Biden administration finalizes controversial minimum staffing mandate at nursing homes
The Biden administration finalized on Monday the first-ever minimum staffing rule at nursing homes, Vice President Kamala Harris announced.
The controversial mandate requires that all nursing homes that receive Medicare and Medicaid funding provide a total of at least 3.48 hours of nursing care per resident per day, including defined periods from registered nurses and from nurse aides. That means a facility with 100 residents would need at least two or three registered nurses and at least 10 or 11 nurse aides, as well as two additional nurse staff, who could be registered nurses, licensed professional nurses or nurse aides, per shift, according to a White House fact sheet.
Plus, nursing homes must have a registered nurse onsite at all times. The mandate will be phased in, with rural communities having longer timeframes, and temporary exemptions will be available for facilities in areas with workforce shortages that demonstrate a good faith effort to hire.
The rule, which was first proposed in September and initially called for at least three hours of daily nursing care per resident, is aimed at addressing nursing homes that are chronically understaffed, which can lead to sub-standard or unsafe care, the White House said.
How are you getting $95 an hour?
3.5 hours of nurse care per resident per day (from the bill).
Resident pays $120K per year to stay at the facility.
There are 365*3.5 hours in a year they need nursing care = 1277 hours of nursing care per year per client.
$120K per year / 1277 hours per year = $94/ hr maximum cost for each nurse - assuming there are no other expenses for the facility.
Must have mistyped to get $95, but that is the math.
Okay, now I understand what you meant by maximum cost. It should be noted that the nurses will likely be paid closer to $30 / hour, give or take depending on the area.
The $94/hr isn't a salary, it's the cost to the business. Employees generally cost a business 1.3-1.5X their salary - since insurance, payroll taxes, PTO, etc. all also need to be paid for.
Again this is not considering any other cost for the facility: utilities, food, other staff, medical equipment, maintenance, insurance, rent...
I'm not worried about their profits tbh. Nursing homes had total net revenues of $126 billion and a profit of $730 million (0.58%) in 2019. They can afford to staff properly and fairly and still make a disgusting amount of profit.
That is an insanely small margin, and directly contradicts your claim that they can staff properly.
Let's take the entire profit for the industry and hire nurses. Let's say reach nurse costs $80K ( $60K salary, $20K for taxes/insurance/other benefits).
That pays for 9600 more nurses. Which, given the nursing requirements in the bill (3.48 hours per day per resident), only covers staffing for 22K residents.. a rounding error to the more than 1.2 million nursing home residents in the country.
There are ~15K nursing homes in the US, each of them getting 0.6 more nurses doesn't help anything.
I'm no economist, but if the business can't afford to perform its function (such as a care home taking care of its residents) then the business shouldn't exist.
And that is a valid opinion. Unfortunately what do you do with all these people if the homes close because they can't afford staff?
The intent of the bill is to prevent neglect in nursing homes - that is a worthy and important goal. The mandate doesn't actually help make that happen.
It doesn't provide funding the care providers to increase staff, it doesn't add incentives for individuals to get certified and help address the personnel shortage, it doesn't put a cap on administrative costs for care facilities, it doesn't actually DO anything to help solve the problem.
Good mandates also provide an avenue to meet them.
The government is already providing funding, this just makes that funding dependent on having enough staff.
If a business needs the government to hold its hand every step of the way to be successful then it should be a government facility instead of a private business.
We get it, you don't like nursing homes.
You don't seem to be engaging with the substance of the matter, so I'll leave it here.
I like nursing homes. I don't like nursing homes that don't take care of their residents.
That is the substance of the matter here. I don't care how profitable the business is if the residents aren't being properly cared for.
The businesses are hardly profitable. For every dollar they get from housing a resident, they get just above half a penny of profit.
As I showed above, you can take the entire profit and put it into hiring more staff and it won't actually make a difference. They either need to raise prices, cut costs elsewhere (maybe administration? I'm not familiar enough to know), or pay people less.
That's what the numbers say.
Again: I don't find the argument "we can't take proper care of our residents because it's not profitable" to be compelling.
No one seems to be arguing that the care being asked for is unnecessary, just that it's expensive. And in that case I just don't care.
Their asshole