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NEW HOPE, Minn. — Pfc. Shina Vang and her fellow Minnesota National Guard soldiers have had an extremely busy year. They helped process Afghan refugees fleeing Kabul for the United States, provided security at American military bases in the Horn of Africa, and stood guard in Washington DC following the January 6 attacks on the US Capitol.

Closer to home, they were stationed in Minnesota during the civil unrest caused by the police killing of George Floyd in Minneapolis and Daunte Wright in the nearby Brooklyn Center.

But none of these experiences prepared Private Vang and the other Guard members for their final mission: collecting bolts, clipping toenails, and feeding residents at North Ridge Health and Rehab, the largest hospice in the state in suburban Minneapolis.

“I had the protesters throw apples and water bottles at me, but that doesn’t compare to the difficulty of giving someone a bed bath,” said Private Vang.

Over the past two weeks, 30 Guard members are working as certified nurse assistants on North Ridge, which has been so badly disrupted by an employee migration that administrators have had to mothball all the wings and severely limit new admissions.

As a result, hospitals cannot send patients to long-term care centers like North Ridge, creating a reserve that erodes Minnesota’s capacity to treat people with Covid-19 and other medical emergencies. Similar backlogs – hospital patients who are well enough to be discharged but too fragile to go home – are choking healthcare systems across the country.

“This is beyond a crisis,” said Katie Smith Sloan, president of LeadingAge, the nonprofit long-term care facilities association. “For many providers across the country, this is a slump.”

On Tuesday, President Biden announced that 1,000 military medical professionals will be sent to hospitals across the country this winter to help overwhelmed doctors and nurses.

Public health experts fear the worst is yet to come as the highly contagious Omicron variant spreads to communities where healthcare workers are already struggling to cope with the surge of patients sick from Delta. Maine, New Hampshire, Indiana and New York have placed the National Guard in overburdened hospitals and nursing homes in recent weeks, but Minnesota’s initiative may be the most ambitious, with 400 guard members with no previous nursing experience. being sent to long-term care facilities throughout the state.

Last week, senior executives from the state’s nine largest hospital networks ran ads in Minnesota newspapers begging residents to get vaccinated and take further steps to limit transmission of the coronavirus. “We’re overwhelmed,” the ads said.

Governor Tim Walz, a Democrat and National Guard veteran whose mother is a nurse’s aide, said he considers the program a temporary measure.

“Our healthcare workers are heartbroken and tired,” Governor Walz said on Tuesday, shortly after learning of this. he and his wife and son The coronavirus test was positive. “It’s a blessing for the guards to take a break, but to be clear, we don’t see the end of the surge right now when we look at the horizon.”

Staffing shortages have long been a problem for nursing homes in the United States, but the coronavirus has pushed many to the brink as low-paid aides retire early or leave for better-paying and less-taxed jobs. “The epidemic underlined the fragility of the system and the need for fundamental change,” said R. Tamara Konetzka, a long-term care economics expert at the University of Chicago.

In Minnesota, this means 23,000 nursing home positions were unfilled in October, up from 8,000 last March. questionnaire of providers.

North Ridge has been particularly hard hit by the outbreak, with more than 592 cases and 52 Covid deaths among residents since March 2020. Centers for Medicare and Medicaid ServicesBut the vast majority of these cases, 472, were among patients who were already sick with Covid when they arrived. In the past four years, North Ridge has been fined more than $180,000 by federal investigators and cited for a number of health and safety violations. It received two stars out of five from the CMS for general maintenance, with a rating of “below average”.

Austin Blilie, vice president of operations, said the two-star rating is based on surveys in 2018, and North Ridge has greatly improved the quality of care since then. He noted that the most recent rating earlier this year gave the facility five stars for staff quality. He added that the 8.5 percent mortality rate for Covid patients in North Ridge is less than half the state average for patients in public care settings.

“Every time I look at the number of those we’ve lost, I am once again surprised by the fact that each represents an individual with a life, a history, and connections with other people.” “Please know that we have never overlooked that here.”

North Ridge, a low-rise collection of brown and tan brick buildings, has 320 beds, but 100 are currently unoccupied due to staff shortages. The remaining employees are rambling because they work overtime, and on some days managers, dietitians and physical therapists have to help make beds and fill water jugs. “We’re doing our best because the show has to go on,” said Liz Ellenz, 37, the food director, who usually works on weekends and washes dishes until 9 PM. “Some days are really dark.”

But on Thursday, Ms. Ellenz was absolutely dizzy as the five Guardsmen roamed the kitchen with soldierlike purpose and precision. They hosed the food trucks, bagged the trash, and helped pack the day’s lunch: ham and pasta, gratin, stir-fried snow peas, and citrus gelatin cubes.

One of them is Staff Sergeant. Nathan Madden, 47, whose civic business is an assistant manager at a home improvement store, said the past two weeks have given him a new appreciation for those who care for the sick and elderly. His past deployments have taken him to Kuwait, Croatia and more recently the Minneapolis courthouse, where Derek Chauvin was tried for the murder of Mr. Floyd. “This sort of thing is absolutely humiliating,” said Sergeant Madden, smoothing the hairnet on his head. “Helping in the community is great, but I have grandparents, so in a way it prepares me for what I’m going to have to do one day.”

Certified nursing assistants, employees of long-term care facilities, normally undergo five weeks of training before taking their final exams, but nursing school leaders have reduced the program to eight 10-hour days. “It feels like we’re supporting a natural disaster,” said Traci Krause, director of nursing at Minneapolis Community & Technical College, as a group of students practiced heart rate monitoring and face washing on bed-bound dummies.

Besides gestures such as providing free pizza and ice cream, there’s not much North Ridge managers can do to stop staff exits; Since the start of the pandemic, the number of nursing home workers has dropped from 590 to 450. While burnout and fears of infection have prompted some nurse assistants to quit, staff and manager say the root of the problem is money.

North Ridge and other long-term care facilities in Minnesota that serve mostly Medicaid patients pay about $16 an hour for newly hired nurse assistants. This is comparable to what some fast food outlets offer in and around New Hope. (The kitchen staff on North Ridge are paid even less: $11.25 an hour.)

Such low fees are mainly due to the state’s reimbursement rate, which averages $270 a day for hospice patients. Minnesota Department of Human Services. Efforts by Governor Walz to increase reimbursement rates have stalled in the state’s politically divided legislature, as has his push to use some of the $1.2 billion unspent Recovery Act funds for bonuses and caregivers.

Fatimate Massquoi, a director of nursing at North Ridge, said the physical demands of the job, coupled with the anxieties and endless loss of treating Covid patients, said inadequate pay was inevitably damaging. “People don’t know what it’s like to hold the hand of someone who dies alone because their family isn’t allowed to be here,” he said. “Sometimes after a patient dies, I go to the bathroom to cry so no one can see me because I have to stay tough.”

As Omicron races around the country, staff and executives fret over the coming weeks. Only 60 percent of residents, slightly above the national average, received their booster vaccinations and filed a federal appeal. court order Last week means that North Ridge may have to lay off 10 percent of unvaccinated employees.

But last Thursday, Ms. Massquoi and her colleagues were feeling happy when they learned that the National Guard would be staying an extra week, including 18 soldiers who volunteered for the Christmas break. Having extra hands doesn’t mean North Ridge can increase admissions numbers, but it does allow tired workers to take a few days off.

“The Guardian really gave us the opportunity to take a breather and allow people to spend time with their families and deal with the emotional burnout of the past 18 months,” said Mr Blilie, Vice President of Operations. “I hope they come back feeling a little refreshed and ready to go back.”