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FHCA Updates House Panel on Long Term Care Facilities’ Worsening Workforce and Economic Crisis

TALLAHASSEE, FL – Emmett Reed, CEO of the Florida Health Care Association, told the House Health Care Appropriations Subcommittee that, almost two years into the pandemic, chronic staffing shortages, ongoing costs to fight COVID-19, and stagnant occupancy levels are taking a significant financial toll on long term care facilities and threatening access to care for Florida’s most vulnerable long-term and post-acute care patients.

“Nearly every long term care center in our state is facing a staffing shortage, as thousands of jobs remain vacant,” Reed said. “At the same time, more than half of nursing homes and assisted living communities are in dire financial straits due to the ongoing costs to fight the pandemic.”

In testimony before the legislative panel, Reed said that long term care staffing shortages are forcing facilities to turn away new residents. An FHCA member survey showed that more than 50% of nursing homes have had to limit new admissions because of a lack of employees. As a result, occupancy rates have been slow to recover, causing significant challenges for care centers that lack the financial means to attract new workers and incentivize current workers to stay.

Reed noted the ongoing costs to operate in a pandemic, including for protective gear, testing, and cleaning supplies. Reed also pointed to labor having the largest impact on facilities’ rising costs. Already faced with reimbursement rates that don't cover the cost of services, facilities are paying overtime and heroes pay to incentivize current staff to remain while also having to absorb skyrocketing agency fees to hire temporary staff to cover vacant shifts.

“We’re fighting for our staff every day, and yet we’re losing staff to other industries, where jobs are easier and the pay is higher. More alarming are the staffing agencies that entice team members away with offers of higher wages and then 'sell' those staff back to the center at a substantial markup. It’s an unsustainable cycle,” Reed said.

Reed highlighted evidence of the financial toll on providers:

  • Costs per patient day are up almost $36 compared to the pre-pandemic period, resulting in an additional cost to the profession of $566 million annually.
  • Facilities have seen a 20.1% increase in direct-care staff costs -  an added $275 million in direct care expenses that facilities are experiencing annually.
  • Facilities’ use of employment agencies to fill vacancies is up by nearly 300%, costing buildings an additional $200,000 per month in some instances.
  • Long term care operators are starting to experience liquidity issues, as one 17-facility operator recently filed Chapter 11 bankruptcy, citing pandemic-related financial challenges.

Chronic Medicaid underfunding, combined with the billions of dollars providers have spent to fight the pandemic, have left long term care providers struggling to compete for qualified staff. Based on national reported data, nursing centers across the country have lost over 220,000 staff over the course of this pandemic. In Florida, that works out to about 10,000 staff leaving the profession. The impending CMS mandate requiring all long term care staff to be vaccinated also threatens to worsen the current labor shortage.

FHCA will be looking to the Legislature to help Florida's long term care facilities recruit and retain more caregivers so our state's most vulnerable have access to the care they need. This includes ensuring Medicaid funding that keeps pace with the costs of rising wages, services, and supplies so our long term care profession is ready to meet the needs of our state's growing aging population.


November 30, 2021

Kristen Knapp, APR
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