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Nursing Homes Must Boost Staffing Under First-Ever National Standards

WSJ News Exclusive | Nursing Homes Must Boost Staffing Under First-Ever National Standards

https://www.wsj.com/health/nursing-homes-must-boost-staffing-under-first-ever-national-standards-66328d5d

The rule would require patients receive weekly care from a registered nurse and a nurse aide.

WSJ News Exclusive | Nursing Homes Must Boost Staffing Under First-Ever National Standards

Nursing homes will have to maintain minimum staffing levels under a Biden administration proposal despite furious lobbying from the industry, which says it will be too onerous amid a continuing labor shortage.

Biden administration officials said the first-ever national staffing rule would require nursing homes that participate in Medicare and Medicaid to provide a minimum of 0.55 hours of care from a registered nurse per resident a day, and 2.45 hours of care from a nurse aide per resident a day. A registered nurse would be required to be on-site at all times and nursing-home care assessments would be strengthened under the proposal.

The Centers for Medicare and Medicaid Services estimates that about 75% of nursing homes would have to strengthen staffing in their facilities under the proposal. The proposed staffing standard exceeds those existing in nearly all states.

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The administration said it also plans to launch a national initiative to tackle the staffing shortage in the nursing-home industry. It will invest more than $75 million in financial incentives such as scholarships and tuition reimbursement to support staffing prospects for nursing homes.

14 comments

Ryan213

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It's not a labour shortage though. Pay people more and they'll come work.

Pistcow

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Nursing homes cost $9k a month and they pack them in like sardines. I'm sure they can pay $5/hr more and add a few more staff.

Ryan213

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Shareholders don't like that. How dare you even point that out!

thisisawayoflife

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If you're lucky it's 9k. It was about 13k for my mom before she died. We feel it was a mistake to do that and we pulled her out because we could take better care of her at home with some hired help for when we were exhausted.

The CNAs were understaffed, undertrained and underpaid and had to deal with some literally crazy people wacked out from dementia and other brain rot that wrote simply made them violent and angry. The people that have to endure that daily need to be paid more, period. We need to start telling our kids that if they want to serve the country, don't go into them military - go into healthcare. I'd story giving them an equivalent to the GI Bill.

Aesculapius

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This is great!

Right now there is a serious issue with discharging patients from the hospital environment into skilled care. Since COVID, many nursing homes don't take admissions over the weekend, limit admissions to long term care (as opposed to transitional care which is short term - and better reimbursed), and often have wait times. This has the effect of increasing the length of time a patient is in the hospital unnecessarily, thus decreasing hospital capacity.

Yes, the nursing homes have staffing issues, but they pay for shit. Many of them pay less than $20/hour. You need to goto school to get your CNA license which isn't free. You can get many other jobs for better pay without the investment of education.

Source: I am a hospitalist physician. I work with nursing homes a great deal and my wife used to work at one as a CNA.

CADmonkey

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My other half works in a nursing home. They contract out their nursing, and that contractor pays $16 per hour for CNA's. You could go nearly anywhere in the local city and make that much, or more, and you won't have to clean the shit off grandpa.

Adeptfuckup

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Wow, scholarships and tuition reimbursement meaning it’s not free. How the fuck is that an incentive? How about raise the pay so caregivers aren’t living out of their car? Or tent? I hate this tone deaf bullshit. The incentive is to pay someone what it’s worth to put up with someone’s demented abusive grandpa. Pay up or it will be taken from you. Not a threat. Just a fact of human nature.

GFGJewbacca

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Thank God at least something is being done about this. I don't think it's perfect, because I feel like the requirements they're imposing will barely help most patients deal with basic daily tasks. Even so this is way better than little to no coverage at all.

conditional_soup

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Fucking good, but not nearly far enough, IMO. I work in EMS, done it for 13 years. Almost anyone working in EMS can tell you some horror stories about almost any nursing home in their area, I know I can. They're basically medicare farms, and the elderly and disabled are the livestock.

shadowSprite

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Used to work in EMS, now just a lowly vollie, can't agree with you more. I'd rather die before going to a nursing home, even the good ones. Those of us in EMS see the things no one else sees, we see what the state doesn't see when they do their inspections, we see what is hidden from the families. But when we speak up, does anyone ever listen to us? Nope. I don't know how any "civilised" society can be ok with treating their elderly the way we treat ours. Places where if you are standing in one place you have to keep shifting from foot to foot because if you actually stand still your boots will stick to the floor, residents in beds with sheets that look like they haven't been changed in weeks, people crying for help all through the hallways, and just the general neglect and ignorance by staff, and when you do get staff who aren't burned out and still care they are so overwhelmed by the patient ratios there's still only so much they can do.

Trainguyrom

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My wife worked at an assisted living facility for a while and it's no better. Plus they'd frequently delay transferring patients who really needed to be in a nursing home to try to squeeze an extra month or two out of them, leading to patients being more often transferred to hospice care than a nursing home

The amount of BS that occurred leads me to believe it's either an unsustainable business model that pushes assisted living and nursing homes to be so terrible or a severe lack of government oversight and consequences for facilities that allows them to be so scummy

Chetzemoka

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It's an unsustainable business model for profit.

"In 2005, private equity-owned firms owned less than 1 percent of skilled nursing facilities. By 2015, they owned 9 percent; the share is likely higher today.

Purchases of nursing homes by private equity firms are associated with higher patient mortality rates, fewer caregivers, higher management fees, and a decline in patient mobility."

https://www.nber.org/digest/202104/how-patients-fare-when-private-equity-funds-acquire-nursing-homes

Squeezing profit out of the end of elderly people's lives is an extra special level of disgusting

conditional_soup

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Private equity tries not to ruin anything it touches challenge (impossible)

roguetrick

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Interesting requirements. 9 patients max per CNA is very reasonable in SNF staffing.