ST. PAUL — Minnesota long-term care providers are facing a critical shortage of caregivers and their situation could worsen next month as federal vaccine requirements take effect for nursing home workers.

With the clock ticking down to a Dec. 5 deadline to get all nursing home employees a vaccine, industry leaders on Wednesday, Nov. 10, told lawmakers that they wouldn't be able to sustain additional staffing losses without state or federal help.

Minnesota nursing homes have reported that most had to turn away new patients and residents because they didn't have enough caregivers. Across the state, long-term care facilities report a shortage of 23,000 caregivers.

And that staffing crisis could get worse in the countdown to the implementation of the vaccine mandate imposed by the Centers for Medicare and Medicaid Services. Long-term care employees at facilities that participate in the Medicare or Medicaid programs must have the first vaccine in a series by that date or be able to document medical or religious exemptions from the rule.

Unlike a requirement rolled out by the Occupational Safety and Health Administration, known as OSHA, there is not a separate option for regular testing under the CMS rule. Each facility will be required to keep a record of vaccinations and exemptions. Providers could face financial penalties and ultimately the loss of Medicare and Medicaid funds if they don't comply.

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"This is a potential powderkeg with a very short fuse for long-term care," Kari Thurlow, vice president of advocacy at Leading Age Minnesota told a state Senate panel. "We face a scenario where we don’t have enough workers to serve the seniors in our settings and despite our pleas for help over the last several months, there are no concrete solutions either at the state or the federal levels to help us solve our unprecedented workforce crisis.”

Thurlow and others told the committee that nursing homes around the state were unprepared for the mandate to take effect. And without state or federal intervention, the facilities could lose thousands of employees, prompting "devastating impacts."


Some facilities had already closed their doors or started moving residents to other nursing homes to consolidate caregivers. Gov. Tim Walz last month reopened an emergency staffing pool to help long-term care facilities fill staff vacancies and activated the Minnesota National Guard to assist in nursing homes and alternative care sites.

Despite that, long-term care industry advocates said staffing shortages persisted and lawmakers should use federal COVID-19 relief dollars to boost caregiver pay to recruit and retain workers there. They also said the state and federal government should provide additional staffing solutions ahead of a potential exodus next month.

“We have a particular concern in those communities where overall vaccination rates are low because that’s our potential talent pool for replacement staff,” Care Providers of Minnesota Vice President of Strategic Initiatives Nicole Mattson said. “We certainly hope that the mandate will encourage some who have been hesitant, but we know many remain steadfast in their declination and we are very concerned about implications for our workforce."

Department of Health and Human Services agency heads said $200 million in federal funds were set to flow out to nursing homes, and they urged legislators to craft additional policies that could help keep staff in place.

"It’s a body issue, it’s a money issue, it’s an existential issue in some ways for this industry and I think we all have some really hard work to do in the coming months to get all those options on the table," said Diane Rydrych, acting assistant commissioner of Department of Health's Health Systems Bureau.

Sen. Jim Abeler, R-Anoka, urged the Walz administration to ask President Joe Biden to delay the rule's rollout and said legislators should work on solutions to help nursing homes in the short term.

“There is no partisan benefit in this thing going bad, the only thing that’s going to happen is people are going to come to harm,” Abeler said.

Other Republicans on the panel, meanwhile, said the long-term care organizations and other groups needed to be more vocal in their opposition to the rule.

“In my mind, these are all unconstitutional mandates we are talking about. We and that means us at the state and every organization, need to push back because we are losing the providers," Sen. Paul Utke, R-Park Rapids, said. "Better wages are always good, yes, but who’s going to fill those spots?”

Follow Dana Ferguson on Twitter @bydanaferguson, call 651-290-0707 or email