The pandemic has exposed staffing shortages in nursing homes. A new push from the White House aims for a solution

WASHINGTON – Vice President Kamala Harris said Monday that the first rule to establish minimum staffing levels at federally funded nursing homes and require that a certain portion of the taxpayer dollars they receive go toward caregiver salaries is a long-awaited “milestone” that recognizes its value to society.

Harris announced the rules in Washington before flying to LaCrosse, Wisconsin, to meet with nursing home officials. In the swing state, the Democratic vice president also held a campaign event focused on abortion rights.

“It’s time we start recognizing your value and paying you appropriately and giving you the structure and support you deserve,” Harris told a small group of healthcare professionals.

The federal government is requiring nursing homes for the first time to have minimum staffing levels after the COVID-19 pandemic exposed grim realities in understaffed facilities. The change will mean more staff at these facilities, fewer emergency room visits for residents and peace of mind for caregivers who will be able to spend more time with their patients, Harris said.

The vice president said that Medicaid, the federal state health insurance program for low-income people, pays $125 billion annually to home health care companies, which are not required to report how they are spending their money. money. A second rule that will be finalized Monday will require that 80% of that money be used to pay workers rather than administrative or overhead costs, Harris said.

“It’s about dignity, and it’s a question of dignity that we as a society owe to those in particular who care about the less privileged,” she said.

President Joe Biden first announced his plan to set staffing levels for nursing homes in his 2022 State of the Union address. Current law only requires that nursing homes have “sufficient” staff, leaving to interpretation to the states.

The new rules implement a minimum number of hours staff spend with residents. They also require a registered nurse to be available 24 hours a day in federally funded facilities, which house about 1.2 million people.

Allies of seniors have sought regulation for decades, but the rules have provoked resistance from the nursing home industry.

Mark Parkinson, president of the American Health Care Association, which lobbies for care facilities, said Monday in a statement that the organization was disappointed and concerned that the federal government was moving forward with what he said was a “ unfunded mandate.”

“It is unfair that the administration is finalizing this rule, given our country’s changing demographics and growing shortage of caregivers,” Parkinson said. “Issuing a final rule that requires hundreds of thousands of additional caregivers when there is a nationwide shortage of nurses only creates an impossible task for providers.”

Wisconsin Republicans echoed staffing concerns, noting shortages, especially in rural parts of the state. In Elroy, Wisconsin, for example, an 80-bed nursing home would be required to hire six additional nurses, but “we just don’t have the bodies,” said Wisconsin state Rep. Tony Kurtz.

Noting the additional costs and requirements, Republican U.S. Senator Ron Johnson bluntly insisted to reporters on a conference call that the rule “might look good. It will not work.

Health and Human Services Secretary Xavier Becerra said the change aims to establish a standard for quality of care.

“We believe that with more and more Americans going into nursing homes, it is time to ensure that quality is the standard that everyone strives for,” Becerra said in an interview.

He said the administration has listened to feedback from the nursing home industry and is allowing the rule to be phased in with longer deadlines for nursing homes in rural communities and temporary hardship exemptions in places where staffing is difficult.

The outreach event marked Harris’ third visit to the swing state this year and is part of Biden’s effort to win the support of union workers in his re-election bid. Republican presidential challenger Donald Trump made inroads among blue-collar workers in his 2016 victory. Biden regularly calls himself the “most pro-union” president in history and has received support from prominent labor groups such as the AFL-CIO, the Federation American Federation of Teachers and the American Federation of State, County and Municipal Employees.

Lisa Gordon, a certified nursing assistant who told Harris, “I’ve been doing this job for 29 years,” said she was grateful that Biden and the vice president were “finally getting something done.”

“I got into this field because I care about caring for our seniors,” Gordon said during a conversation with other caregivers, Chiquita Brooks-Lasure, administrator of the Centers for Medicare and Medicaid Services, and April Verrett, secretary-treasurer of the International Union of Healthcare Providers. Service Employees.

“Being understaffed is not taking care of them as they should,” Gordon said. “They didn’t ask to be there. Your residents are your family. They are your loved ones. We need these changes.”

The coronavirus pandemic, which has claimed more than 167,000 nursing home residents across the U.S., has exposed low staffing levels at facilities and led many workers to leave the industry. Advocates for the elderly and disabled reported residents being neglected, going without meals and water, or kept in dirty diapers for too long. Experts said staffing levels are the most important marker for quality of care.

The new rules provide for staff equivalent to 3.48 hours per resident per day, just over half an hour coming from nurses. The government said this means a facility with 100 residents would need two or three registered nurses and 10 or 11 nursing assistants, as well as two additional nurses per shift to meet the new standards.

The average U.S. nursing home already has a general staffing of about 3.6 hours of caregivers per resident per day, including RN staff just over the half-hour mark, but the government has said that most of the roughly 15,000 nursing homes of the country’s seniors would have to add staff under the new regulation.

The new limits are still lower than what advocates have long noted, after a landmark 2001 study funded by the Centers for Medicare and Medicaid Services recommended a daily average of 4.1 hours of nursing care per resident.

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Associated Press writer Scott Bauer in Madison, Wisconsin, contributed to this report.