News and Events

Southeast Minnesota long-term senior care facilities struggle through financial crisis, staffing shortages

The COVID-19 pandemic exacerbated the money struggles already facing care centers. Now, advocates are asking for help from the state to retain workers and keep their facilities open.

Zumbrota Care Center
Jessica Lomeli, front, a certified nursing assistant at the Zumbrota Care Center, and Brianna Ryan, a basic care aid, work with residents on Tuesday, May 17, 2022, in Zumbrota.

ZUMBROTA, Minn. — The Zumbrota Health Services building is noticeably less full than it once was. Rooms down one hallway are mostly unoccupied. Residents sit in the common areas, but it just feels empty.

About four years ago, the senior care center was a 50-bed facility. Now, there’s a 40-bed capacity, but only 32 beds are full.

But the emptiness isn’t just because of a lack of residents. It’s noticeable that the staff is fairly small. And this isn’t exclusive to the Zumbrota facility: There are 23,000 open positions for caregivers across the state.

Zumbrota Care Center
A “now hiring” sign out front of the Zumbrota Care Center on Tuesday, May 17, 2022, in Zumbrota.

The staffing shortage is one domino that fell as a byproduct of the biggest struggle long-term care facilities are facing right now: the financial crisis.

Leaders in the long-term senior care industry are heavily advocating the Minnesota Legislature before the session ends on Monday, May 23, 2022, to use part of the budget surplus to ease the financial burden facing so many facilities.

It’s important to note that the financial crisis within the industry wasn’t created by the pandemic, but the associated costs with protective gear and operating COVID-19 units suddenly pushed onto facilities exacerbated the struggle. The crisis even caused five nursing homes to close in the first five months of 2022. Twelve facilities have closed since 2020.

Prior to the pandemic, nursing homes in particular were functioning under tight margins. And, according to Kari Thurlow, the president and CEO of LeadingAge Minnesota, the reimbursement rates set by the state legislature were a big reason for the financial crisis.

Nursing homes are reimbursed for residents through a daily rate set by lawmakers. In Minnesota, the Medicaid rate and private pay rate have to be the same, according to state law. Facilities submit a cost report with their total operating costs to be reimbursed.

The issue is that the expenses are not reimbursed until 27 months after the cost reports are submitted, so nursing homes right now are paid based on 2020 cost reports.

“Most of those costs are before the pandemic got really bad,” Thurlow said. “If you think about all that we’ve been through since, like the huge inflationary increases, the added cost of testing and vaccines and all of those things, none of that has been covered in cost reimbursements.”

Nursing homes, assisted living facilities and other long-term care centers are operating on incredibly slim margins because the costs they face are far more than the reimbursements they are currently receiving from the state.

The lack of money is the reason there’s also a staffing shortage across Minnesota. Thurlow and other long-term caregivers are advocating for a reimbursement rate increase not to ease the operating cost for facilities, but to increase the wages of caregivers in order to retain current workers and attract new ones.

“One of the biggest challenges we have, and you see this all over the state, is that because of inflation and wage inflation, we’re losing caregivers because we can’t keep up with wages. And when we lose caregivers, we can’t admit more residents. And it creates a financial issue,” Thurlow said. “So our theory is by immediately investing in base wages this session, we’re able to recruit caregivers and increase occupancy in our settings to help with the financial crisis.”

It would be helpful to facility leaders like Sue Knutson, who is operating Samaritan Bethany in Rochester with about 200 staff members, down from the 440 she had five years ago. Operating with half the staff means they’re “just not having people move in.”

“It’s difficult because we don’t normally say no,” she said.

Cami Peterson-DeVries, the vice president of senior services at St. Francis Health Services, the parent organization over Zumbrota Health Services, said because of the staffing crunch, the Zumbrota care center has been “very selective in who comes in because we want to make sure that we have enough staff to prepare and take care of them.”

Zumbrota Care Center
Dr. Cami Peterson-DeVries, the vice president of senior services with St. Francis Health Service of Morris, is pictured at the Zumbrota Care Center on Tuesday, May 17, 2022, in Zumbrota.

