ICYMI: Mark Parkinson: One-Size-Fits-All Nursing Home Fix Doomed To Fail

Workforce; Advocacy; Regulations

In case you missed it, Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), discusses the current state of U.S. nursing homes and the impact of an unfunded federal minimum staffing mandate in a new op-ed published in RealClearHealth.
Nursing homes are still in crisis three years after the start of the pandemic. Workforce levels are the lowest they’ve been since 1994, and more than half of nursing homes say they may not be able to sustain operations for more than one year at their current pace. Worsening labor and economic challenges are negatively affecting seniors’ access to care, as nursing homes nationwide are limiting admissions or closing for good.
The Biden Administration is expected to implement a federal minimum staffing mandate, but an unfunded, one-size-fits-all approach in the middle of a nationwide labor shortage would only further limit access to care. Instead of arbitrary mandates, Parkinson calls on lawmakers to make 2023 the year we work together to pass comprehensive solutions that will transform long term care, including fully funding Medicaid and creating recruitment programs that will help facilities build a strong workforce. 
Read the full op-ed below.
One-Size-Fits-All Nursing Home Fix Doomed To Fail
Mark Parkinson
February 24, 2023
Three years ago, the first outbreak of COVID-19 was reported at a nursing home in Washington State. Today, I am grateful for how far we’ve come. I am especially thankful for the millions of caregivers who faithfully responded and helped save countless lives in long term care and other health care facilities across the nation.
Today, residents in nursing homes and assisted living communities are the safest they’ve ever been against COVID-19 thanks to vaccines, treatments and infection control procedures. More than 50 percent of nursing home residents are up to date with their vaccinations, three times higher than the general population. Weekly mortality rates have been at historic lows for nearly a year.
We are moving forward with greater resolve than ever before to provide the highest quality care for our residents. But our industry is still in crisis. The challenges we must confront, which we have perpetually sounded the alarm about, have worsened in the wake of the pandemic.
Nursing homes across the country are on the verge of financial collapse. Sixty-two percent of nursing home residents rely on Medicaid to pay for their care, but reimbursement rates only cover 86 percent of the total cost.
Nursing homes have spent billions on pandemic-related costs such as personal protective equipment (PPE), testing and staffing. The cost of goods and services has risen 8.5 percent because of inflation. The federal funding that nursing homes received during the pandemic has either been exhausted or is set to run out this year. Today, more than half of nursing homes report they may not be able to operate for more than a year at the current pace.
Further troubling matters, the pandemic has depleted our workforce. Unimaginable stress and burnout have caused caregivers to exit the industry in droves, leaving us with the lowest workforce levels since 1994. While most other health care sectors have rebounded, nursing homes are still down 210,000 workers since the start of the pandemic.
Nursing home providers are doing all they can to hire more staff, but their resources are limited. Nine out of 10 providers have increased wages or offered bonuses to aid retention and recruitment. In fact, wages for nurses have increased by 28 to 34 percent from 2020 to 2022. Despite these incentives, 96 percent of providers are still struggling to find staff.
Our financial and workforce crisis is having a detrimental impact on access to care for our nation’s seniors. With too few workers, more than half of facilities are forced to limit the number of new residents they can accept. More than 35,000 beds have been taken offline, as these staffing shortages force facilities to close wings and units. For some, keeping their doors open is simply unsustainable. More than 450 nursing homes have closed during the pandemic, displacing more than 18,000 seniors. 
Hospitals are directly affected by nursing home staffing shortages, as patients are waiting days, weeks and sometimes months to be discharged to a nursing home for recovery. Hospital backlogs are causing emergency waiting rooms to overflow into hallways. Limited access to care is hurting our most vulnerable citizens.
We can do better, and we must do better.
Nursing homes cannot fix these problems alone. The Biden Administration is expected to implement a federal minimum staffing mandate in the coming months. This mandate, which currently neglects to offer any resources, is a one-size-fits-all approach that fails to address the root cause of staffing shortages and will only make our labor crisis worse.
A bipartisan group of senators sent a letter to the Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure, discouraging the administration from adopting this proposal and expressing particular concern about its impact on our rural and underserved communities.
We must broaden our focus and craft policies that will truly transform our industry. We need to fully fund Medicaid so nursing home providers can compete for workers and enhance their services and infrastructure. We need programs that will incentivize the next generation of health care workers to choose a career in long term care, such as tuition reimbursement and loan forgiveness. These investments will lead to better care and better patient outcomes.
The long term care profession is committed to being part of the solution. We recently launched Careers in Caring, a nationwide campaign to help attract and retain caregivers. In 2021, we proposed the Care for Our Seniors Act with four pillars of reform that will help strengthen nursing home care. A collaborative partnership between industry leaders and lawmakers will ensure that our seniors have access to the best long term care services possible.
Our aging population is growing rapidly. The time to prepare is now. Supporting long term care must be a priority for policymakers this year. In 2023, let’s put seniors first.