News Digest: Consumer Advocates, Unions and Some Congressman Support the Staffing Mandate
With the loud and consistent negative reaction to CMS’ proposed minimum staffing standards, one could fail to recognize that supporters of the new rule exist. Some even believe the minimum standards do not go far enough and need to be higher.
Groups of US senators and attorneys general defend proposed staffing rule
Fifteen state attorneys general and 12 US senators have submitted separate group letters strongly supporting the proposed nursing home staffing mandate from the Centers for Medicare & Medicaid Services.
Their arguments come during a period of unprecedented scrutiny and controversy from the public and elected officials. Nearly 50,000 comments were sent to CMS before the comment period ended Monday.
The high-profile pro-mandate letters are counterpoints to a coalition of 15 Republican governors, who urged the Biden administration to reconsider supporting the controversial rule in an open letter dated Nov 1.
Henreckson, Josh. “Groups of US Senators and Attorneys General Defend Proposed Staffing Rule.” McKnight’s Long-Term Care News, 8 Nov. 2023, www.mcknights.com/news/groups-of-us-senators-and-attorneys-general-defend-proposed-staffing-rule.
Right now, nursing homes are in crisis.
We support the Biden administration’s commitment to improving nursing home care through strong federal staffing standards for nursing homes across the country.
Decades of understaffing have spread workers thin, putting our nation’s 1.2 million nursing home residents at risk. While many nursing homes do provide adequate staffing, some facilities force nursing home workers to care for 20, 30 or even 40 residents at a time.
More and more families are deeply worried that their loved ones are not receiving the care they need. Despite what corporations and wealthy owners of nursing homes say, this is not because of a “worker shortage.” This understaffing has gone on for years.
Too often, some nursing home owners divert taxpayer dollars away from staff and direct care and into profit, placing residents and workers in harm’s way. Even during the height of the pandemic, most for-profit nursing homes remained profitable – while they claim they can’t afford to hire more staff, there is plenty of evidence they can.
We support strong nursing home staffing standards. (n.d.). https://sites.google.com/seiu.org/strongstaffingstandards?usp=sharing
CMS Official: Nursing Home Staffing Mandate ‘Balanced and Achievable,’ Stakeholder Comments Valued
More than a month after the announcement of the federal minimum staffing proposal, an official with Centers for Medicare & Medicaid Services (CMS) reinforced the agency’s commitment to the rule and urged providers and other stakeholders to continue submitting comments on the matter by Nov. 6.
Dr. Dora Hughes, acting CMS Chief Medical Officer and acting Director of the Center for Clinical Standards and Quality, said during a quarterly stakeholder call on Tuesday that the agency took a multifaceted approach to help inform its proposal, and that it reflects “ all the available evidence.”
“We believe that our staffing proposals are balanced and achievable,” Hughes said. “They would help advance safe quality care for residents, while also striking an appropriate balance that considers the current challenges some nursing homes are experiencing particularly in rural areas.”
Amy Stulick. “CMS Official: Nursing Home Staffing Mandate ‘Balanced and Achievable,’ Stakeholder Comments Valued.” Skilled Nursing News, 17 Oct. 2023, skillednursingnews.com/2023/10/cms-official-nursing-home-staffing-mandate-balanced-and-achievable-stakeholder-comments-valued.
Groups of US senators and attorneys general defend proposed staffing rule
Fifteen state attorneys general and 12 US senators have submitted separate group letters strongly supporting the proposed nursing home staffing mandate from the Centers for Medicare & Medicaid Services.
Their arguments come during a period of unprecedented scrutiny and controversy from the public and elected officials. Nearly 50,000 comments were sent to CMS before the comment period ended Monday.
The high-profile pro-mandate letters are counterpoints to a coalition of 15 Republican governors, who urged the Biden administration to reconsider supporting the controversial rule in an open letter dated Nov 1.
Henreckson, Josh. “Groups of US Senators and Attorneys General Defend Proposed Staffing Rule.” McKnight’s Long-Term Care News, 8 Nov. 2023, www.mcknights.com/news/groups-of-us-senators-and-attorneys-general-defend-proposed-staffing-rule.
CMS gets it right: Individuals receiving care will benefit from RN staffing mandate
Skilled nursing and assisted living facilities have long relied on licensed practical/vocational nurses (LPN/LVN) as the “backbone” of care to keep nursing salary costs low and increase profits, despite multiple studies demonstrating improved care outcomes with higher levels of registered nurse presence.
To state that an LPN can do “almost all the ‘work’ of an RN with the exception of initial assessments” grossly minimizes the level of RN education and expertise required to assess and synthesize the impact of complex interconnected health conditions, effects of social determinants of health, and risks for and prevention of further disabling incidents, into mere “tasks” to be performed.
Haugen, Nancy. “CMS Gets It Right: Individuals Receiving Care Will Benefit From RN Staffing Mandate.” McKnight’s Long-Term Care News, 16 Oct. 2023, www.mcknights.com/blogs/guest-columns/cms-gets-it-right-individuals-receiving-care-will-benefit-from-rn-staffing-mandate.
Proposed Minimum Staffing Requirements Poised to Impact Nursing Homes
The proposed rule would have several impacts on nursing homes. Nursing homes that participate in Medicare and Medicaid would be required to meet minimum nurse staffing levels. The rule would require nursing homes to have a Registered Nurse on site 24/7. According to the fact sheet, 22% of nursing homes would have to hire a Registered Nurse to meet this requirement.
In addition to a full-time Registered Nurse, the proposal requires nursing homes to provide at least .55 hours, or 33 minutes, per resident day of care from a Registered Nurse. For example, a facility with 100 residents would have to provide 55 Registered Nurse hours per day to meet this requirement. The fact sheet indicates that 36% of nursing homes would have to hire Registered Nurses to meet this requirement.
