Despite state and federal efforts, Colorado’s LTC workforce continues to struggle


Boram Kim


Colorado nursing homes continue to experience staffing shortages as the state moves forward on its road to recovery from the COVID-19 pandemic.


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The pandemic took a huge toll on the nursing home community. According to data released by the COVID Tracking Project, 8%, or nearly 1 in 12, of residents in US long-term care facilities have died from COVID-19 as of March 2021. For nursing homes alone, the figure is nearly 1 in 10.

While deaths at nursing homes have dropped significantly in 2021, case counts hit highs during the last Omicron-Delta variant surge this past winter.. 

According to data from the US Bureau of Labor Statistics, some 2,300 nursing home employees, many of them skilled nurses, left their jobs during the pandemic through 2021. 

The shortage has compounded rising operational costs and contributed to a 10% decline in patient occupancy, according to Doug Farmer, President and CEO of the Colorado Health Care Association and Center for Assisted Living.

He said 25% of front-line nurses across the nursing home and assisted living system are coming through staffing agencies, which are charging hospitals 2-4 times higher for nurses than they typically pay.

In an effort to ensure federal funds go more directly to the people being cared for in these facilities, the Biden administration announced it may impose spending restrictions and mandatory staffing ratios in nursing homes.

Kaiser Health News reported recently that CMS is considering a mandate requiring nursing homes to spend most of their payments from Medicaid on direct care for residents and limit the amount used for operations, maintenance, and capital improvements, or overhead. Farmer disagrees with this initiative.

“Until we figure out a fix for the workforce solution, and until we get Medicaid rates to catch up with the modern reality of what’s occurred in the last two years, I think it doesn’t make a lot of policy sense to start going down the pathway of dictating where providers spend their money,” Farmer said.

Gov. Jared Polis committed $313 million dollars to invest in health care workforce stabilization and expansion as outlined the administration’s recovery plan in March. Yet health care providers have not seen the increased staffing necessary to resolve another potential crisis situation should the state witness infections levels like it did late last year. 

Farmer estimates that the care workforce remains 5,000 employees short of pre-pandemic levels across the state’s nursing home and assisted living facilities.

Farmer emphasized that while the focus on improving the quality of care has become sharper, the pandemic remains a lingering threat to nursing homes and their residents.

“Across the country, people sort of feel like the pandemic is over in a lot of ways. In nursing homes that is certainly not the case,” Farmer said.

“While the outcome is not as severe as it has been in the past, the way [infection] changes [how] the work gets done in a nursing home [has] definitely changed. One positive case, whether there are any symptoms or not, means that we go back to COVID protocols in the nursing home and that has an impact on cost. 

But it also has an impact on the morale of our staff and our caregivers. It has a big impact on the mental well-being of the residents, to be asked to be masked again, to be dining apart from people that they want to talk with or interact with. Until we find a way to live and sort of accept where we are at with COVID, that’s going to be the reality for long-term care providers for the foreseeable future.”