“It really is a sadness in the sense that we’re not able to take care of all the people we’d like,” she said.

Some care centers have navigated the staffing shortages without closing and without compromising care for residents who need the facilities they’re in. But funding is desperately needed for many facilities to continue operating.

“We do need finance. We do need funding,” Peterson-DeVries said. “We as an organization have been working together to say, ‘Okay, how do we tighten our belts? What do we do?’ But there are certain things you can’t compromise on. You can’t compromise on resident care. You just can’t.”

11% of Nursing Homes; 20% of Assisted Living Face Closure According to New Long-Term Care Imperative Survey

On May 5, 2022 by Jeff Bostic

Aging services providers across the state face dire financial conditions that jeopardize access to care for Minnesota’s seniors, according to a recent survey conducted by the Long-Term Care Imperative.

The survey – which garnered responses from 156 care centers and 179 assisted living settings – illustrates the challenges faced by providers during this unprecedented workforce shortage. The survey findings are sobering and show that providers have been doing all they can to respond to the workforce crisis, creating an existential threat for many of them.

Negative 8.7% Operating Margin for the Average Nursing Home

For care centers, the most significant finding is that March’s financial performance was abysmal, with a median operating margin of negative 8.7%. If March is indicative of all of 2022, the average care center will lose almost $900 thousand on operations, which is a considerable problem when many of them have already used some or all of their reserves. The financial performance is primarily driven by significant increases in expenses, including the large number of providers who have given employee wage increases of more than 10% in the last two years and the number experiencing large spikes in temporary staff use and the cost of that staff.

One significant finding is the number of providers looking at sales or closure as they continue to struggle financially. 11% of care centers, which works out to about 40 statewide, indicated they are looking at those options. That will have severe impacts on access if it comes to pass, and the number considering those options is likely to grow if the financial performance from March continues for several more months.

20% of Assisted Living Face Closure

For assisted living settings, the picture is also quite challenging. While financial performance is not as gloomy as care centers, they are at a median operating margin of negative 1% in March. An even higher proportion of them have increased employee wages by more than 10%, and they are using reserves to cover those and other increased costs in many cases. While they are more able than care centers to raise charges to stabilize their financial performance, the ability to do so will be limited by market realities. In many cases, it has been already.

The number of assisted living providers considering closure or sale is even higher than care centers, at around 20% or about 400 locations statewide. If numerous sites close, that will cause substantial access problems for this service, when alternatives like care centers are also under stress and may not be able to take the clients who cannot access assisted living sites.

Action Needed Now to Help Struggling Providers

The story told in the data is staggering, and the Long-Term Care Imperative understands the importance of sharing this story to help advocate for action. To help aid in our advocacy efforts and encourage the legislature to pass funding to support caregivers with the wages they deserve and ensure access to care for Minnesota’s one million seniors.

We cannot address this crisis without your help and a bipartisan commitment to supporting the care our growing senior population needs.

This starts with adjustments to state Medicaid rates for senior care services to support competitive, family-sustaining wages. Minnesota has over 23,000 open positions in nursing homes and assisted living settings. Without sufficient staff, senior care providers cannot admit residents, resulting in revenue losses for organizations throughout the state.

Take Action

In addition to efforts to garner media attention, we will ask all providers to contact the Governor on Monday, May 9, to share why action is needed. Our goal is to flood his office with calls that illustrate just how dire the circumstances of inaction this session are.

On Monday, May 9, we ask you to call Gov. Walz; click here to connect or dial 651-370-8632. Tell the person who answers the phone that seniors and their caregivers need action this session. Here are suggested talking points you can use:

  • Hello, my name is ____, and I provide care in a long-term care setting.
  • According to a recent survey conducted by the Long-Term Care Imperative, 40 nursing homes and 400 assisted living settings face closure.
  • Over 14,000 older adults are in jeopardy of losing the care they need in long-term care settings throughout the state.
  • Without permanent investments from the state, the average nursing home is projected to lose over $800k this year alone.
  • This crisis will continue to worsen for seniors needing care if left unsolved until the 2023 session. Lawmakers cannot go home without taking action.
  • In the final stages of the legislative process, I respectfully ask that seniors and their caregivers be your top priority. Invest in the wages professional caregivers deserve and help ensure access to care for Minnesota’s growing population of seniors!
  • Please support the Senate’s Health and Human Services bill that funds permanent wage increases needed to recruit and retain professional caregivers.

