The bill passed by the House of Representatives will require some personnel changes


Nearly 187,000 people died of COVID-19 in long-term care facilities, accounting for one-third of all COVID-19 deaths in the United States, according to Caesars Family Foundation.

Rhonda Richards, Senior Legislative Representative for Government Affairs, said: “For a long time, we have known the importance of adequate staffing in nursing homes to provide quality care to residents, and we also know that there has been a shortage of staff for some time. Question.” At AARP, it supports these regulations. “But we saw during the pandemic that people are paying attention to these issues and what happens when you don’t have enough employees.”

However, the American Healthcare Association/National Center for Assisted Living believes that it is almost impossible to comply with these regulations without substantial government funding.

AHCA estimates that if the HHS study finds that nursing homes should increase clinical staff by 25%, nursing homes will have to employ more than 150,000 people, costing US$10.7 billion per year. In contrast, according to a report, the number of people employed in nursing homes has fallen by 221,000 since March 2020. AHCA report According to data from the Bureau of Labor Statistics.

AHCA/NCAL President and CEO Mark Parkinson said at a press conference on Wednesday: “Unfortunately, if these regulations become law, we believe that thousands of (if not most) skilled nursing institutions in the United States will closure.”

But Michel Mahon, assistant director of nursing practice at the National Federation of Nurses, said the problem is not the shortage of trained nurses. She thinks this is a shortage of conditions for nurses to be willing to work.

“What really drives this labor transfer is the need for respect,” Ma Hong said.

Specifically, pack The HHS secretary will be required to conduct a study no later than three years later to determine the “appropriateness” of establishing a minimum staff-to-resident ratio for nursing staff in skilled nursing facilities. HHS must publish regulations on minimum staffing ratios no later than one year after the study is submitted to Congress—if deemed appropriate in the study.

HHS can waive the rate requirement for facilities in rural areas, but the family must be notified and the waiver must be renewed annually.

Mahon said that both National Nurses United and Harrington believe that HHS should skip the investigation and directly mandate safer staffing levels.

“This is absolutely necessary, we don’t need it — we don’t need to study it. This is a long-standing problem and well-documented,” Ma Hong said.

The current law only stipulates that nursing homes must provide “sufficient” staffing to meet the needs of its residents 24 hours a day, but it does not stipulate any ratio.

The “Better Rebuild Act” also requires a registered professional nurse in nursing homes to be on duty 24 hours a day.

The link between RN staffing and better health outcomes for nursing home residents has been established. A 2020 Learn It is found that for every 20 minutes of increase in RN staffing, it is predicted that in nursing homes that have experienced at least one COVID-19 death in Connecticut, the reduction in COVID-19 will be reduced by 26%.

Harrington said nursing homes make money by keeping the number of registered nurses low and hiring cheaper but less skilled nurse practitioners as alternatives. Nevertheless, only registered nurses can evaluate patients.

Medical insurance pays more for nursing homes with more severely ill patients, but does not have to hire more staff to take care of them.

“Usually, you have a registered nurse who is really responsible for all the nursing services provided at all times. Sometimes we are responsible for hundreds of patients. Therefore, even if only one RN is on-site 24 hours a day, it is still not enough,” Ma Hong Say.

Based on residents’ acuity in 2017 and 2018, approximately 75% of nursing homes have almost never reached the level of staffing of registered nurses expected by the government. Learn Harrington and colleagues published it in Health Services Insights last year.

Harrington said: “The reason the nursing home industry is fighting against this is because they don’t like mandatory requirements, which will make them spend more money.”

“Patients are suffering. We have had all these infections and deaths due to insufficient staff, so I think Congress really needs to continue to act.”

AHCA/NCAL and LeadingAge’s policy suggestion In order to improve the quality of nursing homes, a federal requirement was issued in March, requiring nursing home staff to have a registered nurse 24 hours a day. But their proposal calls for federal funding of financial incentives to bring nurses into the industry, provide exemptions and other flexibility for nursing homes with severe labor shortages.

Parkinson said: “Although these two regulations sound great, we again believe that they are well-intentioned by people who want to improve care, but they are not realistic in the real world.”

The “Rebuild Better Act” will also take measures to improve the accuracy of data and cost reports for some nursing home facilities, and improve surveys.

The AHCA stated that none of the provisions in the Rebuild Better Act can solve the problems faced by nursing homes.



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