The two largest organizations representing US nursing homes this week fired back against a pair of influential lawmakers who have tried to paint industry efforts to stop a minimum staffing rule as motivated by “greed.”
American Health Care Association President and CEO Mark Parkinson called last month’s accusations by Sen. Elizabeth Warren (D-MA) and Rep. Jan Schakowsky (D-IL) “offensive,” arguing that provider organizations are protesting the unfunded mandate because it threatens seniors’ access to care. A previous analysis found the new staffing rules could force nursing homes to limit services or close, possibly displacing 290,000 residents at a time when the senior population is growing.
“We believe we share a common goal: to ensure every senior in America has access to the quality care they need and deserve,” Parkinson wrote Monday. “Reasonable people should be able to discuss policy differences without questioning the motives of one another.”
LeadingAge President and CEO Katie Smith Sloan also pushed back against the narrative of corporate malfeasance that was promoted by the lawmakers in a June 30 letter sent to her and Parkinson — and also shared with a widely read Capitol Hill publication.
Sloan said LeadingAge had made its opposition to the rule “extremely clear” for a simple reason.
“America’s current infrastructure of long-term care cannot sustain staffing mandates until they are supported by adequate funding and available staff,” she wrote Monday. “By our calculations, at least 27,000 additional full-time equivalent registered nurses and 78,000 additional full-time equivalent nurse aides are needed (not including exemptions or waivers), just in the first full year of implementation. Where will those 100,000 caring, qualified individuals come from? And what about the cost?”
“The staffing mandate simply ignores the bigger issues: lack of staff and — even if they were readily available — the dearth of additional funding to support the costs imposed by the mandate,” Sloan added.
Estimates for the annual cost of compliance have ranged from $6 billion to more than $10 billion.
Willing to partner on policy
Both AHCA and LeadingAge noted that they had endorsed other legislation that would increase staffing in nursing homes, including the 2021 Care for Our Seniors Act that would have required — and funded — 24/7 RN staffing for nursing homes.
Each executive asked for partnership on the issue, rather than blame. Their letters were calm and collected compared to the sharp-toothed missive publicized by the lawmakers.
“Your attempts to reverse this rule make a mockery of your claim that you have an ‘unwavering… dedication to providing quality care solutions for people who are frail, elderly, or living with disabilities, and you should put a halt to these misguided efforts,” the lawmakers wrote on June 30.
“Industry claims that nursing homes cannot afford to hire more nurses are undermined by a recent investigation by our offices, which found that for-profit nursing homes have been stuffing hundreds of millions of dollars into their pockets with sky-high executive salaries, massive dividends, and large stock buybacks,” they added.
While the lawmakers have been highly critical of the associations’ campaigns against the staffing rule — including lobbying efforts for which they requested additional spending documentation — Schakowsky has been openly aligned with union leaders on the issue.
Health and Human Services Sec. Xavier Becerra had previously credited the SEIU and other unions with bringing the staffing rule to life.
Multi-front fight
On Tuesday, a coalition of nearly 50 labor organizations headed by the AFL-CIO sent its own letter to Congress, urging legislators to vote against more than a dozen forthcoming Congressional Review Act resolutions they call anti-worker, including an “imminent” vote to overturn the Centers for Medicare & Medicaid Services’ nursing home staffing standards.
“We ask that you not allow private equity, the financial industry, multinational franchisors, union busters, or other special interests to use this tool to undo the progress that workers are making via federal rulemaking,” the signees, including the SEIU, wrote. “There may be upcoming votes disapproving of HHS’s groundbreaking Nursing Home Staffing Rule, as well as the DOL’s Retirement Security and Overtime Rules, among others. We strongly urge you to stand with working families and vote no on all such CRA resolutions. And should those resolutions pass and be rightfully vetoed, we likewise urge you to vote against overturning that veto.”
While AHCA and LeadingAge have backed the use of the Congressional Review Act and other legislative fixes in Washington, DC, they each are also involved in a federal lawsuit filed in Texas that seeks to block the rule.
“Whether through the courts or Congress, we will continue to vigorously defend our members, those they serve, and those they employ,” Parkinson told Warren and Schakowsky. “Federal agencies cannot exceed their statutory authority, and we cannot stand idly by when unfunded mandates threaten to negatively impact our residents.”
