Rural states like South Dakota are requesting more funds to address challenges to nursing homes from staffing shortages, which have accelerated shutdowns and suppressed occupancy levels.
South Dakota’s Department of Human Services (DHS) requested its Legislature this week for $715.8 million in funds for fiscal 2025 in order to support nursing homes and long-term care facilities. This is an increase of $26 million from last year, according to a report in the local news outlet, Siouxlandproud.com, a community portal for an ABC News affiliate that serves parts of Iowa, Nebraska, and South Dakota.
The extra funds are being requested to maintain staff and increase the number of clients they are able to support, the article noted.
Nursing facilities are only at 82% occupancy in South Dakota, according to the state’s Deputy Commissioner for Bureau of Finance Management Steven Kohler, who addressed the state Legislature’s Joint Committee of Appropriations on January 17. The providers are having a difficult time recruiting staff in order to care for any additional patients, Kohler stated.
“The thing that concerns me is if we don’t keep the funding in place and we do see an increase in staff and fill more beds, we as a state have to pay that bill,” Kohler said. “That’s why we want to make sure we have the funding in place to meet that need for tomorrow.”
Other legislators such as Republican State Senator Lance Koth raised concerns about potentially leaving people who need care “out on the streets.”
A majority of the funds requested by DHS will be directed toward Long Term Services and Supports (LTSS), which includes in-home services, nursing homes, and assisted living facilities. For fiscal 2025, $347.9 million, or 48.6%, is allocated for long-term services.
South Dakota has 96 nursing homes and 160 assisted living centers.
Problems with staff retention in the state have suppressed the census for facilities and reduced the “bed days” over the years, the article noted. In fiscal 2019, there were roughly 3,200 patients in nursing homes in South Dakota, and that number has shrunk to 2,400 in 2024.
The pandemic, group homes closing and individuals moving or passing away were cited as possible reasons for the lower number of patients in recent years, Kohler said.
“We have more people that are utilizing assisted living homes and other resources that allow them to live independently in their home, that does delay or cause them not to go into a nursing home,” Kohler said.