LTC Imperative Financial Survey Shows Continuing Challenges for Providers

Posted on April 27, 2023 by Jeff Bostic

A new survey of nursing home and assisted living providers conducted by the Long-Term Care Imperative shows that the challenges faced by providers are continuing. Lack of adequate state funding to support higher wages for Minnesota’s long-term care workforce has pushed nursing homes and assisted living settings deeper into financial distress, resulting in diminished access and fewer care options for Minnesota’s seniors and families.

Key findings from the most recent survey show a decline in the condition of the sector from previous surveys:

• The monthly total of denied referrals by care centers and assisted living settings in March of this year (13,953) was more than 2,0000 more than the number in October of 2022 (11,556). Almost all of that growth in the number was from care center denials.
• Compared to July of 2022, the percentage of care centers that report having exhausted their reserves has increased dramatically, from 5.7% to 15.8%. This problem is especially acute in greater Minnesota, where 16.9% of care centers have exhausted their reserves.

• The number of care centers considering closure continues to increase. 5.9% of 7-county metro and 12.2% of greater Minnesota nursing facilities are considering closure.

• While the number of vacant positions in care centers and assisted living settings has declined, from 18,448 in January of this year to 15,543 now, it is likely due to providers resetting their expectations for how many people they can serve than due to improved ability to recruit for critical positions.

Access to care in jeopardy

Seniors are being denied care at alarming rates in communities that were able to meet demand just a few years ago.

Some of the most alarming data points include:

• Every day, 450 referrals are denied by nursing homes and assisted living facilities. Each denial represents a senior and family unable to receive care in their community.
• Admission referrals declined by nursing homes have increased by nearly 44%. This means that more seniors are being turned away from long-term care settings, driven by the lack of available staff.
• Referral denials in nursing homes are particularly striking in the Twin Cities, Southeast Minnesota, and West Central Minnesota – where the average nursing facility declined about 25 referrals during March 2023.
• In March 2023, 13,952 admission referrals (6,582 in assisted living; 7,371 in nursing homes) were denied in Minnesota’s long-term care settings.
• 42% of nursing facilities and assisted living settings using their reserves have six months or fewer before exhausting.

Increase in the number of settings considering closure

More long-term care settings are closing or considering closing, a devastating move for the seniors, families, and communities that rely on their services. According to the survey:

• 5.9% of 7-county metro and 12.2% of greater Minnesota nursing facilities are considering closure.
• 3.2% of 7-county metro and 10.1% of greater Minnesota assisted facilities are considering closure.
• Nearly 40% of Assisted living facilities and 75% of nursing facilities report not having enough licensed staff.
• Over 80% of assisted living facilities considering sale or closure reported receiving “little to no” interest in the vacant positions.
• Nearly 100% of all nursing facilities considering sale or closure reported “little to no” interest in vacant positions.

Seniors and families are being denied care in their communities. Assisted living and nursing home settings are reducing capacity or closing their doors altogether, which means seniors are less likely to have access to the care they need when and where they need it. Caregivers and the settings they work in are hanging on by a thread.

The state of Minnesota has a record budget surplus. The only solution is for Gov. Walz and legislative leaders to adequately fund long-term care this session.

The Long-Term Care Imperative continues its strong push for action on this vital issue in the remaining days of the current legislative session. At the Capitol, we have brought the data to key decision-makers. We anticipate it will receive special attention at upcoming legislative proceedings.