South Dakota also needs to do more to care for older adults who require nursing homes or assisted living centers. The pandemic has worsened staffing shortages at nursing homes, with over 1,000 employees — or 15% of the workforce — lost in the course of two years. At the same time, the underfunding of Medicaid, which is below that of our neighboring states, is leading to the closure of nursing homes. As U.S. News reports, nursing homes in South Dakota lose about $65 each day for each resident paying through Medicaid, which is 55% of the nursing home population. South Dakota determines its reimbursement rate, and we need to set that rate to reflect the cost of running these facilities in order to care and provide for our population of older adults.