Guest opinion: Doing nothing in a crisis makes things worse

Originally ran in the Billings Gazette Feb. 25, 2022

Reprinted with permission from the author

by DARYL TOEWS

The older people in our nursing homes have a problem. The state puts people on Medicaid and promises them services and then doesn't pay those who provide these services at a rate that is commensurate to the actual costs. Seventy-five percent of those in our nursing homes are on Medicaid and down to their last $2,000.

Valley View, a non-profit nursing home in Glasgow, did pretty well in 2019 and 2020. Then about mid-2021, it hit. We were dealing with various new regulations without funding. COVID outbreaks that required quarantine and meant we couldn't accept new residents, families that didn't want to put their family members in quarantine, a severe shortage of nurses and other staff, and agencies who charged us three times the normal salary for traveling nurses and sometimes tried to steal the nurses we had.

The ultimate mistake made that will need to be fixed at the next legislative session is the $0.65/day increase in the rate state Medicaid pays. Nursing homes received less than a one percent rate increase during a pandemic while caring for the most vulnerable Montanans. A similar 0.3 percent rate increase is scheduled for July 1 - less than one percent over a two-year period. These rates are what these facilities depend on to operate day to day.

Mistakes happen, fine! That is why the state of Montana has $400 million in reserves. When I was in the Legislature, we always had a bill to take care of extra fire expenses, disasters, cost overruns in our prisons and any other crisis that happened between sessions. This money was OK'd by the governor and the Legislature approved this the next session. Our reserves at Valley View will be gone by midsummer.

We have had donations and received some county money, but it will not be enough. Valley View and other nursing homes are looking at what closing will look like, and the cost involved. All state help related to COVID ended in October but COVID didn't end. We are in year three of high costs, decreased revenues and severe workforce shortages.

Gov. Greg Gianforte has been the most troubling. He sells himself as a businessman, which is why he got my vote. ARPA workforce funds are readily available to help with recruitment and retention of workers, but his answer has been no. His response to this nursing home problem is to do nothing. A  current example of doing nothing is the mess at the southern border. It shows us what doing nothing looks like. You do not do anything bad, you just do nothing.

A businessman who has run a business for a short time may think that makes sense, but by not helping with short-term money through a crisis, it often costs more in the long run. If many of the more rural nursing homes close, it is because they do not have short-term help. We will then need places for the elderly, so the government will spend a lot of money building nursing homes in the bigger cities. Tens of millions of dollars spent in a short-term crisis will save hundreds of millions of dollars in future spending.

The time has come for the governor and my Republican legislative friends to do something. Let's prove that we can not only start new businesses, but keep the older nursing-home businesses in business. And maybe taking care of the elderly can be valued as one of those "high-paying jobs" worth training for and having.

Daryl Toews is a former Montana state senator and a board member of Valley View Home.