WASHINGTON, D.C. — The American Health Care Association (AHCA), representing more than 14,000 nursing homes and other long term care facilities across the country that provide care to approximately five million people each year, released an
analysis today by professional services firm CLA (CliftonLarsonAllen LLP), which analyzed the impact of President Biden’s proposed federal staffing mandate on nursing homes. The proposed rule would require specific nursing home staff to spend a minimum number of hours with each resident – 2.45 nurse aide hours per resident per day (HPRD) and 0.55 registered nurse (RN) HPRD – as well as have a RN on site 24 hours a day.
Among CLA’s findings:
- Nursing homes would need to hire an estimated 102,154 additional full-time employees (80,077 nurse aides and 22,077 RNs).
- The proposed mandate would cost nursing homes approximately $6.8 billion per year – higher than the $4 billion per year estimate from the Centers for Medicare and Medicaid Services (CMS).
- Ninety-four percent of nursing homes are currently not meeting at least one of the three proposed staffing requirements: the 2.45 nurse aide HPRD, the 0.55 RN HPRD, and the 24/7 RN.
- Of the 94 percent, 36 percent of facilities are not meeting all three requirements; 34 percent are not meeting two of the requirements; and 24 percent are not meeting one of the requirements.
- Nursing homes that did not meet at least one of the requirements were more likely to have a majority of their residents relying on Medicaid (56 percent average Medicaid census) compared to facilities that met the criteria (43 percent).
- If nursing homes are unable to increase their workforce to meet these new requirements, more than 280,000 nursing home residents, or nearly one-quarter of all residents, could be impacted by census reductions.
“What CLA’s analysis confirms is that this proposed rule is deeply flawed, and the Biden Administration has woefully underestimated the feasibility and cost of this unfunded mandate,” said AHCA/NCAL President and CEO Mark Parkinson. “When nearly every nursing home in the country would be considered out of compliance if this went into effect today, it demonstrates how out of touch Washington bureaucrats are with reality. Nursing homes are already grappling with a growing caregiver shortage; to demand they hire 100,000 additional caregivers, without any meaningful resources or support, is a disservice to our nation’s seniors. We all want to grow the nursing home workforce, but this impossible policy is absolutely not the way to do it.”
“Based on these figures, nursing homes will need considerable resources to meet the requirements of this mandate, but 60 percent of the profession is currently operating in the red,” said Cory Rutledge, Chief Assurance Officer at CLA. “Nursing homes are facing increased operating costs while still struggling to rebuild their workforce and occupancy rates to pre-pandemic levels. If this rule is finalized without the financial support that nursing homes will need to hire these additional workers, hundreds of thousands of seniors will be at risk of losing the care they need.”
Access to nursing home care is a growing crisis.
The Wall Street Journal reported that nursing
home beds continue to decline frequently because of labor shortages, with more than 600 fewer nursing homes in the U.S. than there were six years ago. For the nursing homes keeping their doors open, many are resorting to limiting new admissions, or closing units or wings in order to maintain the highest quality care with the staff they have.
A recent
NPR article highlights how the federal staffing requirement will especially hurt rural
facilities and communities. Hundreds of rural nursing homes have shut down because of staffing challenges, and a new mandate would accelerate even more closures, forcing residents to find new care farther away from loved ones.
Nursing homes need supportive policies that will strengthen their workforce, not a blanket
mandate that threatens access to care for hundreds of thousands of seniors. AHCA/NCAL’s reform agenda, the Care for Our Seniors Act, offers comprehensive solutions that address the underlying causes of labor shortages and help recruit and retain caregivers.
Read the full CLA analysis
HERE.