This week, U.S. House members plan to introduce legislation that would boost federal Medicaid payments to nursing homes to increase the amount of time nurses spend with nursing home residents.
"The elderly are receiving inferior care because nursing homes are understaffed-many qualified and skilled professionals are simply overwhelmed," said Rep. Janice Schakowsky (D-Ill.), a sponsor of the bill with Reps. Henry Waxman (D-Calif.) and Brad Carson (D-Okla.).
The bill would require that nursing home residents receive from 4.1 to 4.85 hours of care daily from certified nursing assistants, licensed practical nurses or registered nurses.
To enable nursing homes to increase their staffs, the proposed legislation would increase the federal Medicaid match to states by 1.5% and would reinstate the Boren Amendment, federal legislation that guaranteed "reasonable and adequate" Medicaid reimbursements for providing quality care. The amendment was enacted in 1981 and was repealed by Congress in 1997. State inspectors would be able to examine financial records of nursing homes under the bill.
The provisions for the proposed bill come directly from an HHS report released in March that found nine of 10 nursing homes do not have enough nursing assistants and nurses to provide adequate care to residents.
The bill would cost at least $8 billion to reach minimum standards, said a Waxman staff member. "We have the money if it is a priority," Schakowsky said at a press conference last week.
Nurses endorsed the proposed bill. "It means they will be able to give every patient the care they need," said Barbara Coufal, legislative affairs specialist at the American Federation of State, County and Municipal Employees, AFL-CIO.
Nursing homes are not as positive.
"We get a mixed feeling from it," said John Gillan, spokesman for the American Health Care Association. The association opposes blanket minimum staffing standards and wants facilities to have the flexibility to determine a patient's individual needs. "But it is great to see funding talked about to help with the staffing," he said.
The proposed bill comes on the heels of National Nursing Week. Hundreds of nurses descended upon Washington last week to support legislation that would increase staffing and ban mandatory overtime.
The Senate and House both have passed different versions of the Nurse Reinvestment Act, which would authorize federal funding for nursing students who agree to work in shortage areas after they graduate. The Senate bill would award healthcare facilities a total of $40 million over five years for workplace-improvement plans. It also would authorize $5 million for a study of the grant program.
Last week, Rep. Carolyn McCarthy (D-N.Y.) introduced a separate nurse bill with the same language but half the costs. McCarthy's bill would provide $20 million for the workplace-improvement plans and $2.5 million for a grant program.