SIOUX FALLS, S.D. (KELO) — A project in Brookings to add more independent living, assisted living and memory care living spaces in South Dakota is good news, said Mark Deak, the executive director of the South Dakota Health Care Association (SDHCA).

But, the flip side is that many nursing homes in the state are still grappling to fill staff care positions as the need for nursing home services continues, Deak said.

“The challenges are still great,” Deak said. “Assisted living is only one part of the continuum of care.”

The project by Peaceful Pines in Brookings will help fill a need but others remain, he said.

As people age 77% of those older than 65 will “still require some sort of long term care,” Deak said.

Seven nursing homes closed in South Dakota in 2022. Challenges such as inadequate state nursing home Medicaid reimbursement rates, staffing needs and COVID-19, impacted many nursing homes. They were also factors in the closures.

The landscape has improved somewhat, Deak said.

“Knock on wood, I hope we are done with closures at least for (the time),” Deak said.

Deak said nursing homes and his organization are grateful that Gov. Kristi Noem and the Legislature addressed Medicaid reimbursement rates.

Nursing homes will receive 100% of the methodology rate for Medicaid reimbursement for residents on Medicaid, Deak said.

That doesn’t mean the 100% will completely cover the costs to provide service to those Medicaid residents, he said.

The reimbursement methodology increase means the reimbursement will cover about 92% of the cost. “That’s much better than it was,” Deak said.

The SDHCA said before the legislative change that the state’s rates were the lowest in a seven-stage region at $158.54 in 2021.

The South Dakota Department of Social Services said in a 2020 report that more than 54% of the residents in nursing homes used Medicaid.

Medicaid reimbursement rates can be tied to staffing, he said. Nursing homes are competing for workers in a very tight job market with an unemployment rate of 1.9%.

Deak said the increased reimbursement can help nursing homes increase staff pay.

Meanwhile, the public may continue to hear of long waits for a nursing home spot or of empty rooms in nursing homes in large part because of staff shortages.

“We want to be positive and it’s getting a little better all the time. But the reality for long term care is that there are 1,000 fewer staff now compared to before the pandemic,” Deak said.

About 3/4s of the nursing home respondents to a recent SDHCA survey said “they could accept new residents but they don’t have enough staff hired to care for them,” Deak said.

Deak said nursing homes want staff with an interest and desire to provide long term and that requires a specific type of employee, Deak said.

The organization developed a scholarship to pay for the education of future long term employees. Twelve scholarships were available for this year and another 12 are available for next year.

Another positive is the interim legislative committee studying long term care needs and solutions this year, Deak said.

Help will also be needed at the federal level.

The federal government needs to increase the number of visas available to international health care workers, he said. These are health care workers who want to work in long term care and want to live in the U.S., Deak said.