SIOUX FALLS, S.D. (KELO) — South Dakota is in the midst of a nursing home crisis. We’ve lost 15 over the last five years, seven in the last year alone. Many of the homes struggling right now are in smaller communities.

Tieszen Memorial Home has been taking care of people in the Marion area since 1945. Families have relied on this place for generations.

Laura Wilson is the administrator. She’s been working in this building since she was a teenager. So she understands the industry, the business model and the challenges unique to small-town nursing homes.

“When I did our budget for 2023, it is the first year I had a deficit on the budget and that was just cost that was not a profit built in there at all. So I think the budget I had was projecting a $33,000,” Wilson said.

The state determines Medicaid payments to long-term care facilities. Governor Kristi Noem proposed a substantial increase in Medicaid payments in this year’s budget. It is now in the hands of state lawmakers.

“When I heard the Governor’s proposal of the 20, 21 percent, I did the math immediately, and I said that will get us out of the red,” she said.

According to Wilson, there are two major threats to South Dakota’s nursing homes: the amount of money nursing homes are reimbursed by Medicaid and staffing. So she has focused on her staff. She set up a program to pay 50 percent of her workers day care costs. And she recently raised salaries, using money she would normally fork out to highly-paid traveling nurses to meet staffing requirements.

“I took a look at what we were paying, and I did about a $10 bump on my LPNs and about an $8-10 bump on my RNs salaries. It was cheaper for me to pay them and consistently pay them those wages than to pay for these temp salaries,” said Wilson.

Kathy Witkop is a certified nursing assistant who’s been working in this building for 48 years. She lives three blocks away.

“The benefits and the staff I work with and all the little extra things they do for us here, you know sometimes little snacks. You know that means a lot. Makes a difference? It does,” said Witkop.

Wilson can’t control the Medicaid payments; that’s up to the legislature and the Governor. So she will remain focused on her workers.

This week four high school students will be added to the support staff at Tieszen Memorial Home. Wilson and others in the nursing home industry are hoping the legislature comes through with a large funding increase in Medicaid.