A coalition backing nursing home workers in Rhode Island is calling for a $15-per-hour wage for certified nursing assistants and new minimum staffing hours, even as nearby states are experiencing closures at facilities struggle to make payroll.

The District 1199 SEIU New England union blamed low wages and high staff turnover for what it calls a “resident care crisis” in the Ocean State.

“Rhode Island nursing homes are understaffed and Rhode Island caregivers are underpaid,” certified nursing assistant Shirley Lomba said at a Thursday press conference, during which the union and a coalition of other groups supporting workers and families unveiled a report titled, “Raise the Bar on Resident Care.”

Skilled nursing providers in nearby states pay their CNAs at least a dollar per hour more on average, the report said. For Rhode Island, the average rate is $14.42 hourly.

The Rhode Island coalition — which also includes the RI Interfaith Coalition to Reduce Poverty, the Women’s Fund of Rhode Island, Rhode Island AFL-CIO, and the RI Organizing Project — wants the minimum pushed to at least $15 an hour.

“Like many other states, Rhode Island is facing staffing challenges,” Scott Fraser, president and CEO of the Rhode Island Health Care Association told McKnight’s via email. “Skilled nursing facilities received a 1% increase in Medicaid funding for the upcoming year. We continue to advocate for additional Medicaid funding in order to provide quality care for our residents and to retain our caring and dedicated staff.”

Facilities in states that have pushed the general minimum wage to $15 are struggling to pay all the help they need. Some have pointed to increased salary pressure in announcing closures.

In Connecticut, provider organizations said this spring that raising that state’s minimum wage to $15 would have a devastating impact on that state’s skilled care facilities. LeadingAge Connecticut estimated its 35 members would need to pay an additional $9 million in wages.

They were already struggling, with as many as 3,100 workers threatening to strike. Gov. Ned Lamont (D) agreed to negotiate increased Medicaid payments totaling 4% between this month and January 2021.

In other areas, pay rates have risen naturally as skilled nursing providers try to attract and retain talent in a tight labor market. But even in those cases, providers struggle to cover all their bills without a matching increase in Medicaid reimbursements.

In Massachusetts, rates have been stagnant since 2007. As many as 35 facilities were threatening to close earlier this year, and state officials have since agreed to include $50 million more in a proposed budget. But providers there still have an annual Medicaid shortfall of more than $300 million, which has prevented some from making wage improvements.

The Rhode Island coalition argues its demands will result in better care. In addition to pay increases, members want the state to regulate a minimum staffing requirement of 4.1 hours of direct care per resident per day. The state is one of just 11 that does not have its own rules, according to the “Providence Journal.”

“When our residents have more time with their caregivers, they have better outcomes,” CNA Lomba said. “The lack of staffing standards forces us to rush through the very basics of care and doesn’t give us any time to answer questions or even just chat with our residents; basic things that are necessary to maintain quality of life.”