Short: Staff mandates for nursing homes would hurt patients

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Danny Short, a Republican, serves Seaford in the Delaware House of Representatives.

I have dedicated my life to public service. From being a life member of the Seaford Volunteer Fire Department, a city councilman and mayor, and now state representative in Dover, the safety and well-being of Delawareans has and always will be my top priority.

That’s why recent federal rulemaking has caught my attention. The Centers for Medicare and Medicaid Services’ proposed staffing mandate for nursing homes threatens to undermine care for some of our most vulnerable — those residing in nursing homes — and we need our lawmakers to speak out against it.

The mandate is the administration’s answer to boosting low staffing levels in nursing homes. While it’s true that nursing homes are experiencing a labor shortage, a blanket federal mandate isn’t the magic bullet that will solve the problem.

There’s a misconception that nursing homes aren’t hiring. If they would just hire more people, workforce challenges would disappear. But lack of hiring is not the issue at all. There is a historic staffing shortage facing the health care system, and long-term care facilities are being acutely impacted. Nursing homes have lost approximately 15% of their workforce since the pandemic.

Nursing homes are trying to regain their losses by offering more competitive wages and benefits, among other things, yet they continue to struggle to find available, qualified workers because of the sheer lack of available workers in today’s labor market to fill vacancies they need.

Access to care is becoming an alarming problem. We’re seeing nursing homes turn away new residents because they don’t have enough staff. This disrupts the entire health care system, including hospitals that are unable to discharge patients who need to continue their post-acute care in a nursing home. As a former board member of Nanticoke Memorial Hospital, I know nothing is worse for a nonacute patient than having to board in a hospital or wait at home for an available bed at a long-term care facility.

Mandating more workers will not create more workers. Currently, 93% of our state’s nursing homes do not meet the three requirements of the proposed rule, and it would cost $13 million annually for our state to hire the additional workers needed to meet it. But there is no new federal funding that will aid in hiring efforts.

Keep in mind that a study commissioned by the Centers for Medicare and Medicaid Services found that there was no staffing level that would guarantee better quality care. Federal policymakers need to come to the table with solutions that actually help nursing homes develop a strong pipeline of caregivers.

We need workforce development programs that incentivize future generations to join the health care and long-term care workforce. Delaware is leading the way with its Tuition Incentive Program, an inaugural effort to get state employees trained to be certified nursing assistants. This is a true example of addressing the problem at its most fundamental level.

The people I represent in western Sussex County need access to long-term care when it is time. The current workforce shortages among nursing assistants will only get worse with the proposed regulation, leaving more people who need to be in a skilled nursing facility without the ability to access a bed on a timely basis.

Many lawmakers on Capitol Hill have publicly voiced their concerns with the mandate and have asked that President Joe Biden go back to the drawing board. Let’s hope the First State’s lawmakers serving in Congress support our seniors and caregivers, and join them in calling for a different approach.

Reader reactions, pro or con, are welcomed at civiltalk@iniusa.org.

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