Healthcare worker with resident
Katie Smith Sloan, LeadingAge

The COVID-19 pandemic has brought to light “decades of state and federal underinvestment in our aging services infrastructure,” Katie Smith Sloan, president and CEO of LeadingAge, wrote in an opinion piece for The Hill published Saturday.

Medicare reimbursements, she said, make up a large portion of the aging services infrastructure challenge, because reimbursements do not fully cover skilled nursing care expenses in some states. She cited a recent LeadingAge Pennsylvania study that showed that rates in that state are $86.23 per day lower than the cost of providing care. According to Sloan, that works out to more than $31,000 per year in uncompensated care per Medicaid resident in Pennsylvania alone.

Eliza Bryant Village in Cleveland will close its doors after more than 125 years, showcasing the need for improved aging services infrastructure, Sloan noted, not naming the facility. EBV President and CEO Danny Williams told the local CBS television station affiliate that the nursing home is losing about $100 per day, per patient due to inadequate Medicaid reimbursement.

“This cruel deficit, combined with a once-in-a-century pandemic, means that we don’t have the direct care professionals we need: 400,0000 people have left the field since the pandemic began!” Sloan wrote. “And while caring for older people is a true calling for many, the hard fact is that professional caregivers can earn more money (with less emotional and physical stress) working shifts at a fast food restaurant or retail warehouse.”

Because a large portion of the aging services infrastructure is paid through state and federally funded Medicaid reimbursements, that’s not likely to change. Nursing homes, Sloan commented, don’t have the luxury of raising wages as do many other employers, which in turn has led to a caregiver shortage in the sector.

“Quality of care and staffing work hand-in-hand — and neither can be achieved without sufficient funding,” she wrote.

According to the CEO, a “bold, all-of-government approach” is needed to bring the aging services infrastructure up to snuff. She offered four suggestions, for starters: compensate frontline staff fairly, expand the pipeline of applicants, make immediate changes in immigration policy, and address price-gouging by temporary staffing agencies.