The majority of US nursing homes currently meet at least two of the three criteria of the federal nursing home mandate, according to a new brief from federal health officials. Only about 30% meet the requirements for certified nursing assistants, however.
The 12-page report examined what percentage of facilities meet the requirements and also estimated how many new staff positions would have to be filled by the average nursing home that cannot yet meet them. It was published Friday.
Overall, report authors gave an optimistic outlook of providers’ potential ability to meet the new requirements.
“Our results show that a majority of US nursing facilities currently staff at or above the level of two of the three minimum HPRD requirements of the final rule,” wrote its authors, a group of four policy and social science analysts with the Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation (ASPE)
As of May, 50% of nursing homes met the requirement for registered nurse care and 59% met the overall benchmark for 3.48 hours of care per resident per day. Only 30% met the requirement for CNA hours, however — a signal of the staffing retention woes that have plagued the long-term care sector for years.
“Recruiting CNAs has always been a challenge given lower wages, competition with other industries for the same workers, and the hard physical labor and emotional stress that comes with the job,” Sarah Friede, senior vice president of recruitment services at Health Dimensions Group told McKnight’s Long-Term Care News Monday.
The ASPE analysts acknowledged relying on government data that could not specify whether facilities were providing 24/7 registered nurse care or not, but noted that 78% of nursing homes are providing at least 24 hours of RN care each day.
The analysts suggested a fairly light amount of additional staffing would be needed by facilities that fall below the benchmarks set by the Centers for Medicare & Medicaid Services in April.
“Our analysis finds that for an average-sized (i.e. 100-bed) nursing home that staffed below at least one of the minimum HPRD requirements, relatively few staff would need to be added to each shift (between 0.7 and 2 additional staff per shift, depending on the role) in order to staff at or above the minimum HPRD requirements,” they wrote.
Again, CNAs would require the largest adjustment, with the average facility currently below the CMS requirement projected to need two new CNAs per eight-hour shift.
Providers, however, have been sounding the alarm on a workforce that has never fully recovered to pre-COVID-19 pandemic numbers and may be showing signs of stagnation.
Friede told Mcknight’s that there have been some positive shifts in the workforce broadly, but that these changes don’t necessarily apply to all care worker positions or all providers.
“Every community, organization and location have their own unique set of challenges and need to remain competitive with others in their market by adjusting and reevaluating a number of factors from wages, internal equity, benefit offerings, community culture and reputation,” she said.
