Editorial: Long-term care needs support

Wahiawa General Hospital administrators want to close down its long-term care wing within three months. That’s a serious blow to communities in central and north Oahu, leaving elderly residents without a nearby facility.

It’s also a warning bell to the islands: We are on the verge of a crisis when it comes to providing for our kupuna who need constant care with safe, reliable options.

Growing Hawaii’s workforce of qualified nurses and nursing aides, maintaining an adequate supply of long-term beds and addressing the need for supported in-home care are all part of the solution.

The Wahiawa hospital said it plans to shut down its 115-bed skilled-nursing and rehabilitation facility by July 22, ending 55 years of service in Central Oahu. That leaves 60 patients currently residing at the facility in need of alternative care, many of whom have the greatest need.

The offered reasons are inadequate reimbursement from Medicaid and Supplemental Security Income, and overall financial stress for the hospital. Indeed, Wahiawa General has received millions in taxpayer dollars to keep it afloat in the past, as the Star-Advertiser has reported, but is still in the red at about $1 million annually.

This is all alarming news for Hawaii’s long-term care ombudsman, John McDermott, who said the state can’t afford to lose nursing homes at the same time that its senior population is increasing rapidly.

Meanwhile, the COVID-19 pandemic has left nursing homes across the state and nation struggling to hire and retain staff. The Pearl City Nursing Home has openings for registered nurses, licensed practical nurses and certified nursing assistants. There are patient limits in place at Hawaii island’s Yukio Okutsu State Veterans Home and the Honokaa Hospital because of staffing shortages.

Seeking to address an immediate need for nurses, House Bill 1758 would have allowed nurses from the Philippines and other countries to work in Hawaii with a temporary permit. That quick fix won’t be implemented this year, however; the bill stalled without making it to a conference committee.

As for the Hawaii workforce, McDermott said, more training capacity is needed at the community- colleges level, but wages are the bigger issue. Thousands of nurses have left the workforce during the COVID-19 pandemic, and they are not being coaxed back at the current rate of pay.

Both workforce salaries and turnover in the operation of nursing homes have caught the attention of federal regulators, who are considering policy changes at the national level.

Funding for increased at-home care could help. Aging in place has been Hawaii’s stopgap for generations, enabled by our state’s multigenerational households. However, that still leaves a gap for those who need 24/7 attention — for example, being turned in bed throughout the night to avoid bedsores.

Though Hawaii’s population is aging, we are a state that cares for its elders. This has helped cushion us from the dearth of long-term care beds so far. However, our caring families can’t buffer these needs to an unlimited extent.

Ultimately, Hawaii will need more caretakers and more beds, more oversight and better funding. This won’t happen on its own, without nudging and assistance from federal and state governments.

McDermott raises the prospect of a state, interdepartmental task force to assess projected needs and solutions, before the need for long-term care overwhelms Hawaii. It would be a start.

We’d like to hear about this slow-rolling crisis from candidates for office in the upcoming election — and to see action by Hawaii’s elected leaders to address this problem now, and in the coming year.