As 117th Congress Gets Underway, Focus Must Remain on Prioritizing Long Term Care Through the Pandemic

Advocacy; COVID-19; AHCA/NCAL Updates

As members of the 117th Congress begin their work in Washington, D.C., lawmakers will have numerous proposals on their legislative agendas. But as the country continues to battle COVID-19, residents and staff in long term care must remain a top focus.

Long term care facilities have been at the forefront of the fight against the COVID-19 pandemic. In spite of the heroic work of dedicated caregivers across the country, nursing home, assisted living, and other long term care residents account for nearly 40 percent of COVID-related deaths in the United States, while comprising only six percent of total cases. 

Long term care residents are among the most vulnerable to COVID-19, yet many providers still face significant challenges nearly a year into their response to the pandemic. Congress must make long term care residents and frontline workers a priority within the health care system. 

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) is urging Congress to add another $100 billion to the Provider Relief Fund, as was passed in the HEROES Act last year, and allocate $20 billion of this fund to long term care. Additionally, AHCA/NCAL calls on lawmakers to ensure long term care facilities are prioritized for access to testing and proper personal protective equipment—critical resources needed to combat COVID-19 in facilities. 

Read more below on specific areas within the long term care sector that require immediate attention from lawmakers on Capitol Hill.  

Continuing To Fight The Pandemic 
While vaccine distribution has begun in long term care facilities nationwide, there is still a long road ahead. Residents and staff must continue to be prioritized for the vaccines, as well as the tools they need to win the war, namely adequate personal protective equipment (PPE), timely testing and staffing support. This is especially important as cases continue to rise among the general population and long term care facilities experience a record-breaking number of cases and deaths. Ongoing support from the federal government is critical in order for providers to continue protecting residents and staff. 

Staffing shortages have been an ongoing challenge for long term care facilities – a challenge that has only worsened in the wake of the pandemic. Staff members have missed work to take care of family members or have fallen ill with the virus and been forced to quarantine. A November survey by the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) found that staffing has been the top cost in response to COVID-19, with nine out of 10 nursing homes hiring additional staff and/or paying staff overtime, underscoring the need for immediate solutions that will help alleviate this challenge. 

Declining Occupancy
Long term care facilities have seen a dramatic decline in occupancy because of the pandemic. With fewer new admissions, particularly short-term rehabilitation patients, the growing number of empty beds fuels financial losses, underscoring the need for additional funding in order to keep facilities’ doors open for their current and future residents.  

Medicaid Underfunding
Medicaid underfunding has plagued nursing homes for years. The perennial gap between Medicaid reimbursement rates and the actual cost of care has forced nursing homes to operate on shoestring budgets and suffer net losses year after year. These financial strains have been magnified by COVID-19, creating an alarming threat to the entire long term care sector. Adequate Medicaid funding is a long-term solution that will enable providers to invest in critical areas that will improve overall care. 

Nursing Home Closures 
Nursing home closures have risen steadily for the past several years, but COVID-19 has increased the possibility of more providers shutting their doors. Nursing home closures leave residents displaced from their long-standing communities and loved ones and reduce their options for quality care, especially in rural areas. The same November survey AHCA/NCAL found that 90 percent of nursing homes are currently operating at a loss, and two-thirds of nursing home providers say they will not be able to sustain operations for another year at the current cost. Assisted living communities face similar financial challenges after receiving minimal federal aid due to the pandemic, with more than half operating at a loss and a similar percentage fearing their doors will close within a year without further assistance. We must ensure nursing homes and assisted living communities have the financial stability to continue providing high-quality care.

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represents more than 14,000 non-profit and proprietary skilled nursing centers, assisted living communities, sub-acute centers and homes for individuals with intellectual and development disabilities. By delivering solutions for quality care, AHCA/NCAL aims to improve the lives of the millions of frail, elderly and individuals with disabilities who receive long term or post-acute care in our member facilities each day. For more information, please visit