Thank you for your advocacy. With only a few weeks left in the legislative session, we’ve got to keep the pressure on to garner support for the funding needed to pay caregivers the wages they deserve and ensure access to care for Minnesota’s seniors.

9.4.21 COVID Update

9/4/2021

Dear Family and Friends of Bridges of Zumbrota,

We have had a second case of COVID-19 identified among our residents. The resident is being cared for at the assisted living in their apartment. Staff are following all infection control guidelines recommended by MDH, CMS, and CDC. Residents are continuing to quarantine, all services are being delivered to their rooms, and we are conducting vital signs twice daily, as well as daily symptom monitoring. We are testing all residents and staff every 3-5 days for COVID until we have all negative tests for two weeks.

Visitors are not allowed at the Bridges until we have had two full weeks of negative tests.

Zumbrota Care Center operations are continuing as normal at this time.

Do not hesitate to reach out to Laura Erickson, Administrator, at 507-732-8132 or by email at lerickson@zhs.sfhs.org if you have any questions or concerns.

9.2.21 COVID Positive resident

9/2/2021

Dear Family and Friends of Bridges of Zumbrota,

Yesterday we were notified that a staff member at the Bridges of Zumbrota tested positive for COVID-19. Last night a resident was diagnosed with COVID-19 as well. Residents are being quarantined, all services are being delivered to their rooms, and we are conducting vital signs twice daily, as well as daily symptom monitoring. We are testing all residents and staff every 3-5 days for COVID until 14 days since the residents’ last exposure to the positive staff member.

Visitors will not be allowed for the next two weeks at the Bridges, or until we have had two full weeks of negative tests. We will continue to communicate with you throughout the next couple of weeks.

Zumbrota Care Center operations are continuing as normal at this time.

We continue to follow guidance from Minnesota Department of Health (MDH), the Centers for Medicare & Medicaid Services (CMS), and the Centers for Disease Control & Prevention (CDC).

Do not hesitate to reach out to Laura Erickson, Administrator, at 507-732-8132 or by email at lerickson@zhs.sfhs.org if you have any questions or concerns.

9.1.21 COVID Positive Staff at BOZ

9/01/2021

Today we were notified that an employee of the Bridges of Zumbrota has tested positive for COVID-19. Due to the positive test result, we will begin point prevalence testing of all staff and residents of BOZ regardless of vaccination status on September 2nd. This will occur until 2 rounds of testing return with no new positive cases. We are following recommendations from the Minnesota Department of Health (MDH), the Centers for Disease Control & Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS).

Due to the risk of transmission, all residents in close contact with this employee have been put on quarantine pending testing results. MDH requires us to restrict indoor visitation for all residents until at least one round of testing results return negative. Compassionate care and essential care visits will continue as needed.  Resident activities, dining, and doctor appointments will also continue in areas not impacted. We encourage our family and friends to reach out to us to schedule window visits or virtual visits during this time.

If you have any questions or concerns, please do not hesitate to reach out to Laura Erickson, Administrator, at 507-732-8132 or by email at lerickson@zhs.sfhs.org.

COVID Update – No New Cases

4/16/2021

Our care center continues to routinely test staff weekly and when an employee or resident show signs or symptoms of COVID-19 or has had exposure to a confirmed case of COVID-19. As of today, we have no confirmed cases of COVID-19 in our care center. We are following recommendations from the Minnesota Department of Health (MDH), the Centers for Disease Control & Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS).

Health Department calculations on Friday show 49.8 percent of the state’s adult population has received at least one vaccine dose, with more than one-third completely vaccinated; however, active cases are now at levels not seen since December. Hospitalizations have climbed significantly in the past weeks and are hovering around levels not seen since early January. The age of those newly hospitalized is trending younger than earlier in the pandemic. The majority of people in the hospital now for COVID-19 are younger than 60.

