Guest Editorial: A Potential Looming Crisis for Seniors

By Jaime Roberts and David Voepel

Thirty-six percent of Arizona’s population is seniors – more than 2.5 million residents. Of those
2.5 million, thousands are residents in our long term care facilities. It takes an army of devoted
caregivers to look after our seniors, and their commitment to serve is unmatched.
The long term care profession is at a critical junction. Many of the long-standing challenges that
have faced our sector have been magnified as a result of the pandemic, particularly as it
pertains to our workforce.

In the last three years, health care workers have exited the field en masse, especially in our
nursing homes and assisted living communities. Among all health care sectors, long term care
experienced the worst job loss – and unfortunately, we are a long way from fully recovering.
Record-high inflation has led to skyrocketing costs, while chronic underfunding persists. Despite
nursing homes taking every measure to rebuild their workforce, nearly every facility in the
country says it’s still difficult to recruit new caregivers. When you factor in a national shortage of
nurses that is only going to get worse in the coming years, it’s easy to see why. In fact, Arizona is
projected to be the fifth worst state for nursing shortages by 2030.

Staffing shortages are leading to devastating outcomes. The Wall Street Journal reports that the
number of nursing homes are decreasing. There are 600 fewer nursing homes in the U.S. today
than there were just six years ago – a staggering number when we pause to consider how
thousands of our most vulnerable citizens have been uprooted from their homes and left to
search for new care.

Yet another threat looms large. President Biden’s administration is preparing to set a federal
staffing mandate on nursing homes, which would impose an arbitrary staff-to-resident ratio for
every facility. No matter how well-intentioned, the reality is that this one-size-fits-all regulation
will have significant consequences for Arizona seniors and their access to care.

Most nursing homes are already reducing their census because of labor shortages. Nearly half
of nursing homes have days-long waitlists. Hospitals are calling nursing homes so they can
discharge patients to their care but are told they can’t take them. This will continue under this
proposed mandate. It’s estimated that nearly 450,000 nursing home residents are at risk of
displacement if facilities can’t boost their staffing levels to meet the mandate’s requirement.
As the number of nursing homes dwindle, Americans are living longer. Data from the 2020 U.S.
Census shows that the population age 65 and older grew between 2010 and 2020 at the fastest
rate since 1880 to 1890. Today, one in six people are over the age of 65. This presents a
fundamental question: who is going to be there for our seniors when they eventually need long
term care?

Imposing a broad federal regulation on nursing homes does nothing to solve the baseline cause
of our workforce crisis. If lack of qualified and available candidates is the primary obstacle to
hiring caregivers, then the better approach is developing solutions that will build a stronger
pipeline of skilled workers.

To do that, we need a partnership with policymakers. Working together, we can create
comprehensive solutions to these complex problems. There are plenty of ideas on the table, but
we need lawmakers to put them into action.

Common-sense immigration reform that enables us to bring international nurses to the U.S. to
work quickly is a step in the right direction. There are thousands of nurses overseas who are
willing and eager to bridge our labor gaps. We need to lift the green card freeze, remove the
bureaucratic red tape and get these workers to the states.

We need to reach the next generation of caregivers by going into our high schools and teaching
them about the value and reward of working in long term care. Providing financial incentives to
choose this career path, whether it’s wiping away student loan debt or giving providing tuition
assistance for students who commit to working in long term care, will attract more talent to our

We cannot wait for this situation to get worse before we act. Lawmakers in Washington, D.C.
must prioritize our seniors and the long term care profession. Senators Kelly and Sinema should
be front and center to lead the way.

Jaime Roberts is the incoming CEO of Arizona LeadingAge. David Voepel is the CEO of the Arizona Health Care Association