How’s this for a truly perplexing recipe? Nursing homes are closing, access to care for seniors and adults with disabilities is being restricted, Medicaid reimbursement can’t keep pace with the true cost of care, and fewer and fewer workers are available for staffing the plethora of jobs available throughout the long-term care continuum.

Yet regulators in Washington, D.C., think the perfect addition to this already-blistering five-alarm chili is an unfunded, one-size-fits-all staffing mandate.

No matter how it might be garnished and presented, there’s nothing that will help providers and residents in need of care to swallow down this truly awful concoction.

Here are the facts: there is no new funding attached to this staffing mandate; there has been no movement on comprehensive immigration reform or expanded access for healthcare employers to unused H-1B temporary work visas for nurses; there is no consideration for how a federal mandate undermines existing state staffing regulations with a new, incomparable federal mandate; and there is little being done to build a workforce pipeline for the number of workers we’ll need today and well into the future.

The Biden administration, as well as the elected leaders who supported this mandate, knowingly put the cart before the horse, leaving residents to scramble to find care and providers to question the very viability of their operations. 

Two years ago, Pennsylvania’s governor, the workers’ unions and key long-term care stakeholders forged a path forward to enhancing care with increased staffing requirements and a commitment to fund the new mandate. It was that commitment — and collaboration — that drove progress in the commonwealth. 

And while we are still working to secure additional funding to offset the cost of that mandate, the new regulations we agreed to provided an infinitely better result for long-term care workers, residents and providers. 

But today, the shortsightedness of an administration that believes in a one-size-fits-all model — regardless of what states across the country are already doing or have done — is about to disrupt that progress.

To meet both Pennsylvania’s new staffing mandate and this federal mandate, our providers alone will need to find more than 1,000 registered nurses, 6,000 certified nurse aides and 700 licensed practical nurses. If these caregivers even exist, it will cost those same providers more than $540,000,000 total — a mandatory bill without another source to fund it. The ultimate price will be more nursing home closures across the commonwealth, or more providers being forced to close their doors to new residents.

Workers will not just “materialize” for us to meet this mandate. And it’s irresponsible to ignore the research that demonstrates the growing demand for care, the lack of caregivers, and the resulting impacts felt throughout the healthcare continuum. In 2021, Mercer released a report detailing that Pennsylvania will face a shortage of more than 20,000 registered nurses by 2026; but in 2024, the Biden administration believes our state has a surplus of more than 1,000 registered nurses to hire.

We’ve been proud to join AHCA/NCAL and others in calling on the Biden Administration and members of Congress to propose real, tangible staffing solutions to the workforce crisis impacting long-term care. We believe our seniors, adults with disabilities and their caregivers deserve nothing short of those solutions — similar to the work we did in Pennsylvania in 2022. 

The regulatory success of an administration is not measured by the destruction of the long-term care continuum. There are no political points awarded for the amount of hardship levied on nursing home providers, workers and residents — only additional burdens to access to care for hundreds of thousands of vulnerable senior citizens and adults with disabilities.

It’s time to reduce the heartburn caused by this five-alarm regulatory dish — long-term care is already running on fumes. Regulators and elected leaders need to have a taste of reality — and they very likely will in the near future — to truly understand what shortsighted, misguided staffing mandates do to resident care. 

Rather than react to harmful mandates, the long-term care continuum needs help in serving up solutions that address the growing demand for care across this country. It’s past time to bring everyone to the table to figure this out. 

Otherwise, all we’ll be left with is a real mess. 

Zach Shamberg is the president and CEO of the Pennsylvania Health Care Association (PHCA), a statewide advocacy organization for Pennsylvania’s most vulnerable residents and their providers of care.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.

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