George Schoephoerster, MD
I recently retired as a physician, after practicing in the St. Cloud area for 40 years, most recently as a full-time practitioner in local nursing homes. I continue to function as a medical director in four of those nursing homes.
Gradually throughout the years, I noticed the residents seemed to become frailer and were starting to have more complex health problems. The caregivers in the nursing home, therefore, had to change from mostly changing bed pans and providing a meal to providing care for these frail residents.
Their complex health problems often include being on dialysis, being non-ambulatory from strokes, suffering from cognitive decline and/or being severely diabetic.
Most recently, I found myself helping the local nursing homes in learning how to keep their residents safe during a pandemic. This was a scary and exhausting time for those caregivers. In addition, wages for these very same caregivers had not been keeping up with those in the rest of the community even before the pandemic, which led many to leave for better paying and safer jobs.
The fact that pay did not keep up was not the fault of nursing home administration. In nursing homes, the rates the facility receives from payers for the care they provide is set by the State. In this way, it is the State that sets the salary for these senior caregivers. Because these rates are low, senior caregivers feel forced to seek work elsewhere, resulting in not enough caregivers remaining in healthcare. There are approximately 18,500 open caregiver positions across the state.
In order to be able to provide quality care to the residents they do have, nursing homes with open caregiver positions have been decreasing the number of new admissions. For example, there were about 11,000 admission requests denied by nursing homes across the state in the month of October alone. Each of the four facilities where I serve as medical director has had to close up to 25 percent of their beds for a period of time during the past couple years, due to inadequate staff coverage. When that happens, the St. Cloud hospital has difficulty finding nursing home beds available to accept those frail elderly who are ready to be discharged from the hospital. So those seniors remain in the hospital, preventing admissions of new hospital patients.
Several potential solutions are being considered in the Minnesota Legislature to increase the number of needed caregivers across the state:
1.) An increase in State funding and allowable rates for nursing home reimbursement.
2.) Since the same staff shortage is affecting seniors wherever they reside, a potential solution for those who reside outside of nursing homes is to increase the rates provided by the State as part of the Elderly Waiver program, which pays for care provided in Assisted Living and Memory Care.
Contact your legislators. Encourage them to do what they can to assure access to care for our seniors, wherever they reside.