The Georgia Health Care Association (GHCA) is warning that a recently announced staffing mandate from the Biden administration could have an unanticipated impact on cost and risks displacement of residents in nursing homes. The Centers for Medicare and Medicaid Services proposed the rule to set a floor of 2.45 nurse aide hours per resident per day (HPRD) and 0.55 registered nurse (RN) HPRD – as well as have a 24-hour registered nurse (RN) on site.
The study was done by the professional services firm CliftonLarsenAllen (CLA) which found an additional 3,600 full-time employees would need to be found by Georgia’s nursing homes, (2,754 nurse aides and 898 RNs). In an industry that already has difficulty filling open positions, this could perhaps just prove impossible. More than 75 percent of Georgia nursing homes are not currently meeting one of the staffing requirements. Less than 1 percent are already meeting all three of the requirements.
“This analysis underscores that Georgia’s nursing homes cannot meet this staffing mandate as it’s currently proposed without the proper funding and workforce programs,” said GHCA President and CEO Chris Downing. “Nursing homes across our state continue to do everything they can with limited resources to attract new caregivers to the field but continue to face challenges due to the sheer lack of available and qualified workers. We will continue to sound the alarm that Georgia’s seniors are the ones that will suffer the unintended consequences of this flawed policy and urge the administration to reconsider this impossible standard.”
CLA also warned that the mandate could cost Georgia nursing homes $187 million per year. If they are not able to meeting the new requirements, more than 9,500 existing nursing home residents might have to find a new place. Many Georgia nursing homes are already on the verge of having to lower the number of residents, closing units or wings, or even closing completely due to labor shortages. Georgia is in a particularly tough spot as it has one of the lowest ratios of RNs per population in the country according to the National Council of State Boards of Nursing (NCSBN), with fewer than 750 employed RNs per 100,000 people.
“Based on these figures, nursing homes will need considerable resources to meet the requirements of this mandate, but nationwide, 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, too many seniors will be at risk of losing the care they need.”
Instead of the staffing mandates, GHCA supports the proposals from the American Health Care Association’s Care for Our Seniors Act. Interestingly, that plan does call for a 24 hour RN on staff but limits the number of other staffing mandates. They also call for recruiting more caregivers, not as qualified as RNs but capable to checking beds, food and other more simple logistics of nursing home life that may not require medical expertise.
The new rule from the Biden administration will undoubtedly face challenges, stay tuned…
