This week we featured an op-ed written by Matthew R. Trimble, President & CEO of Saint Elizabeth Community, regarding a growing crisis involving Rhode Island’s nursing homes.

The issue is about as thorny as they come, involving complex federal systems such as Medicare and Medicaid, and is underscored by a tricky, bitter to swallow reality: that we don’t have enough people, or pay them enough, to care for our state’s most vulnerable citizens.

The events leading up to this simmering crisis (which now approaches a boiling point), as elder care facilities around the state close down or face impending closure, is a classic conundrum.

Decisions that were made with the best of intentions to prevent the mistreatment and neglect of senior citizens may actually be doing more long-term harm than good, due either to a lack of care in assessing the impact of those decisions prior to making them, or simply ignoring the warnings that were given regarding those decisions.

We have experienced enough consequences to now know for certain that Rhode Island does not have enough caregivers to provide the minimum care requirement passed by the state in 2021.

As a result, and as pointed out by Trimble, someone with direct and authoritative insight in the field, nursing homes and elder care facilities are facing skyrocketing costs and many are faced with possibly closing down entirely; others already have.

Let us be clear that we are not philosophically opposed to requiring a standard quality of care for nursing home patients, nor are we against hard-working caregivers earning enough money to avoid relying on Medicaid themselves. Our main concern is that the current workings of the state’s mechanisms to support staff required to provide that level of care is insufficient, and that won’t change without targeted and thoughtful effort.

Trimble cites a roughly 30% increase in senior healthcare costs contrasted by an increase in Medicaid reimbursements that amounts to roughly one-sixth of that. And although that reimbursement rate is scheduled to increase to around 11% next year, it still won’t fix the underlying problem.

It is not the first time that a state government has put the well-intentioned cart before the beleaguered, ill-prepared horse, and it likely won’t be the last. The state's recognition of this reality is evident in this case by the fact that they have not actually held elder care facilities liable to the fines that were promised with the new care requirement legislation. Because they know it’s not feasible, and that it will spell more disaster if those facilities are forced to shutter amidst an inability to find, pay, and retain staff.

The only solution is to make Rhode Island a more attractive state for caregivers. Enact salary bonus programs for caregivers who excel, provide credits for both in-state and out-of-state students to attend state universities where they are trained in the field, and reward them for getting a job in-state and working with Rhode Island seniors. Boost the federal reimbursement rates for Medicare and Medicaid however possible, and to whatever extent is needed to start fixing the problem. Prevent opportunistic temp agencies from