Biden’s unworkable nursing rule will harm seniors

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What’s wrong with requiring a Registered Nurse (RN) in every nursing home in the United States? Nothing – impossible.

As most facilities are staffed by certified nursing assistants (CNAs), licensed practical nurses (LPNs) and RNs, meeting such a requirement would undermine both nursing homes and the seniors they care for. But, that’s exactly what the Biden administration is trying to do.

A A new law proposed by the Centers for Medicare and Medicaid Services (CMS). The federal mandate seeks to increase staffing levels in nursing homes in two ways. First, the rule, if finalized, would require every nursing home in the nation to have an RN on site at all times, up from the current requirement of eight hours a day, five days a week. Separately mandates a new minimum staffing ratio requiring a certain number of RNs and CNAs per resident per day.

This is a well thought out goal and I, like everyone else, want the elderly to have the best possible care. However, good intentions are not enough. Policy needs to be informed by facts and what is possible. And sadly, the current reality is dire for America’s nursing homes.

Currently, there are approx. 15,000 nursing homes across the country. 29 percent of them are very difficult for workers in rural areas. In my home state of Kansas, that number is even higher — 53.7 percent of nursing homes are in rural areas. Not even half of the country’s nursing homes Currently, utilities across the country are facing labor shortages and are hiring at the levels required by the proposed regulations.

of Nursing home staff decreased by 12 percent Since the start of the Covid-19 pandemic, aging services have been part of an overall reduction in the workforce. Some of this can be explained by workers feeling burnt out due to the scale of the outbreak, but that’s not the whole picture.

Since President Biden takes office in 2021, it has been inflation. It has increased by more than 17 percent.. That puts an incredible strain on anyone running a business and on those trying to afford care for seniors and their families. Labor costs for nursing homes are up 22 percent from early 2020.

Somehow, under these tough conditions, CMS expects nursing homes to find an additional 3,267 RNs to satisfy the 24/7 RN portion of the rule. This will happen. It costs nursing homes $349 million a year. And it increases annual costs to residents by about $2,180. In the Sunflower State, that adds up to about $2,600 in costs for residents each year. To meet the rule’s minimum staffing ratio, an additional 12,639 RNs and 76,376 CNAs are needed nationwide, costing nursing homes $4.2 billion annually at an average cost of $13.24 per resident. Therefore, implementing both parts of this rule would require more than 15,000 new RNs and more than 76,000 CNAs.

These numbers put nursing homes in catch-22. Implementing the rule would cost money that most nursing homes don’t have. But even if money wasn’t the problem, it wouldn’t solve the human resource issues. Surprisingly, the CMS Act does nothing to address any of these concerns and help facilities find a way forward.

The CMS worked perfectly. More It is difficult for long-term care facilities to comply with the requirement by narrowly defining the types of staff that qualify. Inexplicably, the CMS rule excludes licensed practical nurses (LPNs) from the minimum count. By abandoning the type of fully credentialed and licensed nurse that has long existed in nursing homes, CMS further reduces the already limited workforce facilities must support.

The president and his administration need to take a step back from their brutal approach. They should let Congress, which represents America’s top citizens, lead the conversation. There are new solutions coming from the House of Commons that address the workforce, Medicare and other issues related to providing the best possible care for seniors.

In fact, I presented one such solution in May. Binary Ensuring Access to Quality Care for the Elderly Act Unlike LPNs, there is a shortage of CNAs who count toward the minimum staffing requirement. The law allows nursing homes forced to suspend in-home CNA education programs, due to violation restrictions, to continue those programs once quality standards are met again.

This is common sense math. It addresses the staffing challenges nursing homes face while maintaining a commitment to providing quality care to residents.

In-home CNA programs, often free, provide a path to certification for qualified candidates who cannot afford an outside program or do not live near such a program or school. Through these programs, nursing homes can attract, retain, and build a skilled workforce pipeline.

At a time when workers, very few skilled workers, are hard to come by and the cost of schooling is prohibitive for many, every effort should be made to sustain in-house CNA programs. If an institution corrects the sanctioned deficiency, it will be allowed to continue training CNAs with additional supervision if necessary.

Such legal remedies are required before CMS can proceed with any federal minimum staffing regulations. It is imperative that the Biden administration hold off on implementing this law until adequate plans are in place to build the workforce necessary to meet such staffing needs.

The Biden administration should join Congress in working hard to address these issues and support seniors instead of trying to bend the facts to suit their needs.

Before representing Kansas’ 4th District since 2017, Ron Estes, one of the few engineers in Congress, worked in the aerospace, energy and manufacturing sectors. He is a fifth-generation Kansan, a former state treasurer and serves on the House committee. Ways and Means, Budget Committee, and Education and Workforce Committee.

Copyright 2023 Nexstar Media Inc. All rights reserved. This article may not be published, distributed, rewritten or redistributed.



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