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SD Health Care Association: Nursing Home Crisis Becoming Catastrophe

Here’s another reason Governor Kristi Noem won’t talk to the local press: KELO-TV has upgraded the condition of longterm care in South Dakota from “crisis” to “catastrophe“:

“We’re probably facing the most challenging time we’ve ever faced in our history. We’ve had 15 closings in the last five years and of those 15 closings 7 of them have taken place in just the last year,” said Mark Deak.

The Executive Director of the South Dakota Health Care Association doesn’t mince words.

“I would say it is a crisis quickly becoming a catastrophe.”

Dow Rummel’s CEO, Darla Van Rosendale sees the crisis firsthand.

“The economics of running a nursing home is pretty tough,” she said.

There are two main factors driving senior living facilities out of business in South Dakota. Staffing issues and inadequate funding from Medicaid. Estimates show nursing homes lose about 35 dollars daily for every Medicaid resident. Dow Rummel is fairing better than many other senior care facilities because they have fewer Medicaid residents. Van Rosendale says the current Medicaid payment rate is slowly killing long-term care, especially in smaller towns [Tom Hanson, “Nursing Home Crisis Is Becoming a Catastrophe…,” KELO-TV, 2023.02.13].

But Governor Noem is laser-focused in a solution, right?

Currently, South Dakota has one of the lowest Medicaid reimbursement rates in the country. In her budget address, Governor Kristi Noem proposed a 21 percent increase which would be a significant jump, but Deak says it still won’t cover the entire cost of care for a Medicaid resident.

“We want to get to a point where we are fully funded, where the costs that our folks incur for caring for people, the reimbursement would actually keep up with those costs,” said Deak [Hanson, 2023.02.13].

When even a 21% increase in Medicaid reimbursement still leaves nursing homes short 10% of what they need to cover their costs, we see the catastrophic neglect committed by over a generation of Republican one-party rule.

31 Comments

  1. Nick Nemec

    I contend the staffing issues would take care of themselves if Medicaid reimbursements were increased sufficiently. Adequate reimbursement would provide enough money to raise wages for the workers. This has been an ongoing issue for years and has really gotten worse during Gov. Noem’s tenure. She owns it now.

    I sat on the governing board of an assisted living facility for nine years. Low Medicaid reimbursement rates are made up by higher rates charged to the private pay residents. Depending on each facilitiy’s ratio of private pay/Medicaid, this shifting of costs may or may not be sustainable. The bottom line is care will be paid for somehow either by the families of non Medicaid residents through higher rates for those residents or by higher Medicaid reimbursement paid by the State. Doing nothing or nearly nothing will result in facilities not being there when needed.

  2. Because of Republican cuts to Medicaid reimbursements ten long term care properties closed in Montana last year and in October Lantis shut their fifth home including the Friendship Villa in Miles City and Rocky Mountain Care Center in Helena. Spearditch-based Lantis shuttered the Glacier Care Center in Cut Bank earlier this month and closed Beartooth Manor in Columbus on January 7.

  3. e platypus onion

    Magats want to fix Medicaid by doing away with it. That oughta help immensely. Watch the 5th circuit court of appeals for judicial activism on entitlement programs.

  4. O

    South Dakota is going to have to face that the great capitalism experiment has failed. Business have boomed because of SD’s great business-friendly tax rates, low-pay workforce . . . but now cannot stay open because they cannot staff openings. SD has too many businesses. Critical needs are not being met because they are not being funded adequately, and because they are competing against other businesses for workers, staffing costs are being driven up by market forces (or staff are choosing easier work in other less-demanding industries). Capitalism’s race to the bottom for worker conditions has created a race to the bottom for public services that rely on common staffing pool and those workers’ tax base.

    This mess of an economy needs management — real management that looks beyond political ideology to what the needs of a state’s population actually needs to flourish.

  5. JO

    SD population flourish? With Noem’s inadequate intelligence to keep assisted living & long term care centers ability to stay open won’t happen without increasing Medicaid. But don’t worry about anyone but you Kristi because when your dementia continues to evolve you’ll get great elder care in an other state. You certainly will be able to afford it.

  6. Jake

    The SD state’s GOP constant “NO!” to an income tax to help create a three-legged stool of state taxes (Property, Sales, Income) is the reason. It shows their ‘head-in-the -sand” attitude toward governing; proving that they are incompetent at governing for long periods of time (4 or more decades in SD)! They are more interested in protecting the public from themselves (like their LGBTQ stands) than they are from their own incompetence (refusals to regulate firearms; because Lord knows, we in America don’t have ENOUGH guns in hand)!!

