A federal government report issued this month noted “[t]he COVID-19 pandemic has put extreme stress on the health care workforce in the United States” with workers leaving health care and those remaining suffering “burnout, exhaustion, and trauma.”

Yet there can be no hope the federal government itself, given its inertia, will do anything about this workforce crisis. Predatory national staffing agencies have taken advantage, with exorbitant profits as a result, and yet the Biden Administration has refused to respond to a letter from almost 200 U.S. House members imploring it to address this price-gouging. Not only is it demoralizing to loyal, longtime employees to know that a staffing agency worker is making more than them, but those agencies, upon entering facilities, recruit away a facility’s own staff.

Research shows nursing homes have raised wages more than any other health care sector during the pandemic, and yet today the workforce for nursing and residential care facilities nationally is roughly 400,000 workers smaller than it was in March 2020 when the pandemic instigated governmental lockdowns and precautions.

Data shows New Hampshire has almost six times the rate of nursing homes with staffing shortages than neighboring Massachusetts. That is not surprising, given that Massachusetts has invested significant state and federal resources throughout the pandemic in bolstering its nursing home workforce.

Through the American Rescue Plan (ARP) Act funds alone that Massachusetts received, $50 million has been allocated for nursing facility recruitment and retention, and capital improvements, as well as $500 million toward a COVID-19 Essential Employee Premium Pay Program. The competitive implications for cross-border Nashua nursing home care could hardly be more obvious.

Even before the Biden Administration proposed a $320 million net reduction in Medicare funding for nursing home care effective October 1, it was estimated that over half of all New Hampshire nursing homes were at great financial risk in 2022 – with operating margins in the negative by 7.5 percent or more.

There has been a bipartisan effort in Concord to aid nursing home care this session, led by Nashua Senator Cindy Rosenwald. And yet the 5% Medicaid funding increase that the legislation would sustain simply cannot keep facilities open in the face of runaway inflation and out-of-control staffing agency pressures.

Like Massachusetts, and other states, New Hampshire must use its ARP Act funds to save our facility-based care system. Already, pandemic-fueled staffing pressures closed two family-owned assisted living facilities that had been serving their communities for decades.

Examples abound as to what we might do. In the Minnesota Senate, for example, the Republican majority has pushed a proposal under which nursing homes and senior facilities would receive $358 million, and staff could get a $2 an hour raise. In Nebraska’s unicameral legislature, 42 of 49 senators recently voted to override a gubernatorial veto and give nursing home care a 20% funding increase.

Gov. Chris Sununu, with bipartisan Executive Council and legislative appropriator support, was generous with Coronavirus Aid, Relief, and Economic Security Act funding to keep our fragile long-term care system functioning the past two years. Regrettably, that lifeline needs to be extended. The good news is that the means exist to do it.

Brendan Williams is the president and CEO of the New Hampshire Health Care Association.