Many of the attendees at the Red Oak conversation currently work for or have worked for long-term care facilities in the area. The conversation was geared mainly around long- term care and the costs associated with it. A main concern was the nursing shortage in LTC facilities in rural communities, often due to the staff being overworked and underpaid. A nursing supervisor in attendance shared her concern that people enter the nursing profession and leave in a few short years because they spend the majority of their time on paperwork due to federal and state guidelines when they want to be doing hands on patient care. Another regular sentiment was the difficultly for staff to work full-time, pay child care and health care costs, much less save for retirement. It is a constant struggle in rural communities to make ends meet and save for the future.

Another recurring theme through the conversation was the difficulties seniors have understanding the system, be it Medicare, long-term care insurance, or their prescription drug program. One story shared about a 90-year old woman whose husband has been in a nursing home for 10 months and has not yet seen any reimbursements for what they have paid out of pocket. The staff works with her to help navigate the paperwork because she has a hard time understanding it by herself.

How can the federal government and insurance agencies assist seniors in receiving their reimbursements? Are there too many guidelines for long-term care facilities, creating an undue burden on the staff?