    This political party cares more to have more guns-unregulated-than it does for the elderly and infirm…..

  7. LCJ

    How many bills did the D party introduce this year to address this subject?

  8. All Mammal

    SD solely relies on volunteers, decent neighbors and charity organizations to survive. Generous people have to give until there’s nothing left because they’re the only ones unable to sit on a hill, nice and plump and watch the majority grovel and suffer in sickness and despair. The pigs feeding at the trough need to end up getting what the give. Big, fat goose eggs! SD GOP is so cheap and tacky, they expect regular lowlings to hurry up and die with no dignity or respect so they themselves don’t have to deal with the unpleasantness of death. How very Christian; just like ferrel sewer cats.

  9. P. Aitch

    @LCJ (That Snarky MAGA) – Dozens of bills have been passed and dozens more are in the final stages. Just not in your fascist state. Now, tell me why federal legislation to aid nursing homes should include South Dakota? It’s time to only help states that help themselves. Raise your taxes or wither and suffocate!
    Federal Bill Aims to Aid Nursing Home Labor Shortage with TNA Program Extension
    https://skillednursingnews.com/2023/01/federal-bill-aims-to-aid-nursing-home-labor-shortage-with-tna-program-extension/

  10. leslie

    lcj: so quantity of legislative attention is what you seek in a robust Democratic response to the overwhelming failure of your majority Republican ownership of state government? do you know how Democrats prioritize annual legislative and electoral strategy? still just a hipshooter, eh?

  11. LCJ

    Sorry, PA. Independent not MAGA.
    How many D party legislators proposed bills in SD to addressed this subject ?
    Also, I am undefeated vs Ambulance chaser pro temporary Lee S., so dealing with you is a piece of cake.

  12. P. Aitch

    LCJ – “WELCOME TO LOSERVILLE – population YOU” 🤣😂😅

  13. Arlo Blundt

    Our ignoble Governor has lost interest in governing South Dakota. We are a “grey” state with a long term need to fund our long term care programs. Her neophyte staff seem totally unable to carry any water with the Legislature, which putters on, motivated mostly by its own grudge matches and special interests. Tragedy will result from this neglect.

  14. All Mammal

    The state of the state is emaciated. Our proudest youth representative can’t even afford her makeup she needs to do her job.
    https://kbhbradio.com/news/miss-south-dakota-usa-pleads-guilty-to-theft
    I am not posting the link to humiliate our Miss South Dakota. It is relevant evidence that while the long term care facilities suffer in silence, even beauty queens are not exempt from SD’s decay.

  15. flopster

    What a mess. How about selling off the Gov. jet and monies put into Medicaid reimbursement ?
    What will ‘she’ do when its time for mama to have long term care ?
    Oh no problem w/her ‘war che$t’ and farm (or ranch) gov’t subsidies the Arnold’s have accrued. A round the clock at home hire perhaps. By then all the nsg homes will be buttoned up.

  16. LCJ

    PA I guess your answer is none
    Ahhh the loving liberal Democrat shows her inner child. How cute!!!
    And there in your last comment encapsulates why your party will never have a chance in SD politics
    Still living in your moms basement?

  17. leslie

    lcj; so you oppose Lee Schoenbeck’s critique of your governor Noem’s food tax which (among other consequences):

    would devastate the state’s nursing homes. “If you cut $106 million out of the budget, you are going to close the nursing homes in our state,” he said.

    And “Staffing [nursing home] problems were bad before the pandemic,…” “It’s much worse now.” https://southdakotasearchlight.com/2022/12/01/disappearing-nursing-homes-could-suffer-more-under-noems-tax-cut/

    Remember, Operation “Warp Speed, the [your President Trump’s] government’s vaccine effort, is instructing clinics administering the Pfizer vaccine to wait until later this month to inoculate elderly residents at long-term care facilities, even though doses will be arriving in all 50 states this week and despite the CDC’s recommendation that the elderly be prioritized given their vulnerability to the coronavirus.” Dec 14. 1920 Face the Nation

    On March 14, 2020, John Bolton tweeted: “Claims that streamlining NSC structures impaired our nation’s bio defense are false. Global health remained a top NSC priority, and its expert team was critical to effectively handling the 2018-19 Africa Ebola crisis. The angry Left just can’t stop attacking, even in a crisis.” March 19, 2020, candidate Joe Biden ​called the “streamlining” elimination. He tweeted: “The Obama-Biden Administration set up the White House National Security Council Directorate for Global Health Security and Biodefense to prepare for future pandemics like COVID-19. Donald Trump eliminated it — and now we’re paying the price.”

