As the Centers for Medicare and Medicaid Services' staffing mandate looms, nearly half of nursing homes polled by the American Health Care Association are already limiting admissions due to severe staffing shortages, according to a report the industry trade group released Tuesday.
In a survey conducted last month of 441 nursing homes across the country, seven out of 10 operators reported lower staffing levels than before the COVID-19 pandemic. And about half said their workforce had either stayed the same or gotten worse over the last six months. The report comes as nursing homes prepare for CMS to finalize a rule on staffing minimums.
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Polled nursing homes said they are actively recruiting nurses and nurse aides. But the survey found they have limited admissions, closed wings, asked staff to work overtime and hired temporary workers due to a shortage of registered nurses and certified nurse assistants.
Nursing homes said their biggest concern about the proposed rule was finding enough workers to meet its requirements. Under the proposed mandate, nursing homes would have to provide three hours of nursing care per resident, per day, with .55 hours coming from registered nurses and 2.45 hours coming from nurses aides.
The White House Office of Management and Budget began reviewing the final rule last week. But AHCA reiterated calls for the Biden administration to scrap the rule and collaborate on staffing with the industry.
“Nursing homes want to strengthen their workforce but they cannot do it alone,” AHCA President and CEO Mark Parkinson said in a news release.
Nearly 90% of the nursing homes polled said they were either operating in the red or barely breaking even. They attributed this partly to rising labor costs and to what they view as inadequate Medicare and Medicaid reimbursements.
The survey's findings are in line with what many Nebraska nursing homes are experiencing, according to Jalene Carpenter, president of the Nebraska Health Care Association. She said many operators were struggling to offer competitive pay to registered nurses and nurse aides because Medicaid rates do not cover higher wages.
“The Medicaid reimbursement for the state of Nebraska does not cover the cost of care,” Carpenter said. “It is roughly $50 short per resident, per day.”
The National Consumer Voice for Quality Long-Term Care has advocated for a nursing home staffing mandate and said it believes the industry can afford the requirement.
“The staffing standard will require nursing homes to use the tens of billions of dollars they receive annually from taxpayers to create better-paying jobs with growth opportunities,” Sam Brooks, director of public policy, said in an email.
