The Biden administration finalized on Monday the first-ever minimum staffing rule at nursing homes, Vice President Kamala Harris announced.

The controversial mandate requires that all nursing homes that receive Medicare and Medicaid funding provide a total of at least 3.48 hours of nursing care per resident per day, including defined periods from registered nurses and from nurse aides. That means a facility with 100 residents would need at least two or three registered nurses and at least 10 or 11 nurse aides, as well as two additional nurse staff, who could be registered nurses, licensed professional nurses or nurse aides, per shift, according to a White House fact sheet.

Plus, nursing homes must have a registered nurse onsite at all times. The mandate will be phased in, with rural communities having longer timeframes, and temporary exemptions will be available for facilities in areas with workforce shortages that demonstrate a good faith effort to hire.

The rule, which was first proposed in September and initially called for at least three hours of daily nursing care per resident, is aimed at addressing nursing homes that are chronically understaffed, which can lead to sub-standard or unsafe care, the White House said.

  • @just_another_person
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    408 months ago

    Every point you made is legit, but just like psychiatric hospitals and asylums of yore, the statement you quoted is a threat that they (the profit-based company) will just stop operating certain locations if people (or the government) don’t pay up. They will literally leave the elderly in the front parking lot and shut the place down if they can’t keep their profit margins is what I’m reading into that statement.

    For those unaware, I’m referring to the Reagan administration coming down hard on discontinuing the funding for a lot of government funded psychiatric and elderly care facilities in the 80’s. You can read the Wikipedia article, but it doesn’t really address the insane power these awful and privately operated companies hold over an entire segment of the population in this country, and hold tax dollars as ransom “or else”.

    That man in that quote is making a thinly veiled threat to repeat this shit again.

    • @Nurse_Robot
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      248 months ago

      There’s a difference. Psychiatric facilities struggle with funding, nursing homes ABSOLUTELY do not. Have you seen the cost of living in even the shittiest nursing homes? It’s common practice to be paying upwards of $10,000 per month, per resident. Nursing homes have all the money they could ever want, they’re just greedy fucks who purposely utilize dangerously understaffed facilities to maximize profit for those at the top.

      • @just_another_person
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        88 months ago

        They were lumped together in the Reagan administration culling payments for all times of those though. There are few protections for the elderly even still. You don’t need to dig deep and find a zillion hits about these companies raising care rates out of nowhere to vacate tenants. It’s absolutely insane, and there should be laws against it top to bottom.

      • @MonkRome
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        58 months ago

        Plenty of states it’s much higher, in Minnesota the rate is set by the state according to patient need. It’s not unheard of to pay $15k a month as $14k month is the average cost per resident.

        • @michaelmrose
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          38 months ago

          To aid in contextualizing this they are being asked to spend at least $2,500 of the $14,000 on labor which isn’t remotely unreasonable

      • @andros_rex
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        38 months ago

        Yep, and they pay CNAs subhuman wages so they’re staffed by anyone who can pass a piss test. (My local gas station sells “fetish urine” lol).

        My boyfriend had to put in some hours at a long term care facility as part of nursing school. Absolutely disgusting stuff happens there - the CNAs do not give a fuck (which makes sense, it’s not like you’re making that much better than Macca’s)

      • TheChurn
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        08 months ago

        $120K per year per resident isn’t that much revenue to cover 24 hour availability of care, food, lease, etc.

        I’m not saying it is unworkable, but with the requirement for 3.5 hours of nurse care or resident per day, that means the maximum total cost of a Nurse is $95 per hour, or about $190K.

        That really isn’t much - typically employees cost a business twice their base salary. So the nurses can be paid $100K per year while leaving almost $0 for any other expenses…

          • TheChurn
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            18 months ago

            3.5 hours of nurse care per resident per day (from the bill).

            Resident pays $120K per year to stay at the facility.

            There are 365*3.5 hours in a year they need nursing care = 1277 hours of nursing care per year per client.

            $120K per year / 1277 hours per year = $94/ hr maximum cost for each nurse - assuming there are no other expenses for the facility.

            Must have mistyped to get $95, but that is the math.

            • @Nurse_Robot
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              38 months ago

              Okay, now I understand what you meant by maximum cost. It should be noted that the nurses will likely be paid closer to $30 / hour, give or take depending on the area.

              • TheChurn
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                8 months ago

                The $94/hr isn’t a salary, it’s the cost to the business. Employees generally cost a business 1.3-1.5X their salary - since insurance, payroll taxes, PTO, etc. all also need to be paid for.

                Again this is not considering any other cost for the facility: utilities, food, other staff, medical equipment, maintenance, insurance, rent…

                  • TheChurn
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                    28 months ago

                    That is an insanely small margin, and directly contradicts your claim that they can staff properly.

                    Let’s take the entire profit for the industry and hire nurses. Let’s say reach nurse costs $80K ( $60K salary, $20K for taxes/insurance/other benefits).

                    That pays for 9600 more nurses. Which, given the nursing requirements in the bill (3.48 hours per day per resident), only covers staffing for 22K residents… a rounding error to the more than 1.2 million nursing home residents in the country.

                    There are ~15K nursing homes in the US, each of them getting 0.6 more nurses doesn’t help anything.

        • @michaelmrose
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          38 months ago

          Most of that labor can be filled by nurses aids which make on average $17 an hour not $90