Vice President Kamala Harris speaking on the finalized CMS staffing rule at a roundtable event in Wisconsin

Vice President Kamala Harris led a roundtable discussion that included local nursing home staff in La Crosse, WI, Monday — continuing the Biden administration’s push announcing the finalization of the first ever federal nursing home staffing rule. 

Joining Harris were Chiquita Brooks-Lasure, administrator of the Centers for Medicare & Medicaid Services, April Verrett, secretary-treasurer of the SEIU and several veteran certified nursing assistants affiliated with the SEIU Wisconsin.

Speaking to a gathering of nursing home employees, Harris repeatedly emphasized how the new 3.48 hour staffing mandate would impact the lives of both nursing home frontline workers and residents.

“Today’s conversation really is about the safety, the dignity, the guarantee of self-determination that comes with the work that home healthcare workers and [nursing home] care workers do,” Harris said — referencing both the newly finalized staffing mandate and another finalized rule requiring 80% of Medicaid payments for home care be invested in staff wages.

Harris noted that the majority of nursing homes are understaffed — estimating that mark to be around 75%. Brooks-Lasure and Verrett joined the vice president in championing the new rules as a means of ensuring adequate support for care workers and adequate care for residents who might be forced to wait long periods for otherwise routine daily care at severely understaffed facilities. 

The appearance came after the White House had teased Monday’s staffing rule release in a statement, but before providers had seen a chance to see hundreds of pages of details released late Monday afternoon.

A gulf between reactions

Long-term care providers have reacted strongly to the finalized rule. While many acknowledge its good intentions for senior care, the common refrain is that the rule places a high and one-site-fits-all financial burden on already struggling facilities without offering any substantial supplemental funding to assist.

Mark Parkinson, president and CEO of the American Health Care Association, on Monday called the final rule “an impossible task” for nursing homes already struggling to hire and retain workers.

Per the rule, 3.48 hours of care per resident per day must be split between at least 0.55 from registered nurses and at least 2.45 from CNAs, with the additional remaining time more flexibly reserved for CNAs or licensed practical nurses

The 3.48 mark is notably higher than the initially proposed 3.0 hours. Brooks-Lasure told frontline staff in Wisconsin that comments CMS received from workers and residents contributed to that change.

“I just want to say how much all of the stories that we have heard… really impacted all of the analysis that went into this rule,” she said. 

Labor leaders at the roundtable joined Harris and Brooks-Lasure in support of the new mandate.

“Care workers across the country are united in our demand for safe staffing levels, better quality care and employer accountability for our nation’s nursing homes,” said Verrett.

The rule is also expected to ratchet up wages significantly, as both skilled nursing providers and home care jockey for a limited labor pool amid increased regulation.