Guest Column

Our Nursing Homes are in Crisis

We deserve a representative in Congress who will work to solve the real problems facing real Montanans

By Monica Tranel

As I’ve traveled around the district, I have heard too many stories of elderly Montanans struggling to find, and pay for, the long term care they need.

I’ve met Montanans who had to leave a hospital, couldn’t manage at home, and couldn’t find a nursing home or assisted living facility to take them in.

I’ve talked to young families who can’t afford, or can’t find, a home health aide, and struggle to provide round the clock care for grandparents. All while working, keeping house, and getting their kids off to school.

I’ve heard of elderly Montanans who have left friends and the community they love because they could no longer get the care they need in the place where they have spent their entire lives.

I’ve listened to nursing home administrators describe how hard it is to find employees, and their anguish at having to close down parts of their facilities, turn away patients, and cope with looming financial disaster.

Sadly, these stories are not unusual. Here in Montana, and across the nation, there is a crisis.  

Many nursing homes report that they have lost staff since 2020 and have been unable to replace them. Nationally, nursing home employment is more than 10% below where it was before the pandemic. Half of the nursing homes surveyed by the American Health Care Association report they have had to refuse admissions. Many have closed down part of their facilities. Half report operating at a loss.

Even those patients and their families who are able to find a place in a nursing home struggle to pay the bills. On average, a year of nursing home care costs about $100,000. That’s more than the savings of most retired Americans, apart from the value of their houses. Medicare, the health insurance elderly Americans rely on, does not pay for long term care. The financial burden of providing such care is simply unsustainable for many patients and their families.

With our aging population, the crisis will not fix itself. Last fall, the Biden administration proposed new regulations for nursing homes, intended to ensure that staffing is adequate. But a mandate like that, though well-intended, is not enough. It won’t do any good to tell nursing homes to hire more workers if there are no workers to be found. It won’t help to tell nursing homes on the edge of bankruptcy that they have to spend even more.

To resolve this crisis, we have to recognize that most Americans cannot solve this by themselves.

Congress must step in and underwrite the expansion of care by assuring that Medicare and Medicaid provide adequate reimbursement for long term care. In Congress, I will advocate for that enhanced support for long term care and for financing it by making sure that everyone – including the wealthiest – pays their fair share of taxes.

We also need to recognize that nursing home and assisted living work is emotionally and physically demanding. The people who do that work provide a critical service that is worth more than what we pay them. Congress must guarantee that facilities receiving Medicaid funding pay workers what they deserve and provide enough funding to make sure that happens. We can also grow the nursing home workforce by providing training, expediting the granting of work permits for immigrants who are trained and able to help, and by honoring nursing homework for the proud profession it is.

It’s long past time to get moving. Congress has a lot of work to do. Unfortunately, my opponent shows no inclination to do it. We know he knows how to draft a bill, since he proposed banning all Palestinians from our country when that looked like a politically popular thing to do. But we deserve a representative in Congress who will work to solve the real problems facing real Montanans, rather than vilifying imagined enemies halfway across the world.

Monica Tranel is an attorney and Democratic candidate for Montana’s Western District for U.S. Congress.