Failing to see the moral urgency to mitigate the pandemic takes a toll on the frailest among us

LICENSED STAFF SHORTAGE

We are a reactive society. Even amidst a pandemic that has now claimed over 700,000 American lives, our attention span is limited. For a time last year, our attention was focused upon the plight of nursing home residents and staff, as all congregate settings suffered a devastating human toll from Covid-19. Yet with the miracle of vaccinations dramatically reducing nursing home deaths, challenges facing our most vulnerable citizens are once again out of sight, out of mind.

But those challenges remain. With over 100 open jobs, the nursing home run by our largest county, Hillsborough, has had to take one-fifth of its beds offline and turn away admissions to responsibly serve its residents. The Merrimack County Nursing Home consolidated a wing and was down 90 beds on Sept. 23. This is a story repeated across the state of New Hampshire, as a staffing crisis has effectively capped admissions and put nursing facilities, whether public or private, into survival mode.

New Hampshire healthcare providers simply cannot find enough home-grown licensed staff. This problem predated the pandemic and had sparked ongoing efforts like the NH Needs Caregivers! initiative and the New Hampshire Sector Partnerships Initiative, which has recognized Healthcare Heroes.

To its credit, the state government supported the launch of these efforts. But it can feel very daunting when one watches the data and sees months where the net loss of licensed nursing assistants, for example, exceeds the gain in new licensees. Thus, providers are forced to rely upon out-of-state nursing agencies that are predatory in their pricing.

I know a facility that could not find local LNAs to hire for $17 an hour and had to pay an agency up to $69 an hour for an LNA. If you need a registered nurse, you might as well hand the agency a blank check. Facing price-gouging and the desperate circumstances, one facility was surprised to receive what looked like an agency’s offer to provide RNs for $75 an hour, before realizing that is what the RNs were being paid by the agency. Indeed, some agencies have gone to a sort of eBay auction model where desperate providers bid against one another on prices. It is an utterly unsustainable, slow-rolling catastrophe exploding outside the limitations of Medicaid funding.

Beyond the licensed staff, facilities compete against the red-hot service economy in hiring support staff, such as dietary, housekeeping and maintenance positions. Drive down a street and look at all the “Help Wanted” signs. I have watched one national fast-food franchise in my city, Dover, change its outside board from an offer of $15 an hour for closers to $17.50 an hour. Operating at a loss already, a nursing home cannot match such wages in hiring kitchen staff.

New Hampshire has the nation’s second-oldest population and perhaps its oldest nursing home population. We need an urgent public focus on the crisis facing our state’s frail elderly. Instead, we have screaming protesters disrupting an Executive Council meeting, opposed to our becoming the final state to accept some federal vaccination funds. Instead, we have people promoting a horse dewormer as an alternative to vaccination. To profanely assail public servants, traffic in nonsense and fail to appreciate the moral urgency of mitigating this pandemic’s terrible toll is to luxuriate in health privilege that less fortunate Granite Staters do not enjoy.

Self-reliance is one thing, but we are also taught to love others as much as ourselves. Where is that love and compassion when we need it?

Brendan Williams is president and CEO of the New Hampshire Health Care Association.