Biden’s ‘Build Better’ puzzle to devastate nursing homes


WASHINGTON, DC – The Build Back Better Act, recently passed by the United States House of Representatives, includes two unfunded nursing home mandates that could force thousands of nursing homes to further limit the number of admissions to their homes. establishments or even to close their doors for good.

Bill requires nursing homes to have a registered nurse (RN) on staff around the clock and requires the US Department of Health and Human Services (HHS) to conduct a study on minimum staffing ratios and implement the regulations within one year without funding, but offer no resources to providers to implement these provisions.

The intent of the measures is widely supported by the American Health Care Association and the National Center for Assisted Living (AHCA / NCAL). In particular, having a 24-hour RN on staff is a key part of the AHCA and LeadingAge’s comprehensive reform proposal, the Care for Our Seniors Act. However, without funding and programs to recruit tens of thousands of additional nurses, providers will not be able to meet these demands. The AHCA / NCAL recently held a press conference to outline their concerns.

The Build Back Better Act mandates will cost nursing homes billions of dollars a year. The AHCA / NCAL estimates that if the HHS study found that nursing homes were to increase clinical and direct care staff by 25%, more than 150,000 registered nurses, licensed practical nurses (LPNs) and nurses would have to be hired. Certified Practical Nurses (CNA), at a cost of $ 10.7. billion a year. The mandate of registered nurses would require the hiring of an additional 21,000 nurses at a cost of $ 2.5 billion per year.

Retirement homes are already facing a historic staffing crisis. Many caregivers have been exhausted by the pandemic and workers are leaving the long-term care sector for jobs in other health care facilities or other industries.

Hospitals, doctor’s offices, ambulatory care centers and other health care facilities have reached or exceeded pre-pandemic staffing levels, but nursing homes and assisted living communities are still suffering losses substantial jobs. October data from the Bureau of Labor Statistics (BLS) shows nursing homes have lost 221,000 jobs since the start of the pandemic – a drop in employment levels of 14%.

Chronic underfunding for Medicaid and billions of dollars spent to fight the pandemic have pushed providers to struggle to recruit qualified staff. The inability to recruit and retain workers has led many establishments to limit the number of residents they serve, and some establishments have even had to close permanently. A September AHCA / NCAL survey found that 78 percent of nursing homes and 61 percent of assisted living communities fear workforce issues will force them to close.

Sadly, this is already a reality for nursing homes across the country. Locations in Illinois, Maine, Michigan, Nebraska, New Jersey, and New York, among others, have closed due to understaffing, while others in Texas, North Dakota , Oklahoma and Rhode Island had to reduce or suspend new admissions. If this continues, millions of older people could face limited care options.

Nursing homes have faced unprecedented challenges due to the COVID-19 pandemic. Lawmakers must help the long-term care sector attract and retain more caregivers, so our country’s most vulnerable have access to the long-term care they need and caregivers have access to well-paying jobs and enriching.


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