Nursing home staffing rule could cost $10B a year, AHCA says

President Joe Biden’s proposal to mandate staffing levels at nursing homes would require providers to hire 187,000 new nurses at a cost of up to $10 billion a year, and displace nearly 1 in 5 residents, according to a report the American Health Care Association released Tuesday.

The nursing home lobbying group has long opposed regulations that dictate how many employees they must have on duty without a corresponding increase in Medicaid reimbursement rates to cover the added expense.

“This report makes it crystal clear that increasing staffing standards in nursing homes requires substantial and consistent government resources. Even then, nursing homes would have the impossible task of finding another 187,000 nurses at a time when vacant positions sit open without applicants for months on end,” AHCA President and CEO Mark Parkinson said in a news release.

The trade association commissioned consulting firm CliftonLarsonAllen to prepare the report, which uses payroll-based journal data and Medicare cost reports to estimate the effects of higher staffing ratios. The consultants considered three potential policies: 4.1 hours per patient per day; 3.6 hours per patient; and 3.1 hours per patient.

“Every staffing minimum scenario we analyzed found that tens of thousands of additional full-time employees as well as billions of dollars each year would be necessary in order for nursing homes to be in compliance,” Deb Emerson, a principal at CliftonLarsonAllen, said in the news release.

Federal staffing minimums are part of the Biden administration’s broader push to improve quality and safety in nursing homes after the heavy toll the COVID-19 pandemic exacted on residents and workers, who have been disproportionately affected. Biden also wants to tackle overcrowding, increase inspections and enforcement, and force greater transparency on the nursing home operators.

The Centers for Medicare and Medicaid Services plans listening sessions to gather input from the industry and other parties that would guide the agency’s policymaking, CMS research analyst Pauline Karikari-Martin said during a stakeholder call last week.