As nursing homes continue to suffer staffing shortages, some long-term care providers are dealing with another headache: potential price gouging by direct care staffing agencies. 

Dave Voepel is the CEO with the Arizona Health Care Association, which represents 148 skilled nursing homes in the state. 

"Well, we're in such a crunch now on the staffing side, that these agencies have increased the amount of dollars that they ask for facilities," Voepel said. 

Voepel says some agencies are charging nearly $60 an hour, while the caregiver might earn anywhere from $18 to $20 an hour. This is not just an Arizona issue. Several long-term care providers across the country are asking lawmakers in Washington, D.C., to step in and prevent agencies from price gouging. 

"So you'll get a market basket increase Oct. 1, when the federal fiscal year starts for Medicare," says Voepel, referring to the time of year when a facility might get a funding increase. "And then Medicaid is whatever the state sets and we lobby for. So since those don't change, and your staffing cost increases, it really hits your bottom line."

He says roughly 50 facilities are now operating under a 0% margin on Medicaid services. Now long-term care providers across the country are looking to Washington to prevent agencies from charging rates they consider price gouging.