Long-term care facilities have become ground zero for Covid-19. Not only do they house a population of patients that is among the most vulnerable to Covid-19; but the professionals who care for this population are among the most financially vulnerable. It is common for these workers to be paid at or only slightly above the minimum wage and few avail themselves of employer-sponsored health insurance. Illness can therefore be financially catastrophic.
When Covid-19 cases rose in long-term care facilities, front-line workers without health insurance or with high-deductible insurance avoided work. Fewer workers were left to deal with a higher number of acute care cases. Some facilities experienced staffing levels that dropped 50% when compared to non-Covid periods, and at times like these, nursing homes require more staffing not less.
The health care professionals left behind were overworked and exposed to more sick patients increasing the likelihood of becoming sick themselves and in turn worsening the staffing shortage. This cycle exacerbated already difficult circumstances with sometimes lethal results.
The problems that arose from a pandemic were predictable. The long-term care business has always had narrow financial margins. They rely on lower-income professionals to meet their needs. The biggest purchaser of their services is Medicaid and Medicare, so unlike other businesses, they have only limited ability to raise prices to meet their needs. Their only choice is managing their staffing costs.
Covid-19 struck at the financial and physical health of its lowest-paid workers. Lower-income workers were forced to choose between health and low pay. This should come as no surprise.
The question is what can we do about it? Can we increase wages or benefits without busting the long-term care facilities budget? Maybe.
Enroll these frontline workers in Medicaid and you save the worker the cost of premium sharing so you increase their take-home pay. The organization will also save the cost of premiums for any employee who chooses Medicaid.
This is not a complete solution to the staffing problems created by Covid or other ailments that risk the overall health of nursing home patients and the professionals that work there, but it is one solution and a solution that has benefits for both the workers and the businesses.