The Perfect Storm: Montana Workforce Crisis in Longterm care Facilities

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Daryl Toews serves on the board of Valley View Home, a 96-bed skilled nursing home in Glasgow, Montana. He’s concerned the long-term care facility is going to have to close. 

“Our operating costs are about $100,000 a month more than we can afford,” he said. “We’ve scraped together some funds to cover it, but it just isn’t enough. If we can’t cover it, we’re talking about having to close the doors.” 

Governor in Denial

Toews, a former Republican state senator from Glasgow, is well-acquainted with the gears and levers of state government. 

“Governor Gianforte is in total denial that he’s got a problem,” he said.

What prompted this crisis? A perfect storm of the COVID-19 pandemic and a shift in Montana’s state government. 

Rose Hughes, the Executive Director of the Montana Health Care Association (MHCA), spells out the particulars in a response she wrote to Gov. Gianforte’s January 14 open letter to MHCA. 

In March of 2020, then-Governor Bullock “directed an additional $40 per Medicaid member per day to combat the rising cost of health care during the pandemic,” Hughes wrote. “The Gianforte administration ended the payments May 31st, 2021—even though the pandemic was not over.” 

In addition, she explained, Quarantine Incentive Payments totaling more than $8 million dollars had been made available under Bullock, but “these payments were ended in February 2021 even though facilities continued to experience higher costs associated with quarantine and isolation.” 

Hughes acknowledged the Gianforte administration did provide a “one-time-only” American Rescue Plan Act payment of $15 million, “to support routine activities and promote staff recruitment and retention.” 

The problem was that the one-time payment replaced the $40 per-patient, per-day Medicaid rate increase and was “only sufficient to cover about five months of the $40 per day.” 

Worse, once that money ran out in October of 2021, according to Hughes, facilities were on their own. She said they now need to depend solely on “their ‘normal’ revenues—including a Medicaid rate of $211 total per patient day, while costs have increased to more than $300 per day.” 

Toews concurred. “We can’t pay competitive wages to keep staff in the facilities. So you have to go to contract labor, which can be three times the usual cost,” he said. “We’re having a dickens of a time hiring.” 

Hero Pay for Urgent Problem

Toews anticipates the Legislature will fix the long-term problem down the road, but he said, in the  meantime, the increase is so big, the local facilities can’t handle it. 

“The current administration thought, when COVID was over, everything would go back to normal—but it hasn’t,” he said. Meanwhile, Valley View Home needs that additional $100,000 a month to keep its doors open.

That works out to $1.6 million they’ll need while waiting for the Montana legislature to meet again in 2023. 

Meanwhile, the MHCA is advocating for the current state administration to use federal funding from President Biden’s American Rescue Plan Act (ARPA), to employ a short-term solution. 

“Millions of dollars of funds received from the federal government are specifically available for ‘hero pay’ for our direct care workers as well as for recruitment and retention bonuses,” she said. “This is the type of funding we need to assure workers are available to care for the elderly Montanans we serve.” 

Both Hughes and Toews indicate the problem is urgent. “We have a direct care workforce crisis,” Hughes said, “Funds are available to help with this crisis, but the administration continues to say no to these workers.” MSN

The author reached out to Gov. Gianforte’s office seeking comment on this issue. At the time this publication went to press, his office had not responded.

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