74% and limits admissions as we have relied on more expensive temporary agency staff to fill the void.

Cost have gone up at least 15% and revenues from patient care have grown by less than half that amount, largely due to inadequate reimbursement rates, especially from Medicaid. Medicaid accounts for sixty-nine percent of our current patient census and only pays 80% of the cost of providing care.

These trends are unsustainable. Our legislature has the opportunity to make changes to ensure the future of providing care to our elderly, especially in rural communities. Medicaid nursing home rates must be rebased to account for inflation and prevent further nursing home closures and reduction of services.

Michele Schoonover, CEO, Virginia Gay Hospital