We continue to work on vaccinating our residents and staff. You are a key partner in keeping our care center open for visiting and ending this pandemic. We encourage you to connect with your primary health care provider or use the Vaccine Locator map (Vaccine Locations / COVID-19 Updates and Information – State of Minnesota (mn.gov)) to find a vaccine appointment near you.

Looking for ways to help? We have a variety of positions available with flexible scheduling and on the job training. For more information or to apply, visit www.jobswithus.org, search “Zumbrota.”

Please follow our Facebook page (@Zumbrota Health Services) or our website (www.zhs.sfhs.org) for all COVID updates and information on what is happening inside our care center. Please do not hesitate to reach out to Laura Erickson, Administrator, at 507-732-8132 or by email at lerickson@zhs.sfhs.org if you have any questions or concerns.

COVID Update

4/09/2021

 Our care center continues to routinely test staff weekly and when an employee or resident show signs or symptoms of COVID-19 or has had exposure to a confirmed case of COVID-19. As of today, we have no confirmed cases of COVID-19 in our care center. We are following recommendations from the Minnesota Department of Health (MDH), the Centers for Disease Control & Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS).

This week, MDH stated they will follow the CDC guidelines for national and international travel. If an employee is fully vaccinated they do not need to quarantine after travel. They would need a COVID test 3-5 days after return. 

The percentage of Minnesotans who are vaccinated continues to climb. 41.8% of Minnesotans have received at least one dose of the vaccine and 27% of Minnesotans are considered fully vaccinated. Even with the climbing vaccination rates, Minnesota’s state COVID positivity rate is now 6%, rising one percentage point from last week. Hospitalizations also continue to climb and are now the highest since the Pandemic’s peak in January.

One of the best ways you are able to help our community is to get vaccinated. We continue to encourage you to connect with your primary health care provider or use the Vaccine Locator map (Vaccine Locations / COVID-19 Updates and Information – State of Minnesota (mn.gov)) to find a vaccine appointment near you.

Looking for ways to help? We have a variety of positions available with flexible scheduling and on the job training. For more information or to apply, visit www.jobswithus.org, search “Zumbrota.”

Please follow our Facebook page (@Zumbrota Health Services) or our website (www.zhs.sfhs.org) for all COVID updates and information on what is happening inside our care center. Please do not hesitate to reach out to Laura Erickson, Administrator, at 507-732-8132 or by email at lerickson@zhs.sfhs.org if you have any questions or concerns.

MDH Recommendations for Safe Family Gatherings

MN Department of Health

Information for Safe Family Gatherings

Plan ahead

Take steps to lower the risk of COVID-19

  • If you are unvaccinated, limit chances for contact with someone with COVID-19. Two weeks prior to your gathering, avoid people who do not live with you and settings where you cannot stay at least 6 feet away from others. Avoid bars, restaurants, or carpools where people do not consistently wear a mask.
  • Wear a well-fitting mask when you are inside places other than your home.
  • Wear a well-fitting mask at outdoor events where you cannot stay at least 6 feet away from others. See CDC: Improve How Your Mask Protects You (www.cdc.gov/coronavirus/2019-ncov/yourhealth/effective-masks.html).
  • Wash your hands regularly and thoroughly and ask people coming into your home to do the same.
  • Stay at least 6 feet from others who live outside your household, whenever you can.

Create a safe setting

Create a safe setting for visitors

  • Before anyone enters your home, ask if they have had a fever, cough, body aches, fatigue, runny nose, or other symptoms of COVID-19. People with symptoms should stay home and away from all others. They should be tested for COVID-19 as soon as possible.
  • Before anyone enters your home, ask if they have recently been near someone with COVID-19. People who have spent time near a person with COVID-19 should stay home and away from others. They should be tested five to seven days after the contact.
  • Before bringing someone who needs long-term care into your home, get yourself and your household members tested for COVID-19.
  •  Before anyone enters your home, especially someone at-risk for more severe illness, wear a mask that covers your mouth and nose completely.
  • Before anyone enters your car, wear a mask that covers your mouth and nose completely. If people staying with you can also wear a mask, ask them to do so as well.
  • Before anyone enters your home, set up your house so people can stay 6 feet apart from others. See Indoor Air Considerations: COVID-19 (www.health.state.mn.us/diseases/coronavirus/indoorair.html). LONG – TERM CARE GUIDANCE FOR OUTINGS.
  •  For current recommendations about creating a safe space for visitors, see Protect Yourself & Others: COVID-19 (www.health.state.mn.us/diseases/coronavirus/prevention.html).

