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Staffing shortages have left nursing homes at a breaking point

The Biden administration is proposing new federal staffing requirements for nursing homes — but can the care centers afford it?
Posted at 4:24 PM, Mar 07, 2024

At 39 square miles and with a population of 463 people, "small" is how some people might describe the town of Chelsea, Vermont. Jennifer Doyle, though, just calls it home.

"I went to school here, my kids went to school here," Doyle said, standing along the town's Main Street on a recent Thursday morning.

Doyle and her husband own Riverbend Residential Care Home. The 30 residents there all consider the place home. Most grew up in this rural section of New England. Riverbend, though, is at a crossroads. Like many assisted-care facilities and nursing homes nationwide, it is facing a staffing shortage.

"We are vital to this community. But there's not enough funding for us to pay competitively," she said.

Doyle currently has 18 full-time workers; she's been short two staff members for more than a year. That may not sound like much — but for a family-owned facility this size, it means longer hours for Doyle and her husband.

Closing or shortening hours, she says, is not an option.

"Pizza shops can close on Sundays and Mondays. But when you're running health care, you need what you need. You can't shut down because you don't have enough staff," Doyle explained.

Like many long-term care homes across the country, Riverbend can't keep up with wages at places like McDonald's or WalMart, which are not only paying upwards of $18 an hour in many places, but can also offer health insurance. Doyle says offering health insurance to her employees would cost upwards of $20,000 a month, something she can't afford.

"If we provided health insurance to our staff we would go out of business, there's just no way. There's nobody that I can think of more than me who wants to provide health insurance to take care of the people I care about. But we just can't compete with bigger businesses," she added. 

According to the American Health Care Association, a staggering 99% of long-term care facilities are looking for workers. Seventy percent of them have smaller workforces than before the pandemic. The result is that many nursing homes are having to close down wings, close entirely or turn patients away.

"The impacts are really challenging — if we don't have the staff we need we can't take care of as many residents," said Mark Parkinson, who serves as president of the American Health Care Association and National Center for Assisted Living.

Parkinson is also incredibly concerned by the Biden administration's recent move to set minimum staffing levels for care facilities. The move is aimed at increasing patient care.

Under the mandate, though, facilities would need to hire 102,154 additional full-time workers.

"Although the Biden administration means well they're just making this worse. They've issued a mandate that we can't meet because the workers aren't out there," Parkinson added.

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