Gallatin County is a close-knit community, and as one of your commissioners, I see so many helpers across our communities working to support their vulnerable neighbors and make our community safety nets stronger. A recent act of goodness came in the form of a successful mill levy in 2022 that voters approved to maintain the only skilled nursing home in our area: Gallatin County Rest Home. As the second most populated county in Montana, ensuring the vitality of our only remaining skilled care nursing home is critical for our seniors needing long term care. Voters stepped up to save this essential facility, but, unfortunately, recent federal regulations proposed by the Biden Administration threaten to diminish any progress that the mill levy guarantees.

In the coming months, the Centers for Medicare and Medicaid Service (CMS) is expected to finalize a federal staffing mandate for nursing homes across the country. For Gallatin County Rest Home, the consequences of this rule would be dire.

Gallatin County Rest Home is a county-run nursing home licensed to hold up to 69 residents, but our average census is closer to 50. The nursing home can’t operate at full capacity because we do not have the necessary staff.

Gallatin Rest Home’s staff vacancies are due to the distorted contract nursing market, and the resulting scarcity of available, qualified workers. Montana’s cost of living is extremely high, and those willing to work in long term care facilities oftentimes cannot afford to live in Montana. Add in a national workforce shortage that is worse than any other health care sector, and it’s no wonder we cannot find caregivers to join the long-term care continuum.

In order to fill vacancies, Gallatin County Rest Home relies on costly staffing agencies to contract labor to meet the demand. Contracting nurses and other caregivers needed to care for our seniors is expensive, and not sustainable in the long run. We need to be moving away from contract staffing, and are currently working on strategies to do so.

The Biden Administration’s rule claims to address workforce issues, but in reality it would exacerbate our workforce challenges in Montana. Eighty-eight percent of all nursing homes in the Treasure State do not currently meet one of the three staffing requirements, and it would cost our state $15 million to meet this one-size-fits-all mandate. Further, the rule fails to recognize licensed practical nurses (LPNs) as nurses and excludes them from being counted in the staffing requirements, leaving out an entire sector of the medical community that our state’s colleges and universities continue to train – discounting the vital role they play in the health care system.

Gallatin Rest Home is already having to turn away prospective residents due to staffing shortages, even though many are willing to pay for our quality care. This forces many to look for care miles away from their loved ones.

When pushed to meet this mandate, Gallatin will be forced to increase our dependance on contract staffing – costing taxpayers more money and limiting quality care for our seniors.

Senator Tester is fighting against this misguided staffing mandate by introducing legislation, the Protecting Rural Seniors’ Access to Care Act, which prohibits the U.S. Department of Health and Human Services (HHS) from finalizing the proposed staffing requirement for nursing homes. I commend him for his efforts to push back against the Biden Administration, and hope others in the Montana delegation will fight with him to stop this mandate.

Senator Tester understands that we need supportive policies to effectively build a strong long-term care workforce. Instead of a mandate, let’s find ways to make housing more affordable, so those wanting to work in a Montana nursing home can actually afford to live here; or implement workforce development programs to incentivize people to join the long-term care sector.

Montanans come together to do what’s best for our citizens, especially for our most vulnerable, but we need our nation’s leaders to also step up. Montana can’t afford to lose any more of our senior long-term care facilities, and I am grateful that Senator Tester is fighting for this important issue in the U.S. Senate.  

Zach Brown is a Gallatin County Commissioner.