It's time to care about long term care
Bringing Community Back to Healthcare

It's time to care about long term care

Nursing homes are an integral piece of our health care system, providing personalized care to seniors in a loving and nurturing environment. Long term care communities are not only medical facilities, but they are also homes for thousands of women and men across our state. And at facilities such as mine, our dedicated caregivers are the heart of the operation.

Unfortunately, the reality is that the last few years have been tough for the long term care workforce. Because of pandemic-related burnout and staff turnover, Nevada long term care facilities – and the health care sector as a whole – are in a rebuilding phase as we look to address long-standing staffing shortages that significantly worsened during the pandemic.


It’s been difficult to see caregivers leave the field in recent years. We have been doing everything we can to hire new staff, including raising wages. But despite these unprecedented efforts, we still often come up short in attracting the skilled staff we need.


Unlike some Nevada long term care facilities, we are fortunate that we haven’t had to rely on expensive staffing agencies. We have worked to offer generous benefits to staff, including substantial amounts of overtime, but it’s a fine line to walk. The last thing we want is for long hours to cause additional burnout and turnover.


The fact is that there’s a nationwide nursing shortage that is only expected to get worse, and long term care providers can only do so much on their own. We need help from our leaders in Washington – not only for the vulnerable seniors we care for today, but for the millions who will call a long term care facility home in the future. The fundamental question is: how do we do it?


The Biden Administration’s proposed solution is a minimum staffing requirement, which is expected to be announced soon. While this may be well-intentioned, the policy will make the situation worse, not better.


Registered nurses (RNs), certified nursing assistants (CNAs) and other health care professionals are in high demand and in short supply. On top of that, we are in direct competition with hospitals and other health care facilities that are trying to fill similar roles and are able to offer better compensation and benefits to secure skilled labor.


Nursing homes can’t meet an arbitrary ratio of staff to residents when we’re facing a shortage of caregivers. Fining facilities that fail to hire workers who do not exist is like fining them for failing to squeeze water out of a rock. Fortunately, collaborative solutions do exist that can help grow our workforce in a sustainable way. This is where state and federal policymakers need to step in.


In Nevada, there is good news. This year, the state legislature and governor approved a much-needed Medicaid rate increase for nursing homes. It could not have come at a better time, as the cost of supplies and services have doubled and even tripled since the pandemic.


Closing the gap between what we pay for care and the amount we’re reimbursed will give us more resources to invest in our workforce. In addition to better funding, lawmakers should also focus on creating policies that will help us hire and retain caregivers.


Immigration is a vital piece of this. There are thousands of nurses who are eager to come to the United States to work in health care. I know because I was one of them.


I was given the chance to come to the United States from the Philippines to work as a nurse. I received my green card through my employment at a Maryland nursing home in the 1990s. This incredible opportunity set me on the career path I’m on today.


We are doing the same thing in the Silver State by sponsoring nurses from the Philippines to come to the United States. If we can do this at the federal level, starting with lifting the freeze on green cards, we can begin to fix our nursing shortage.


Other programs, such as scholarships and tuition assistance for nursing students and loan forgiveness programs for students who choose to work in long term care, will help us set a foundation for the next generation of caregivers. We can make long term care a more attractive career path if we create the right incentives.


Enacting these big-picture policies now will ensure we have a strong workforce in the future and help to continue to raise the quality of care we can provide Nevada residents. As our aging population grows, I hope our leaders in Washington, D.C., including our Senators Jacky Rosen and Catherine Cortez Masto, will make this a priority.


Marie Costa Nadora is the vice president of clinical services at Revive Health Senior Care Management in Reno, Nevada.