Child care centers could be located in nursing homes under a proposal discussed Monday by the South Dakota Study Committee on Sustainable Models for Long Term Care.

The idea, if implemented, would allow elementary school-aged children to learn how to care for nursing home residents, proponents say.

State Sen. Erin Tobin (R) said the situation could be a win-win and might help reduce the overhead for both child care centers and nursing homes.

The idea was one of several on a list compiled by the committee for consideration in the 2024 legislative session. The committee, chaired by state Sen. Jean Hunhoff (R) and state Rep. Taylor Rehfeldt (R), met with multiple health organizations in the state to gather suggestions.

“The focus has primarily been on nursing homes, and there have been a number of innovative positive ideas brought forward so far. However, the primary area that needs to continue to be addressed is fully funding South Dakota’s updated skilled nursing facility methodology,” Mark Deak, executive director of the South Dakota Health Care Association, told the McKnight’s Business Daily. “This is the foundation of continuing to sustain long-term care providers in South Dakota.”

Among the topics discussed, long-term care experts expressed concerns over the Centers for Medicare & Medicaid Services proposed minimum staffing rule for nursing homes, which would mandate at least 3.0 hours per patient day of direct care – 0.55 hours of that by a registered nurse and 2.45 hours by a nurse aide. As currently written, the rule would allow  non-rural nursing homes three years to comply with some elements of the rule, with rural facilities given five years to get up to speed on the overall hourly rate.

“I call the proposed rule kind of the tornado warning of the storm. We don’t know if this will hit us or not. If it does, some of my members that I’ve had conversations with said that it will be financially catastrophic, and that is the consensus across the United States,” South Dakota Association of Healthcare Organizations Chief Operating Officer Tammy Hatting testified.

In South Dakota, 15 nursing homes have closed in the past five years, with seven closing last year alone, according to data from the SDAHO.

Even though the federal staffing mandate is for nursing homes, senior living experts say that it would put assisted living communities at risk of losing staff members. Competition for workers, especially nurses and other caregivers, may increase at a time when all providers already face recruiting and retention challenges.

Over time, the state has commissioned several studies, task forces and committees to evaluate the state of long-term care in South Dakota. Those efforts led to Dakota at Home, a single-point-of-entry system meant to ease access to information, assessment and referral to appropriate service providers.

Previous studies also addressed targeting assisted living capacity toward growing regions, expanding home health and home- and community-based services, Medicaid eligibility for long-term care facilities and geriatric mental health services.