    How many legislators did you contact to address these huge problems in the state, besides voting for Trump and Noem, as an independent thinker? Btw, who hasn’t beat Schoenbeck at his game?

  18. Retired

    Need a union to elevate the issue.

  19. Come on folks, Kristi has cultural issues to consider. Keeping those trans in their God given sex for instance. Right LCJ? That does stand for Loud, colorful jerk correct? Why do you want Democrats to waste their time filing bills that will never pass anyways. Killing time is good for some though, right Ian?

  20. LCJ

    I want no tax on food.
    But I have serious doubts that this is a genuine effort proposed by my former employer
    Also which one of you loving, caring and peaceful libs made a death threat on an elected official today?
    Thats really going to help your party win over South Dakota

  21. Death threats, basement living, come on LCJ, get with it. Your way too foxie comments are behind the times. I thought you were colorful.

  22. Arlo Blundt

    For the past fifty years, Republican Legislatures have determined and passed State Aid for Public Schools and Nursing Homes (through Medicare) on just about the last working day of the session. They wait until the swag has been divided between all the favored scams and lobbyist advocated “projects”, and then sweep the spare change off the top of the dresser and that goes to schools and nursing homes. They then speak about how heroic and selfless they have been in their support of the elderly and of children. It is a game that never ends.

  23. grudznick

    Mr. Blundt is righter than right on this issue. But he knows not how much some of those fellows deal in the dark rooms and back alleys to split up the nursing home share after whiskeys and steaks.

  24. Arlo Blundt

    Unfortunately Grudznick, I do. It has enraged me for fifty years. Now I’m old and frail, and can’t expend the necessary energy to be enraged…so I just argue with you.

  25. grudznick

    Mr. Blundt, grudznick is in lockstep with you and not arguing. I have much deep, manly affection for you. But if you must verbally beat me about the head and shoulders, I can absorb your rage.

  26. Arlo Blundt

    Thank you, Mr. Grudznick, for your kind words.

  27. All Mammal

    Get a room, you two!

  28. MB

    As for democratic proposed solutions, maybe I am missing something, but I believe we had an initiated measure on Medicaid expansion.

    LCJ is clearly out of the loop, as the essentially gerrymandered legislature is best fought with initiated measures, which of course legislature is working to quash. Lots of Democratic activism on these.

    But hey, thanks for dropping by, LCJ. Hope you feel better now for checking off ‘crash liberal blog’ from your bingo card.

    Now go watch CSPAN coverage of MTG and Boebert trying to string sentences together in their new committees. South Dakota certainly has tough sledding ahead, but watching GOP eat itself on national TV is a nice diversion. It may even get coverage in your bubble.

    Added bonus will be watching Krusty go into full pageant mode to compete with all these other suckups to be VP on Trumps losing 24 ticket.

  29. Mb

    As for the VP pageant, looks like the lineup of female brunette Trump sycophants that either were, are, or ran for governor gets longer everyday.

  30. WillyNilly

    AM… I’m not sure but I think you have insulted the feral sewer cats by comparing them to Republicans.

  31. algebra

    the nursing home crisis is the result of a failed business model.

    I have worked in these facilities: No private rooms, shared toilets with the residents in the room next door, and the shower is down the hall, shared with the other 59 residents. No AC, no in-room climate control, no locks on the doors.

    Nobody would spend a single night in a motel like that, and as a result, nobody with the means to go to one of the newer facilities, where you get a room to yourself, with your own full bath & thermostat, goes into one of these run-down dumps. I have been present when residents have been admitted, spend one night, find out they can’t control the heat, the roommate is violent, or the food is terrible, and have moved out the very next day.
    The newer facilities are located in population centers like Sioux Falls. That’s where the private pay residents are going.

    One should remember that these nursing homes are private, for-profit businesses and they are failing because they can’t compete in the marketplace. If these were motels nobody wanted to stay in, or apartment complexes nobody wanted to live in, how much sympathy would the owners get from the state legislature?

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