New staffing levels will be established at federally funded nursing homes

Vice President Kamala Harris said Monday that the first rule to set minimum staffing levels at federally funded nursing homes and require that a certain portion of the tax dollars they receive go to health care workers’ wages is a long-awaited “milestone” who recognizes their value. for society.

Harris announced the rules in Washington before flying to LaCrosse, Wisconsin, to meet with nursing home care workers. In the battleground state, the Democratic vice president also held a campaign event focused on abortion rights.

“It’s time we recognize your value and pay you accordingly and give you the structure and support you deserve,” Harris told a small group of caregivers.

The federal government is requiring nursing homes to have minimum staffing levels for the first time after the COVID-19 pandemic exposed grim realities in poorly staffed facilities. The change means more staff in these facilities, fewer emergency room visits for residents and peace of mind for providers, who can spend more time with their patients, Harris said.

The vice president said Medicaid, the federal health insurance program for lower-income people, pays $125 billion annually to home health care companies, which were not required to report on how they spent the money. A second rule finalized Monday would require 80% of that money to be used to pay employees, rather than administrative or overhead costs, Harris said.

“This is about dignity, and it is about the dignity that we as a society owe to those in particular who care for the least of them,” she said.

President Joe Biden first announced his plan to fix nursing home staffing levels in his 2022 State of the Union address. Current law only requires nursing homes to have “adequate” staffing, leaving that up to states to decide interpretation.

The new rules introduce a minimum number of hours that employees spend with residents. They also require a registered nurse to be available 24 hours a day in publicly funded facilities, which are home to about 1.2 million people.

Allies of older adults have sought regulation for decades, but the rules have been opposed by the nursing home industry.

Mark Parkinson, president of the American Health Care Association, which lobbies for health care facilities, said in a statement Monday that the organization was disappointed and disturbed that the federal government was moving forward with what he said was an “unfunded mandate.”

“It is unconscionable for the administration to finalize this rule given our country’s changing demographics and growing healthcare provider shortages,” Parkinson said. “Issuing a final rule requiring hundreds of thousands of additional health care providers when there is a nationwide nursing shortage simply creates an impossible task for health care providers.”

Wisconsin Republicans echoed concerns about workforce levels and pointed to shortages, especially in rural parts of the state. In Elroy, Wisconsin, for example, an 80-bed nursing home would need to hire six more nurses, but “we simply don’t have the bodies,” said Wisconsin state Rep. Tony Kurtz.

Republican U.S. Senator Ron Johnson, pointing out the additional costs and requirements, bluntly emphasized to reporters on a conference call that the rule “could sound good. It will not work.”

Secretary of Health and Human Services Xavier Becerra said the change is about setting a standard for the quality of care.

“We believe that as more Americans enter nursing homes, it is time to ensure that quality is the standard that everyone strives for,” Becerra said in an interview.

He said the government has listened to feedback from the nursing home industry and is allowing the rule to be phased in, with longer timelines for nursing homes in rural communities and temporary hardship waivers in places where staffing is difficult.

The healthcare event marked Harris’ third visit to the state this year and is part of Biden’s push to earn the support of union workers in his bid for re-election. Republican presidential candidate Donald Trump caused a stir among workers with his victory in 2016. Biden regularly calls himself the “most union-strong” president in history and has received support from leading labor groups such as the AFL-CIO, the American Federation of Teachers and the American Federation of State, County and Municipal Employees.

Lisa Gordon, a certified nursing assistant who told Harris, “I’ve been doing this job for 29 years,” said she was grateful that Biden and the vice president were “finally getting something done.”

“I went into this field because I believe it is important to care for our seniors,” Gordon said during a conversation with fellow health care providers, Chiquita Brooks-Lasure, administrator of the Centers for Medicare and Medicaid Services, and April Verrett, secretary-treasurer of the Service Employees International Union.

“If you don’t have enough staff, you don’t take care of them the way you should,” Gordon says. “They didn’t ask to be there. Your residents are your family. They are your loved ones. We need these changes.”

The coronavirus pandemic, which has killed more than 167,000 nursing home residents in the U.S., exposed poor staffing levels in facilities and prompted many workers to leave the industry. Advocates for the elderly and disabled reported that residents were neglected, left to live without meals and water, or left in dirty diapers for too long. Experts say staffing levels are the most important measure of quality of care.

The new rules require a staffing of 3.48 hours per resident per day, with just over half an hour of that coming from registered nurses. The government said this means a facility with 100 residents would need two or three registered nurses and ten or eleven nursing assistants, as well as two additional nurses per shift to meet the new standards.

The average nursing home in the U.S. already has a staffing ratio of about 3.6 hours per resident per day, including RN staffing just above the half-hour mark, but the government said a majority of the nation’s roughly 15,000 nursing homes are staffing should add under the new regulations.

The new thresholds are still lower than those advocates long eyed after a landmark 2001 study funded by the Centers for Medicare and Medicaid Services recommended an average of 4.1 hours of nursing care per resident per day.