ATLANTA — For the first time, the federal government plans to regulate staffing levels at nursing homes.
The proposal, announced on Sept. 1, follows a push by the Biden administration to deliver on the President’s State of the Union promise earlier this year. The White House called the proposed federal minimum staffing requirements and enforcement efforts part of the plan to ‘crackdown’ on nursing homes chronically understaffed—which can endanger those in its care.
However, those in the nursing home industry in Georgia and across the country question the ability of facilities to meet a new staffing mandate amid a worker shortage.
“We completely understand the administration's attempt to put standards to our industry,” Deke Cateau, CEO of A.G. Rhodes in metro Atlanta, told 11Alive. “We understand that we care for the most vulnerable of individuals, but we really think this has been not done in the right way.”
Cateau is among those calling the plan ‘cookie cutter,’ adding it doesn’t take into account other roles, such as licensed practical nurses and other caregivers.
“Each of our facilities is extremely different, and I think this approach suggests that all nursing homes on the same level look the same, and all nursing homes take care of the same types of residents,” Cateau said.
The proposed federal staffing rule, which would phase in over years and include a hardship exemption, calls for staffing equal to three hours per resident per day, just over half an hour from registered nurses. Facilities would also be required to have a registered nurse on staff at all times, per the proposal.
According to unions representing some nursing home workers, the proposal marks a “critical first step.”
“Our country doesn’t have a shortage of good nursing home workers—just a shortage of good nursing home jobs,” AFL-CIO President Liz Shuler said in a statement. “Workers and the families of residents have been sounding the alarm for decades about the need for a minimum national staffing standard in nursing homes, and we commend the Biden–Harris administration for answering the call.”
Yet, industry associations representing nursing homes, such as the Georgia Health Care Association (GHCA) and LeadingAge Georgia, said in an Oct. 25 letter that “an unfunded mandate amid an ongoing workforce crisis will be impossible for nursing homes to meet.”
The groups said Georgia nursing homes would need to hire an additional 3,652 caregivers under the proposal, adding that less than 1% of Georgia facilities currently meet all three of these staffing requirements.
“I speak to many providers, and I do not know a provider nationwide who does not want more staff,” Cateau said. “The problem is the supply right now just is not there.”
As one of the state’s few nonprofit nursing homes, A.G. Rhodes can rely on donor funding as needed, Cateau said, but he worries about whether he’ll be able to continue other therapy programs if he has to pivot funding. He also points to other positions, such as licensed practical nurses, that are not included in the proposal and notes that facilities in rural Georgia will have fewer options.
“We have counties in this state that have little to no registered nurses,” he said. “We have to think about the entire system and how can we help improve the nation's care for seniors.”
Georgia Governor Brian Kemp joined 14 other Republican governors in a letter calling for President Biden to reconsider the mandate. You can read that letter here.