Contact the nursing home or assisted living-type facility

Nursing homes and assisted living-type facilities follow strict regulations and guidelines to prevent the spread of COVID-19 in their buildings. Before taking someone out of nursing homes or assisted living-type facilities, make sure you understand the current guidelines.

Vaccination for COVID-19 is ongoing. We look forward to the day when more restrictions can be removed.

One Year Since 1st case of COVID-19 was Confirmed in MN

3/04/2021

This week we tested all staff of Zumbrota Care Center. Results are shown below. We continue to work with the Minnesota Department of Health (MDH) and are following COVID-19 recommendations from the Centers for Disease Control & Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS).  As of today, the MDH is not recommending any changes to our visitation process.

  • Zumbrota Care Center – 0 residents and 0 staff tested positive this week. Testing staff weekly due to county positivity rates.
  • Bridges of Zumbrota – 0 tenants and 0 staff tested positive.

This Saturday, March 6th, marks one year since Minnesota confirmed its first case of COVID-19. The state has since recorded 485,230 total confirmed or probable cases. Now, more than 52% of Minnesotans 65 and older have received at least one dose of either COVID vaccine. This week, Governor Tim Walz stated Minnesota will expand vaccination eligibility when 70% of that population gets their first dose. Vaccine eligibility would expand to people with high-risk health conditions and targeted essential workers. Younger groups and the general public would follow in the late spring and summer.

Johnson & Johnson has now received an emergency use authorization (EUA) from the U.S. Food and Drug Administration (FDA) for its COVID-19 vaccine, the Janssen Ad-Vac. The J&J vaccine is different than its Moderna and Pfizer 2-dose vaccine counterparts in two ways. First, the J&J vaccine is a one-shot vaccine, not a two-dose vaccine. Second, the J&J vaccine uses a more common vaccine technology and does not utilize the mRNA vaccine delivery method. The vaccine is published as 85% effective 28 days post vaccination. Side effects listed for this vaccine are similar to those listed for Pfizer and Moderna vaccines.

Visitation will occur by appointment and not in resident rooms/apartments. In order to have an indoor visit, please follow the below guidance:

  • Due to low county positivity rates, COVID tests prior to visiting are no longer required prior to indoor visits (they are still required for Essential Caregiver visits).
  • 2 people may visit at one time.
  • For the Care Center: Visits will be held in the Day Room and visitors will enter/exit through Day Room door.
  • For the Bridges: Visitors will enter/exit through the main entrance and take place in a designated area.
  • Visits are up to 25 minutes.

Zumbrota Care Center time slots starting every half hour will be available:

  • Tuesday from 1-3:30 pm
  • Wednesday from 10-11:30 am
  • Thursday from 10-11:30 am
  • Friday from 1-3:30 pm

Please contact Lacey Boesen, Activity Director, at lboesen@zhs.sfhs.org or 507-732-8409 to set up an indoor visit.

Bridges of Zumbrota time slots starting every half hour will be available:

  • Monday from 10-11:30 am and 1-3 pm
  • Wednesday from 10-11:30 am and 1-3 pm
  • Friday 10-11:30 am and 1-3 pm
  • Alternate times by appointment

Please contact Virginia Cooper at 507-732-8455 or Barb Konter at 507-732-8412 to set up an indoor visit. Visits should be set up at least 24 hours in advance.

Looking for ways to help? We have a variety of positions available with flexible scheduling and on the job training. For more information or to apply, visit www.jobswithus.org, search “Zumbrota.”

