1. Minnesota’s Seniors Public Policy Issues April 9, 2013 Crisis in Long Term Care

2. 2012 Percent of Nursing Facilities at Risk of Closure (Operating Margins of -5% or Worse) Legend =<25% =25%-35% =35%-45% =>45% East Central 22.6% Metro 22.4% Northeast 30.0% Northwest 47.1% Southeast 35.8% Southwest 36.1% West Central 42.1% Approximately 115 Nursing Facilities in MN are Facing a Financial Crisis, Placing almost 15,000 Jobs at Risk LTC Imperative 2012 Nursing Facility Financial Survey Prepared by CliftonLarsonAllen LLP

3. The Wage Gap Sources: 2011 LTC Imperative Salary Survey and 2011 MN Health Care Cost Information Service Hospital Salary Data Gap=$2.07 per hour or $4,306 per year Gap=$5.79 per hour or $12,043 per year Gap=$17.39 per hour or $36,171 per year Gap=$15.77 per hour or $32,802 per year Gap=$1.81 per hour or $3,765 per year Gap=$6.13 per hour or $12,750 per year Senior Living Workers Underpaid in the Marketplace

4. Direct Care Staff Shortages Increasing for Nursing Homes Total Vacant Direct Care Positions Currently Exceed 1,600 Source: Long Term Care Imperative 2013 Legislative Survey

5. Rate Changes Assisted Living (Elderly Waiver Customized Living) Nursing Facility Source: LTC Imperative 2012 Nursing Facility and Elderly Waiver/Customized Living No base increase in last four years In 2011, 70 low rate homes received increases of up to 2.45% In 2012, 7 homes were designated “critical access” and received rate increases

6. Care Center Rates Do Not Cover Costs Source: Data from Report Prepared By Eljay, llc for the American Health Care Association MN has 9 th Highest Gap of 37 States in 2010

7. Statewide Monthly Average EW Rate More Than 40% Less Than Average Cost of Providing Services Source: Long Term Care Imperative 2013 Legislative Survey