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Nurse surveyor shortage impacts nursing homes

Assisted living

POCATELLO, Idaho - President and CEO of TanaBell Health Services Troy Bell wants to open a new traditional rehabilitation facilities throughout southeast Idaho, but those plans have been put on hold.

A shortage of nurse surveyors across the state is leaving new facilities stranded in the start-up process for months, which is discouraging a lot of these new facilities from being built. Now, there's a high demand for open spots in these facilities.

"We can't operate without funding or without a license so when you have to wait six months, it's an unnecessary hardship that a business doesn't want to face," Bell said. "It's like opening a business and you have to sit and wait for customers when the customers are (actually) there."

Skilled nursing facilities are required to have an annual inspection by these surveyors . The Department of Health and Welfare is contracted with the Centers for Medicare and Medicaid Services (CMS), in which they provide funding to the state in order to go out to these nursing facilities, nursing homes, and assisted living centers to make sure the quality of care is appropriate and no elder abuse is occurring.

"They're telling us that we're looking at a 16 to 24 month waiting period," Bell said in regards to the time it now takes for a surveyor to come out and visit a new facility after it's built.

Idaho Health Care Association Executive Director Robert VandeMerwe said within the past five years, only three skilled nursing facilities were built due to the backlog of surveyors.

Bell plans to build the new facility in more rural areas because in those areas, there are usually at most, one or two of these skilled nursing facilities that provide 24-hour care for their patients.

Although skilled nursing facilities require an annual survey visit, there is now a 15-month waiting period before a surveyor can come out and visit the facility. For assisted living facilities which do not require quite the same heavy nursing staff, there is a three-year visit requirement.

Bell said a shift in the industry has left many beds to be desired, which is impacting local people who need nursing homes because they are now getting sent to assisted living centers and not skilled nursing homes. Assisted living facilities have now taken over the role of what many think of as a traditional nursing home. 

Now, the two facilities are differentiated by the severity to which the nurse's care is needed.

This now leaves a strong market and need for assisted living facilities.

Monte Vista Hills Nursing Home Executive Director Josiah Dahlstrom said he has also noticed the shift and said this has left a lot of empty beds at skilled nursing facilities.

"I think a lot of that is because the assisted livings have taken on the skilled nursing patients of yesteryear," Dahlstrom said.

But there's good news, according to Dahlstrom who said he said he sees the timing of the surveys getting quicker since the Dept. has now been able to hire more people.

Bell is also the president of the association and works closely with the Dept. on a weekly basis to come up with solutions, such as shortening the length of the surveys from a week to two to three days until they catch up, but the Dept. is still bound by the rules and regulations of the CMS.

"We want to be surveyed on time because it's better for the industry. If you're going to come in and help us understand what we're doing wrong we want to know timely so that way we can correct it, fix it, and move on down the road," Bell said.

Dahlstrom said because all five of the skilled nursing facilities in Pocatello are not running at full capacity, he doesn't see a need to add any more in the area.

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