Congress Must Include Long Term Care In Infrastructure Package


Congress has an opportunity to prioritize our seniors and their caregivers by including long term care in the bipartisan infrastructure package. While nursing homes and assisted living communities will soon receive much-needed resources from the Provider Relief Fund, longer-term investments from the federal government are necessary to help improve quality of care.

Long term care facilities are facing economic and workforce challenges that threaten access to care. Across the country, nursing homes are losing workers, and providers are struggling to fill vacant roles. The Wall Street Journal recently reported:

“Nursing homes have a long-term care problem: 18 months after the crisis began, their staff are shrinking.

“While employment in nearly every occupation has been recovering from the shock of the pandemic, the number of people working in nursing homes and other long-term care facilities has continued to drop, according to federal data.” 

The impact of this labor crisis is making news at the local level: 

  • The Idaho Press reports that workforce challenges are resulting in nursing homes being unable to admit new residents. Troy Bell, president and CEO of TanaBell Health Services, which operates nine long term care facilities in Idaho, said the staffing crisis is the worst he’s seen in his nearly two-decade career. 
  • In Maine, a significant staffing shortage is one of the causes of a recently announced closure of a rural facility near Augusta. In a report by WMTW-TV (ABC-Portland, ME), Angela Westhoff, president and CEO of the Maine Health Care Association, said, “If you can’t staff your building and maintain appropriate staffing levels it makes it really challenging to stay open and viable.” She fears more nursing homes could close, especially in rural areas. 
  • In an op-ed in Tulsa World, Diakonos Group Owner and CEO Scott Pilgrim writes about how staffing challenges led to the devastating closure of one of his nursing homes in Medford, Oklahoma.

Many long term care facilities face dire financial situations, leaving them without the resources to hire more workers or make other necessary improvements. Chronic Medicaid underfunding left many nursing homes struggling to break even long before the pandemic began. But now, the industry is facing an economic crisis due to the ongoing costs of fighting the virus. More than half of nursing homes and nearly half of assisted living communities are operating at a loss, and only one-quarter are confident they will last one year or more. An estimated 1,800 facilities could close over the course of the pandemic without help.

With most residents relying on Medicaid or Medicare to pay for their care, government support is essential in strengthening the long term care industry. With proper funding, facilities can continue to improve residents’ quality of life. AHCA and LeadingAge’s comprehensive reform package, the Care For Our Seniors Act, includes immediate and long-term strategies to address Medicaid underfunding for nursing homes, as well as other reforms that will help boost the workforce, modernize physical structures, and enhance infection control procedures.

Long term care residents and caregivers cannot do this alone. We must take the lessons we’ve learned from the pandemic and ensure that the industry is prepared for the future, especially with a growing elderly population. Congress must allocate funding in the infrastructure package to nursing homes and assisted living communities across the country, so providers can continue to deliver quality care to their residents. 

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