The announcement by Lutheran Social Services here in Jamestown that they were closing their skilled nursing care facility should be a wake-up call for all of us. Nursing homes, at least here in New York State, are in trouble.

Much of their difficulty is related to things beyond their control–like state-mandated staffing minimums and increased wage rates without the commensurate aid from Albany to pay for them. People seem to forget that about 75% of all revenue for nursing homes comes through Medicaid, a federal and state healthcare program.

When 75% of your revenue doesn’t keep up with inflation and mandated expenses, then you have a big problem.

Nursing homes also have a staffing crisis to deal with. I think that one of the most difficult jobs in the world is dealing with aging and infirmed people who need help. As a nurse or nurse’s aide in one of these facilities, you know that many of your patients are never going to be able to go home–they will need continual, full-time professional healthcare for the rest of their lives.

It is especially challenging, in my view, when dementia takes over a person’s life. At that point, virtually everything, including feeding, needs to be done for these patients. It takes a special person with special skills to take care of people with such special needs. It is a job I could never do, and I give credit to those whose daily job is to do this work.

There is another factor impacting nursing homes which I would call a “demographic” change–people are being encouraged to and are finding ways to live longer at home. Government aid is even available, in some cases, to pay for family members to provide healthcare services at home.

As medicine and healthcare delivery services have advanced, it has also become more possible to live longer at home. This is all good, but it does not change the need to also have, at the same time, skilled nursing home facilities for those who cannot help themselves or who don’t have the support structure at home to care for them.

The financial problem is exacerbated by the fact that our existing nursing homes were built with the assumption that all of the beds in these facilities would be needed. Though fewer beds may be needed now, nursing homes are obligated to cover the cost and overhead of their existing facilities. Even if they could fill their beds, many facilities today no longer have the staff to care for more patients.

All of this means that there is a big budget crunch going on in nursing homes.

It used to be that private-pay patients and healthcare insurance helped significantly in paying the costs incurred in providing nursing home services. However, more and more, it is the Medicaid program which has become the major source of funding. This means that state and federal action will be required in order to address the current crisis.

We are always going to need skilled nursing facilities in our communities. We cannot let them fail.

Rolland Kidder is a Stow resident and a former New York state Assembly member.