CMS must help workforce before setting minimum staffing rule

Half Point Images / Getty Images

The Centers for Medicare & Medicaid Services must first help the long-term care industry build its workforce before implementing a national minimum staffing standard for nursing homes, said many vendors to the agency in comments submitted.

CMS is examining ways to establish minimum staffing requirements for nursing homes as part of President Joe Biden’s nursing home reform initiatives.

The agency called on providers to provide feedback on setting minimum staffing requirements when it releases its draft Prospective Payment System for Skilled Nursing Facilities 2023 in mid-April.

CMS said that under the requirements, providers will have to “ensure that all residents receive safe, high-quality care, and care home workers receive the support they need”.

Providers have until June 10 to submit their comments to the agency. The proposed rule already has around 2,960 comments publicly posted within days of that deadline.

While a large majority of comments focus on proposed pay cuts for skilled nursing facilities, around 30% call on CMS to address current staffing shortages and provide more financial resources to institutions before even considering a minimum staffing standard.

“CMS should support our industry by building the workforce before implementing a national minimum staffing requirement. A strong and adequate supply of labor and the necessary financing must first be in place,” wrote Sarah Dujua, Director of Accounts Receivable for Illinois-based Sheridan Healthcare Services, LLC.

“We are feeling the impact of the current workforce challenges which have steadily worsened since the start of the pandemic,” she added. “Our facility is working hard to recruit new employees, yet we continue to face challenges. I don’t see employees becoming available and the workforce increasing in the near future. »

Not the answer

Staffing has been the most difficult hurdle due to the COVID-19 pandemic and the resulting federal vaccination requirement, according to Holly Burley, RN, director of nursing for the Ansted Center, a 60-bed facility in Ansted, WV. Burley told CMS that the mandate has limited the facility’s candidate pool for vacancies, which has forced the provider to rely heavily on expensive recruitment agencies.

“Mandatory staffing minimums are not the solution, and given the current labor shortage across all industries, it would only place an additional burden on an already overworked nursing staff,” he said. she commented.

Josh Kidd, director of the human resources center at West Virginia-based Dunbar Center, said any minimum staffing mandate should be “accompanied by adequate funding as well as solutions that incentivize individuals to work in long-term care, and more specifically, our facilities. ”

“Staffing ratios per position are not the answer as we have seen challenges with this policy in states across the country. Reporting, associated with any increase in staffing, should NOT be overly burdensome and penalties and enforcement should be reasonably tied to the goals of improving care,” he told CMS.

Kidd added that a federal minimum staffing level for NFCs would be difficult or impossible to achieve for many facilities at this time given current labor shortages, particularly in healthcare.

“Furthermore, increased staffing requirements would further increase labor costs and burnout for healthcare workers at a time when costs are high and staff are harder to find,” did he declare.

Michael A. Bynum