While nursing home operators scurried to read proposed new demands regarding a first-ever nursing home staffing mandate Friday, they were also left with another powerful blow to absorb: A full-on attack by President Joe Biden, who aggressively detailed the rationale for the new rule in a guest column in USA Today.

Some long-term care leaders quickly equated the president’s message with an attempt to manipulate the perception of actual conditions.

The controversial staffing proposal calls for 3.0 hours of nursing care per patient per day and also would require round-the-clock registered nurse coverage in a facility every day of the year.

The announcement ignited critical reactions from operators, some of whom found small silver linings in the long-awaited proposal, but who generally are up in arms about being mandated to employ more workers amid nationwide staffing shortages. Meanwhile, consumer groups and other third parties angrily chimed in, hailing the rule’s release but railing that it isn’t tough enough.

As is customary, heads of the Department of Health and Human Services and Centers for Medicare & Medicaid Services released remarks on the proposal. 

But it was the extra Biden column (titled “Nursing homes are putting residents at risk. We’re ending the abuse today”) that made abundantly clear in plain language who is being targeted. For-profit and private-equity-owned nursing facilities remain the primary target.

“We are working to make sure no nursing home can sacrifice the safety of their residents just to add some dollars to their bottom line,” wrote Biden (pictured, during a 2022 speech). “It’s telling that non-profit nursing homes are three times as likely as for-profit facilities to already satisfy the minimum staffing standard we’re proposing today. Some corporate nursing home owners are taking taxpayer dollars while cutting corners on staffing so they can make big payouts to executives and shareholders. It’s wrong.”

He said the new measure should improve workforce conditions.

“We’re also supporting the folks who are doing God’s work — the nursing staff who care for so many of our loved ones, but who are over-worked and under-resourced,” he said. “Nursing home staff describe getting burnt out when they have too many residents to care for in too little time. Many end up leaving the industry. Minimum staffing standards would help them stay in the jobs they love.”

In setting up his argument against nursing homes, Biden implied the responsibility for any shortcomings has been operators’ and not necessarily the government institutions that fund and regulate them.

“Unfortunately, too many Americans across the country know firsthand how hard it can be to find a nursing home that provides that peace of mind” when searching for a facility for a loved one, he wrote.

He also imputed 200,000 nursing home resident and worker COVID-19 deaths to having too few staff on duty. And as has been the case several times over the last two years, he saved some of his strongest language for investors.

“[I]n recent years, more private-equity firms have been buying up nursing homes and slashing key staff to cut costs and make bigger profits, endangering the safety of their residents in the process,” Biden wrote.

The tough language continued throughout for those in the business of taking care of seniors, as Biden addressed potential voting blocs, including an endorsement of union membership, and put long-term care business further under the spotlight. 

“As a country, we’re delivering a clear message to the nursing home industry: no more padding profits on the backs of residents and nurses. If you tell families you’ll take care of their loved ones, then follow through,” he said.

“I have your back,” he concluded to those families.