Janessa Vogel, administrator at Elm Crest Manor in New Salem, talks about the challenges the small nursing home has maintaining a full nursing staff with competitive pay during a press conference last month in Bismarck by the North Dakota Long Term Care Association. 

As a result of stagnant state funding over the past two years, some nursing homes in North Dakota have engaged in deficit spending, dipped into savings, and denied raises to employees.

For the first time last legislative session, lawmakers did not bump funding for nursing facilities in the state, according to Shelly Peterson, president of the North Dakota Long-Term Care Association.

As a result, nursing homes borrowed from banks, went into reserves and "literally depleted any money that they had," Peterson said.

Last week, Gov. Doug Burgum presented his budget plan that includes a 1 percent increase in funding for nursing homes in each year of the 2019-21 biennium. Meanwhile, these facilities are seeking a 3 percent increase to help with recruiting and retaining staff and paying for growing costs, such as building maintenance and employee health insurance.

"(One percent) is a beginning point, but it's not enough to deliver the resident care that we believe that we need to deliver and that, most importantly, every single resident in our care deserves," Peterson said Wednesday at a news conference at the Ramada in Bismarck.

Nursing facilities in North Dakota often face staffing shortages and, as a result, have had to turn to contract nursing agencies to fill positions. On Wednesday, the heads of nursing facilities told reporters more funding is sorely needed to recruit and retain staff.

"Skilled nursing facilities must have the resources to provide salary increases and benefits to its employees so we can recruit and retain staff so no care is being compromised for our residents," said Janessa Vogel, administrator of Elm Crest Manor in New Salem.

Craig Christianson, CEO of Sheyenne Care Center in Valley City, said the proposed 1 percent increase "fell short" of what is needed to account for the rising costs of medical supplies and equipment, as well as employee benefits.

"After two years of operating at a loss and starting the new budget year at a loss, we truly need our governor and legislators to support a 3 percent inflator in 2019 and 2020 for long-term care," he said.

Jill Foertsch, administrator of St. Gerard's Community of Care in Hankinson, said contract staffing costs are twice as much as having regular employees and health care costs are "astronomical." The facility needs additional state funding in order to continue, she said.

"St. Gerard's Community of Care has not been in the black for many years, but we depleted our savings this past fiscal year. We lost several hundred thousand dollars, and I don't know how we'll survive or continue with that," she said.

One legislator said nursing facilities request for additional state funding is well-founded.

"The Long-Term Care Association is correct that they cannot make it with that (1 percent additional funding)," said Sen. Judy Lee, R-West Fargo.

Lee, who chairs the Senate Human Services Committee, said she's aware of some facilities that are using reserves in order to stay open. Lee said funding long-term care is a priority for legislators, and she supports at least a 3 percent increase.

"This is a priority for us to take care of our vulnerable population in the best way that we can," she said. "We may not end up at 3 (percent), but I certainly support 3 percent and I hope we can at least come pretty close to that."

In response to the North Dakota Long-Term Care Association’s request for increased state funding, Burgum’s spokesman Mike Nowatzki said, in addition to the governor’s proposed 1 percent increase, the governor is “committed to working with providers to improve access to home and community-based services and reform the payment system so that our long-term care system can continue to provide sustainable, quality care to North Dakotans.”

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(Reach Blair Emerson at 701-250-8251 or Blair.Emerson@bismarcktribune.com)