SIOUX FALLS, S.D. (KELO) — Most of us will someday need long-term care as we get older. But communities all over KELOLAND are losing nursing homes at an alarming rate. Ipswich, Clear Lake, Huron, and Lennox are just a few examples.

Bernie and Marge Haken moved into Dow Rummel Village in Sioux Falls about three and a half years ago. They stay active at the sprawling campus. We just happened to catch up with them while they were relaxing and watching a little TV. Bernie says his memory gets a little fuzzy once in a while, but it’s clear his sense of humor is intact.

“And I had to give up driving, I could see why because I saved the city of Sioux Falls a lot of damage to other people’s cars,” Bernie said.

All kidding aside, Marge had a stroke at the end of September.

“If I hadn’t been here, I wouldn’t have made it,” said Marge.

Marge says Bernie and the staff acted quickly.

“He ran down there, got the nurse, she was up here just like that and the ambulance was here just like that, they saved my life,” said Marge.

When we get older, care like this is important. And in Marge’s case, life saving. U.S. Government figures show two thirds of us will need long term care as we age. But unfortunately in KELOLAND, it is getting harder to find, because nursing homes are disappearing.

“We’re probably facing the most challenging time we’ve ever faced in our history. We’ve had 15 closings in the last five years and of those 15 closings 7 of them have taken place in just the last year,” said Mark Deak.

The Executive Director of the South Dakota Health Care Association doesn’t mince words.

“I would say it is a crisis quickly becoming a catastrophe.”

Dow Rummel’s CEO, Darla Van Rosendale sees the crisis firsthand.

“The economics of running a nursing home is pretty tough,” she said.

There are two main factors driving senior living facilities out of business in South Dakota. Staffing issues and inadequate funding from Medicaid. Estimates show nursing homes lose about 35 dollars daily for every Medicaid resident. Dow Rummel is fairing better than many other senior care facilities because they have fewer Medicaid residents. Van Rosendale says the current Medicaid payment rate is slowly killing long-term care, especially in smaller towns.

“The rural communities, it is tougher because its harder to find staff. You have such a small area to draw pool from for staffing, then you’ve got a small pool of residents to pick from as well, and they tend to have higher Medicaid occupancies,” said Van Rosendale.

Laura Wilson runs Tieszen Memorial Home in Marion.

“Our local community is 800 people per se, but we also stretch into like Parker, Freeman, Canistota kind of the whole community of sorts, but there are limits there. There are only so many people that live in these small towns,” said Wilson.

“The number one thing that needs to happen is adequate funding. We have not been funded adequately through Medicaid for many, many years, and if this doesn’t change, we are definitely going to see more closings,” said Deak.

Currently, South Dakota has one of the lowest Medicaid reimbursement rates in the country. In her budget address, Governor Kristi Noem proposed a 21 percent increase which would be a significant jump, but Deak says it still won’t cover the entire cost of care for a Medicaid resident.

“We want to get to a point where we are fully funded, where the costs that our folks incur for caring for people, the reimbursement would actually keep up with those costs,” said Deak.

Deak is working with lawmakers in Pierre hoping they increase Medicaid funding before losing any additional nursing homes. So more seniors can have the care they deserve and need, like Bernie and Marge.

“The older I get, the more I appreciate things,” said Bernie.