Don’t forget to get your flu shot this season to help protect our community. Please follow our Facebook page (@Zumbrota Health Services) or our website (www.zhs.sfhs.org) for all COVID updates and information on what is happening inside our care center. Please do not hesitate to reach out to Laura Erickson, Administrator, at 507-732-8132 or by email at lerickson@zhs.sfhs.org if you have any questions or concerns.

COVID Update – Vaccine Connector Tool

2/26/2021

This week we tested all staff of Zumbrota Health Services. Results are shown below. We continue to work with the Minnesota Department of Health (MDH) and are following COVID-19 recommendations from the Centers for Disease Control & Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS).  As of today, the MDH is not recommending any changes to our visitation process.

  • Zumbrota Care Center – 0 residents and 0 staff tested positive this week. Testing staff weekly due to county positivity rates.
  • Bridges of Zumbrota – 0 tenants and 0 staff tested positive.

We continue to receive questions on how and when family and friends will receive their vaccine. Health officials have created a Vaccine Connector tool found at https://vaccineconnector.mn.gov/. This tool helps Minnesotans find out when, where, and how to get a COVID-19 vaccine. After you fill out a simple form, the Vaccine Connector will alert you when you are eligible to receive a vaccine, connect you to resources to schedule a vaccine appointment, and notify you if there are vaccine opportunities in your area.

It is not necessary to sign up if: 

  • You have already received your COVID-19 vaccine.
  • You previously registered for the COVID-19 Vaccine Pilot Program or the COVID-19 Community Vaccination Program. You’re already on the Vaccine Connector list, and there is no need to re-submit your information.  
  • You completed the Minnesota COVID-19 Vaccine Education and Child Care survey. You’re already on the Vaccine Connector list, and there is no need to re-submit your information. 
  • You completed the Health Care Connection Form, you do not need to re-submit your information. The Minnesota Department of Health will work with health systems and local public health agencies to notify you about when and where you can get vaccinated. 

We look forward to the day we can throw our doors wide open to the community. Until then, there are multiple ways residents in our setting can interact with one another and with their loved ones. We have resumed socially distanced communal dining and small group activities. We are currently able to offer indoor visits, virtual visits, essential caregiver visits, and compassionate care visits. We do ask that visitors are tested prior to entering our care center.

Visitation will occur in the Day Room by appointment (not in resident rooms/apartments). In order to have an indoor visit, please follow the below guidance:

  • Proof of a negative COVID test within 5 days prior must provided. If you would like to be tested during our routine testing, please reach out to Laura Erickson, Administrator, at 507-732-8132. This applies to visitors who will be visiting on a regular basis, otherwise COVID tests may be obtained elsewhere.
  • 2 people may visit at one time.
  • For the Care Center: Visits will be held in the Day Room and visitors will enter/exit through Day Room door.
  • For the Bridges: Visitors will enter/exit through the main entrance.
  • Visits are up to 25 minutes.

Zumbrota Care Center time slots starting every half hour will be available:

  • Tuesday from 1-4 pm
  • Wednesday from 10-11:30 am
  • Thursday from 10-11:30 am
  • Friday from 1-4 pm

Please contact Lacey Boesen, Activity Director, at lboesen@zhs.sfhs.org or 507-732-8409 to set up an indoor visit.

Bridges of Zumbrota time slots starting every half hour will be available:

  • Monday from 10-11:30 am and 1-3 pm
  • Wednesday from 10-11:30 am and 1-3 pm
  • Friday 10-11:30 am and 1-3 pm
  • Alternate times by appointment

Please contact Virginia Cooper at 507-732-8455 or Barb Konter at 507-732-8412 to set up an indoor visit. Visits must be set up at least 24 hours in advance.

Looking for ways to help? We have a variety of positions available with flexible scheduling and on the job training. For more information or to apply, visit www.jobswithus.org, search “Zumbrota.”

Don’t forget to get your flu shot this season to help protect our community. Please follow our Facebook page (@Zumbrota Health Services) or our website (www.zhs.sfhs.org) for all COVID updates and information on what is happening inside our care center. Please do not hesitate to reach out to Laura Erickson, Administrator, at 507-732-8132 or by email at lerickson@zhs.sfhs.org if you have any questions or concerns.