A trade group representing certified nursing assistants wants federal officials to increase the number of direct care hours proposed under a mandatory staffing rule by 40%.
The National Association of Health Care Assistants said that the proposed 3.0 hours per patient day of direct care does not go far enough and wants the number at 4.2 per patient per day. The group said, however, that it “enthusiastically” supports the proposed rule overall.
The NAHCA proposal was certain to outrage providers, who have called for clicking down the staffing proposal demands, if not eliminating them altogether.
“We think this is an important first step to address an issue that is plaguing the profession and has resulted in CNAs — who loved their residents and were proud to be part of caring teams — leaving the profession in droves for hospitality, retail, and other jobs that are safer, less stressful, and better paying,” NAHCA said in a statement issued Friday attributed to its Board of Directors. “Ultimately, we enthusiastically support higher minimum staffing requirements for nursing homes. … Facilities must prioritize ensuring adequate staff to provide quality, person-centered care to each and every resident, without the risk of physical or mental stress on the part of CNAs and other team members.”
The group also wants the Centers for Medicare & Medicaid Services to automate fines and payment denials for daily staffing violations that are reported on facilities payroll-based journal systems.
Lori Porter, co-founder and CEO of the association, told McKnight’s Long-Term Care News on Friday that the group plans to submit formal comments to CMS similar to its statement.
The Centers for Medicare & Medicaid Services unveiled details of the long-awaited staffing minimums proposal Sept. 1, calling for a minimum of 3.0 hours per patient day of direct care with 0.55 hours of that by a registered nurse and 2.45 hours by a nurse aide.
The proposal would require 24/7 RN coverage — triple the current standard — that would go into effect for urban providers two years after the rule is finalized; rural providers would have an extra year to come into compliance with this provision. Rural facilities would also get five years to meet the 3.0 hours while non-rural nursing homes would have three years to comply with that. Facilities could also apply for hardship waivers to be excused from all or parts of the rule.
The National Association of Health Care Assistants wants to see any discussion of waivers eliminated from the rule and shorter implementation timelines, stating that the phase-in periods are too long and don’t address immediate staffing needs.
In April, the association released a survey of nearly 3,000 members that named staffing shortages and low pay as the top challenges facing CNAs. The statement issued in support of the staffing rule noted that CNAs are “leaving the profession in droves for hospitality, retail, and other jobs that are safer, less stressful, and better paying.”
The group’s recommendation to increase the proposed staffing minimums to 4.2 total hours per resident per day breaks down to 0.75 RN hours that would include licensed practical nurses and 2.8 hours from a CNA. The cost for the higher hours would come out to less than 5% of “billions in dollars” that nursing homes receive each year from federal programs and private payers, the association noted.
“Specifically, the costs amount to $16.49 per resident per day,” the group’s statement said. “To us, these seem like a reasonable expenditure to enable the best possible care, safety, and quality of life for residents.”
