Nursing home professionals across the country are raising concerns over persistent, worsening workforce challenges. Amid this labor crisis, the Biden administration is considering implementing a federal minimum staffing requirement that will only make the crisis worse. Long term care leaders, providers and caregivers are warning policymakers that an unfunded mandate will force nursing homes to further limit admissions or even close their doors for good and urging them instead to focus on meaningful reforms, including fully funding Medicaid, that will help strengthen the long term care workforce.
See what nursing home professionals are saying about the consequences of a federal minimum staffing mandate:
Vicente Vargas, executive director, New Mexico Health Care Association/New Mexico Center for Assisted Living:
“In New Mexico, a vast portion of the nursing home model of care relies on nursing home providers being price takers. This is because approximately 70% of New Mexico’s nursing home residents rely on state established Medicaid reimbursement rates to pay for their care. On average, 2021 New Mexico nursing home Medicaid reimbursement rates were $55 below the cost of resident care per day. Layering the cost of a minimum staffing mandate on top of the current cost of resident care would only widen that gap beyond what facilities can absorb for any length of time. At the bare minimum, nursing facilities need additional funding in order to close this gap and continue to operate. In the long term, nursing facilities want to partner with lawmakers to create solutions that address the underlying workforce challenges.” (
Federal Staffing Mandate For Long-Term Care Is Unworkable,
Albuquerque Journal, 3/19/23)
Kevin Evans, executive director and administrator, Martha T. Berry Medical Care Facility in Mt Clemens, Mich.:
“Our trade association — the Heath Care Association of Michigan — estimates that in Michigan alone, we’ve lost more than 10,000 nursing facility workers throughout the pandemic… Unfortunately, the government’s recommended solution to address our workforce woes is to mandate minimum staffing levels. This won’t work. To only implement a federal minimum staffing requirement without a staffing solution will punish nursing facilities. There simply is not enough staff to meet current needs. The Medicaid reimbursement models also cause stress, as Medicaid rates have increased only 5%, but the inflation rate’s been 15%. Insufficient resources make it more difficult to address workforce issues. To be clear — we want to hire workers, but there aren’t workers to hire… A federal minimum staffing mandate will lead to noncompliance citations that we’ll only be able to address by discharging residents to meet the staffing ratios. And that’s not good for anyone.” (
Minimum Staffing Mandate Won’t Help The Workforce Crisis,
The Macomb Daily, 3/4/23)
Maureen Westfall, regional registered nurse, Stellar Senior Living in Colorado Springs, Colo.:
“Nursing home caregivers faced unprecedented levels of stress and burnout during the pandemic, and many have left to work for staffing agencies that can offer higher salaries and increased flexibility. Inadequate resources and funding have made it challenging to recruit more workers. As a result, we are estimated to be thousands of employees short of pre-pandemic levels. In our 12 communities alone, we have more than 240 job openings… Increasing staffing minimums at the federal level would cost nursing homes approximately $10 billion each year and 187,000 new nurses and nurse aides. If the talent pool is already limited and resources are thin, an unfunded federal staffing requirement would be impossible for long-term care communities like mine to meet.” (
Senior Care Facilities Face Workforce Crisis,
Colorado Politics, 11/23/22)
Joe Bohunicky, administrator, Mt. Carmel Rehab Center and Nursing Center in Manchester, N.H.:
“In our facility, we currently have 13 full-time and 14 part-time nurse’s aides and 10 full-time and six part-time nurse open positions. We are doing everything we can to hire more caregivers, offering flexible schedules, scholarship opportunities and more, but we are unable to fill these positions because the workers just aren’t there… Staffing minimums are focused on bodies rather than resident outcomes. We are calling on lawmakers to prioritize comprehensive solutions to this workforce issue instead of implementing an unfunded mandate. We need Medicaid reimbursement rates to cover the full cost of care, which will in turn help us invest in our workforce and build a pipeline of dedicated caregivers.” (
Nursing Homes Need Smart Solutions, Not New Mandates,
New Hampshire Union Leader, 11/13/22)