January 25, 2022, Washington, DC—As the Omicron death rate escalates and weakens the nation’s capacity to provide care for millions of endangered older Americans, the national organization representing America’s nonprofit providers of aging services, including nursing homes, called on the president to work with Congress on a six-point package of emergency relief. 

LeadingAge data from a recent member poll shows that an escalating set of challenges driven by COVID—staff shortages, burnout, price-gouging by temp agencies, and even provider closures—are threatening access to and availability of quality care. From Minnesota to New Jersey, more than 20 states nationwide are calling in the National Guard to support nursing homes.

“The Omicron surge is compounding existing challenges driven by the pandemic,” said Katie Smith Sloan, President and CEO of LeadingAge. “Staffing shortages and escalating operating costs are threatening our nation’s ability to care for older adults.” 

In a letter to President Biden, LeadingAge outlined a package that would help struggling aging services providers stay open and address staffing needs; prioritize testing and therapeutics for older adults; broaden support for providers of HUD-assisted housing for low-income seniors; and extend regulatory waivers to ensure older adults’ access to critical services, even after the Public Health Emergency ends.

“Older Americans and the people who care for them have borne the brunt of this unprecedented crisis,” added Sloan. Recent data from the Kaiser Family Foundation, shows that in the week ending January 2, COVID-19 infections among nursing home residents jumped 225% and staff cases 277%, compared to 98% for the general population.

“Dedicated, mission-focused providers across the continuum of aging services are doing all they can to keep meeting the needs of the older people they serve. But we need some additional help,” Sloan wrote in her letter to the president. She urged Biden to work with Congress to deliver a package of help for those who serve older adults by providing high-quality, sustained support to protect against COVID and future variants.

Six Point Emergency Relief Package

The letter calls for six steps to address a series of crises:

• Address Staffing Emergencies: To address widespread staffing emergencies that are causing service shutdowns and causing care disruptions, provide a $5 an hour raise along with one-time relief payments of $2,000 for each worker, allowing us to keep direct care professionals and service coordinators who work with older residents in affordable housing on the job, and recruit and retain new staff.    
  • After decades of steady growth, since February 2020 the aging services workforce has lost 420,000 employees, many of them front-line nursing assistants. Almost 85% of respondents to a recent informal poll of LeadingAge members report that staff shortages are one of their top challenges.
• Deliver Provider Relief Funds to Ensure Access to Care and Services: The enormous and growing costs of COVID—including escalating overtime and even price gouging for temporary staff, tests and other supplies—are limiting providers’ ability to accept new clients or residents. Aging services providers need to be prioritized for remaining Provider Relief Funds, and a new tranche of $8-10 billion is critical to help pay for daily operations and services that are rapidly growing more expensive.
  • Two-thirds of LeadingAge member poll respondents report that staffing costs have increased significantly during the last two years. 77% of seniors housing and skilled nursing providers report currently employing agency or temp staff, enduring price gouging that often costs two, three or four times the cost of regular employees. 
  • Over one-third of LeadingAge members say they are unable to admit new residents or serve new clients because of staffing challenges. 
• Create a Dedicated Testing Supply System: To protect older adults and their caregivers including facilitating family visitation, the letter calls for a testing supply system dedicated to ensuring that all types of aging services providers can meet surging testing needs and prepare for future variants. In an environment with limited supplies, the U.S. needs to prioritize getting tests to the populations at highest risk: its older adults. 
  • Nearly one-third of LeadingAge members say they don’t have enough supplies for adequate/required COVID testing.
  • Those who report having enough testing supplies expressed concern about possible shortages as cases rise: “We currently have test kits but these are quickly running out,” wrote one member. Another reported “…with the reduced ordering capacity of BinaxNow tests, and extended reporting times for PCR testing, we do anticipate issues related to lack of testing materials and delayed reporting”
• Prioritize Older Adults for Therapeutics: To protect Americans most vulnerable to severe COVID symptoms and death, a supply of therapeutics must be dedicated to aging services. Nursing homes and home care agencies need to be first-in-line for limited supplies of break-through medications that can be delivered in non-hospital settings.
  • Older adults are most at risk of being hospitalized without rapid access to therapeutics. 
  • Even though over 3.2 million doses of monoclonal antibodies have been distributed by the Federal government so far, only around 33,000 have gone to nursing homes. 
• Extend Provider Flexibility: There needs to be a two-year extension of temporary waivers after the Public Health Emergency expires to ensure access to efficient care as the pandemic wanes. Specifically, extend the waivers related to:
  • Telehealth, including an expansion to home health and PACE providers, 
  • Key nursing home provisions, including the requirement for Medicare coverage of a three-day hospital stay prior to skilled nursing facility admission (so consumers are not faced with surprise billing for SNF coverage when they thought Medicare would pay) and allowing nurse aides to work longer than four months prior to certification.
• Provide Affordable Housing Relief: The almost 800,000 older adults living in HUD-subsidized affordable homes rely on community-provided resources to stay safe from COVID as they age in place. Housing providers, who have incurred millions in COVID-related costs, need greater access to Cares Act funding, which was legislated almost two years ago—yet more flexibility is needed to use unspent funding. Eligible costs should be expanded to include needed relief for resident internet access, wellness and mental health programming.
  • More than 1.93 million very low income older adult renters pay more than half of their incomes toward rent.
  • Resident mental health led affordable housing providers’ operational concerns, results of a  LeadingAge provider survey fielded in late 2021. 

“Older Americans and their families are in crisis because our country doesn’t have the aging services infrastructure to meet their needs,” added Sloan. “This lack of financial support for the resources, organizations and professionals who serve older adults means that millions of Americans are denied access to fundamental services. It is time to ensure that all of us can access the care and support we need as we age.”

We represent more than 5,000 nonprofit aging services providers and other mission-minded organizations that touch millions of lives every day. Alongside our members and 38 state partners, we use applied research, advocacy, education, and community-building to make America a better place to grow old. Our membership, which now includes the providers of the Visiting Nurse Associations of America, encompasses the continuum of services for people as they age, including those with disabilities. We bring together the most inventive minds in the field to lead and innovate solutions that support older adults wherever they call home. For more information visit leadingage.org.