The adopted bill will require some personnel changes

According to the US Department of Health, about 187,000 people have died from COVID-19 in long-term care facilities, accounting for one-third of the total number of deaths from COVID-19 in the United States. Kaiser family foundation

“We have long known the importance of having enough staff in nursing homes to provide quality care to residents, and we know there has been a shortage of staff for some time,” said Rhonda Richards, senior legislator for government affairs. at the AARP, which maintains the provisions. “But we saw that during the pandemic, all the attention was paid to these issues and what can actually happen when you don’t have enough staff.”

However, the American Health Association / National Center for Life Assistance argues that meeting these requirements would be nearly impossible without significant government funding.

If the HHS study finds that nursing homes are to increase clinical staff by 25%, then nursing homes would have to employ more than 150,000 people, at a cost of $ 10.7 billion a year, according to AHCA estimates. In contrast, nursing home employment has declined by 221,000 jobs since March 2020, according to data AHCA report based on data from the Bureau of Labor Statistics.

“Unfortunately, if these provisions do become law, we believe that thousands, if not most, of skilled nursing facilities in the United States will close,” said Mark Parkinson, president and CEO of AHCA / NCAL at a press conference Wednesday.

But Michelle Mahon, deputy director of nursing practice at National Nurses United, said the problem isn’t a shortage of skilled nurses. She sees this as a lack of conditions in which nurses are willing to work.

“What really drives this shift is the demand for respect,” Mahon said.

Specifically, the package requires the HHS secretary to conduct research no later than three years after the adoption of the “appropriateness” of establishing a minimum staff-to-live ratio for nursing staff in skilled nursing facilities. HHS will be required to issue minimum staffing rules – if deemed appropriate in the study – no later than one year after the study is submitted to Congress.

HHS may waive the ratio requirements for rural institutions, but families must be notified and the waiver must be renewed each year.

Mahon said National Nurses United and Harrington believe HHS should skip the survey and go straight to enforcing safer staffing levels.

“It’s absolutely necessary and we don’t need – we don’t need to learn. This is a problem that has been around for a long time and is well documented, ”Mahon said.

The current law only says that nursing homes must provide “sufficient” staff to meet the needs of their residents 24 hours a day, but does not establish any ratios.

The Health Restoration Act also requires a 24-hour professional nurse on duty in nursing homes.

The link between RN staffing and better health outcomes for nursing home residents is well established. 2020 study found that every 20-minute increase in RN staff predicted a 26% decrease in COVID-19 in Connecticut nursing homes that had at least one COVID-19 death.

Harrington said nursing homes make money from RN’s lack of staff and alternatively hire cheaper but less skilled licensed nurses. However, only nurses can assess patients.

Nursing homes with heavier patients are paid more by Medicare, but they do not need to hire additional staff to care for them.

“It often happens that you have a registered nurse who is really responsible for all nursing care provided at all times. Sometimes we are responsible for hundreds of patients. So even having one nurse on site 24 hours a day is still not enough, ”Mahon said.

According to the study, about 75% of nursing homes almost never met the government’s expected RN staffing levels based on visual acuity in 2017 and 2018. study Harrington and colleagues published last year’s publication in Health Services Insights.

“The reason the nursing home industry is fighting this is because they don’t like mandates and it will cost them more money,” Harrington said.

“Patients are suffering. We’ve had all these infections and deaths due to staff shortages, and so I think Congress really needs to do something. ”

AHCA / NCAL and LeadingAge’s policy recommendations to Improve Nursing Home Quality, released in March, calls for a federal requirement for a facility to have an in-state nurse working 24 hours a day. But their proposal calls for federal funding for financial incentives to bring nurses into the sector, failures for nursing homes with severe labor shortages, and other flexibilities.

“While these two statements sound great, and, again, we believe that people who want to improve health care have good intentions, they are simply not realistic in the real world,” Parkinson said.

The Restoration Improvement Act will also take steps to improve the accuracy of some nursing home data and expense reports, and to improve surveys.

The AHCA said that none of the provisions in the Improved Recovery Act will address the problems facing nursing homes.

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