Cerulli, Paige. “Proposed Minimum Staffing Requirements Poised to Impact Nursing Homes.” I Advance Senior Care, 3 Oct. 2023, www.iadvanceseniorcare.com/proposed-minimum-staffing-requirements-poised-to-impact-nursing-homes.
24-Hour Registered Nurses in Nursing Homes: Affordable, Attainable, & Necessary
Every U.S. nursing home is required to provide skilled nursing care and monitoring 24-hours a day, seven days a week. Unfortunately, too many of our nursing homes provide substandard care and conditions that are demeaning and inhumane. As the country has witnessed in the COVID-19 pandemic, too many nursing homes are not even capable of implementing basic infection control protocols.
Good facilities already provide at least 24-hour registered nurses (RNs). The time has come to ensure that all nursing homes provide this level of care and competency. That is why the Biden Administration’s proposal to require that any nursing home that takes public funds have at least one RN in the building 24/7 is so important.
LTCCC. “24-Hour Registered Nurses in Nursing Homes: Affordable, Attainable, and Necessary – NursingHome411.” NursingHome411, 10 Oct. 2023, nursinghome411.org/costs-24-hour-rn.
How Minimum Staffing Standards Empower Nursing Home Workers
The World War II veteran had no family by his side as he lay dying, so Ella Wilverding and her union co-workers stepped into the role.
They took turns sitting vigil with the man, talking to him, holding his hand, and making him as comfortable as possible during his final days.
“We have a policy,” explained Wilverding, a certified nursing assistant (CNA) at the Oregon Veterans’ Home in Lebanon, Oregon, and the president of United Steelworkers (USW) Local 9559. “No one dies alone.”
This is the kind of compassionate, top-quality care that ensues when responsible staffing levels empower nurses, CNAs, and other nursing home workers to provide the time and attention that residents need.
Conway, Tom. “How Minimum Staffing Standards Empower Nursing Home Workers – CounterPunch.org.” CounterPunch.org, 21 Sept. 2023, www.counterpunch.org/2023/09/22/how-minimum-staffing-standards-empower-nursing-home-workers.
Biden’s nursing home staffing proposal is dangerously inadequate
As nursing home residents and staff died by the thousands in the first months of the COVID-19 pandemic, one thing became clear: Understaffing in America’s nursing homes is lethal. Most facilities lacked the staff needed to prevent neglect and avoidable harm to residents.
President Biden responded to the nation’s nursing home crisis by declaring that his administration would create a minimum staffing standard for nursing homes, to help ensure basic care and services for the nation’s more than 1 million nursing home residents.
This announcement was heralded by long-term care residents and their supporters. For years, nurses, physicians, researchers, consumer advocates and government reports had been sounding the alarm that understaffing in nursing homes jeopardized residents’ health and safety.
Contributors, Nina a. Kohn Charlene Harrington and Lori Smetanka, Opinion. “The Hill.” The Hill, 22 Sept. 2023, thehill.com/opinion/healthcare/4214467-bidens-nursing-home-staffing-requirements-are-dangerously-inadequate.
Nursing home critics attack staffing cost argument, urge providers to come to the table
Federal officials and the public need more visibility into nursing home spending to determine whether their concerns about the cost of complying with a nationwide staffing mandate are justified, well-known industry observers said on a Wednesday webinar.
A key to nailing down a firm answer will be crunching more operational data and money numbers, said Harvard health policy expert David Graboswki, PhD.
He called the staffing rule proposed by the Centers for Medicare & Medicaid Services “the biggest reform” nursing homes have faced in decades while speaking on a panel hosted by the National Association of Health Care Assistants. He noted that providers have raised two major objections: one being a well-documented direct care labor shortage and the other being timing.
Marselas, Kimberly. “Nursing Home Critics Attack Staffing Cost Argument, Urge Providers to Come to the Table.” McKnight’s Long-Term Care News, 21 Sept. 2023, www.mcknights.com/news/nursing-home-critics-attack-staffing-cost-argument-urge-providers-to-come-to-the-table.
Nursing home staffing rule ‘balanced and achievable,’ CMS official says
Officials with the Centers for Medicare & Medicaid Services Thursday defended their minimum staffing proposal for nursing homes as “balanced and achievable,” and provided more details on a coming program to build a pipeline of direct care staff.
The comments came during the first nursing home stakeholder call held since the staffing rule was proposed Sept. 1.
Adam Richards, deputy director of the CMS Clinical Standards Group, reminded attendees about hourly requirements for certified nurse aides and registered nurses, as well as round-the-clock 24 registered nurse coverage and updated resident assessment proposals. He also fielded several questions about where licensed practical nurses fit into the new rule, which does not require them on an hourly basis.
Marselas, Kimberly. “Nursing Home Staffing Rule ‘Balanced and Achievable,’ CMS Official Says.” McKnight’s Long-Term Care News, 15 Sept. 2023, www.mcknights.com/news/nursing-home-staffing-rule-balanced-and-achievable-cms-official-says.
An Overdue New Federal Rule to Improve Nursing Home Staffing
What would happen if the federal government were to propose for the first time specific nursing home staffing minimums?
We are about to find out.
A new rule. A new federal proposed rule introduced yesterday has already survived fierce opposition from the industry, which tried to kill it in the womb. They are not done opposing, but the administration seems to have its course set.
And the new rule is clearly within the letter and spirit of the Social Security Act that requires safe, quality care.
Sherlock, James. “An Overdue New Federal Rule to Improve Nursing Home Staffing.” Bacon’s Rebellion, 2 Sept. 2023, www.baconsrebellion.com/wp/an-overdue-new-federal-rule-to-improve-nursing-home-staffing.
