Money and Flag
(Credit: Getty Images)
Money and Flag
(Credit: Getty Images)

Providers would have to spend an additional $10 billion more per year and hire more than 187,000 new workers to meet requirements of one possible federal minimum staffing approach, according to a new analysis. 

The findings prove that nursing homes would need “substantial and consistent government resources” to comply with the regulations, the nation’s largest nursing home association said. 

“Every staffing minimum scenario we analyzed found that tens of thousands of additional full-time employees as well as billions of dollars each year would be necessary in order for nursing homes to be in compliance,” said Deb Emerson, principal at CliftonLarsenAllen. “Many facilities will have to make difficult decisions, such as reducing census, to meet the proposed staffing minimums.”

The American Health Care Association, in conjunction with CLA, released a new report Tuesday that estimated the impact of implementing a minimum staffing requirement at three different levels: 4.1 hours per patient day, 3.6 HPPD and 3.1 HPPD. The firm used Payroll Based Journal staffing data and hourly rates from Medicare cost reports for the study. 

The Centers for Medicare & Medicaid Services is in the midst of examining ways to set minimum staffing requirements for nursing homes as part of President Joe Biden’s nursing home reform initiatives. The agency called on providers to give input on the matter when it issued its proposed 2023 Skilled Nursing Facilities Prospective Payment System in mid-April. Officials received more than 3,000 comments, which CMS says it is weighing as it designs a study on minimum staffing that will lead to the development of a proposal in 2023.

In the CLA report, just 6% of, or 844 nursing homes, would have met the 4.1 HPPD criteria in the fourth quarter of 2021, while 1,919 providers (13%) would have met the 3.6 HPPD standard and 3,870 facilities (27%) would have met the 3.1 HPPD mark. 

It would also cost providers nearly $10.1 billion annually to meet the minimum staffing in the 4.1 HPPD scenario; $6.4 billion annually to meet the 3.6 HPPD standard and $3.5 billion to meet the 3.1 HPPD mark, the study found.

CLA also found that providers would need to hire 187,112 more full-time certified nursing assistants, licensed practical nurses and registered nurses combined to meet the 4.1 HPPD standard. Providers would need to hire 115,839 full time employees under the 3.6 mark and 60,037 under the 3.1 standard. 

“This report makes it crystal clear that increasing staffing standards in nursing homes requires substantial and consistent government resources,” AHCA President and CEO Mark Parkinson said in a statement Tuesday. 

“The unintended consequences of this sort of unfunded mandate would be devastating to hundreds of thousands of vulnerable residents who could be forced out of their nursing home,” he added. 

A previous study found that it would cost most facilities $530,000 per year in order to meet the benchmark, and nearly $5 billion annually nationwide.