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Brake: Long-term care staffing mandate is not the answer

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Adam Brake
By Adam Brake | Point of View

The Haven Health Group proudly serves Arizona seniors through our network of 23 skilled nursing and rehabilitation facilities. Our dedicated caregivers deliver high-quality care to our residents every day, giving peace of mind to their loved ones that they are safe and healthy.

Long -term care is an essential part of our health care system, but access to this care is in jeopardy because of a proposal from the Biden administration to impose a federal staffing mandate on nursing homes.

The long-term care sector is in a rebuilding phase. This is no more evident than the state of our current workforce. Nursing homes have struggled with workforce shortages for years, but the pandemic only made the worse.

We have yet to regain the thousands of workers we have lost since 2020. Burnout has been a primary driver of the exodus of workers, as many have left for other health care sectors or other industries.

A federal staffing mandate would require us to hire many more nurses and nurse aides, which in theory is something all operators in the industry would like. I want to make it clear that we do not oppose the staffing mandates merely because we don’t want more regulations. As an operator, I welcome regulations that ultimately result in better patient care.

The problem is that in the current labor market, the quantities of workers needed to meet the mandate do not exist. Arizona is already one of the worst states for nursing shortages. Ninety percent of Arizona nursing homes do not meet all three requirements of the mandate as it’s currently written. This new regulation is essentially asking us to accomplish an impossible task.

Labor costs are the biggest part of any nursing home budget, and we are already stretching every dollar we can to hire more caregivers. But the proposed mandate will cost nursing homes an additional $51 million per year. Chronic underfunding due to low Medicaid reimbursement rates puts financial strain on many facilities. This is simply cost we cannot absorb.

In order to meet this one-size-fits-all staffing rule, nursing homes may choose to limit admissions by taking beds offline, leaving members of their community with limited services. Some will even suffer a much more devastating fate by permanently closing their doors, leaving their community completely without a necessary service. Seniors will be left without homes and without the care they need. Given that nearly 36 percent of Arizona residents are age 50 or older, and demand for nursing home care continues to grow, safeguarding access has never been more important.

An arbitrary staffing ratio will do very little to fix the underlying cause of our workforce shortage.

Our focus should be on building a stronger pipeline of workers. One solution is tap into the rich market of foreign-born nurses.

One-quarter of direct care workers in Arizona nursing homes are immigrants. They are a vital part of our workforce, and there are thousands of health care workers across our southern border who are willing and able to help fill our labor gap. Through my seat on the Arizona-Mexico Commission, I am working to expedite the process to allow nurses from Sonora, Mexico, to take the appropriate tests, become licensed and work in the U.S. These are the types of solutions that will make a difference in improving quality care for our seniors.

Every nursing home wants to increase staffing levels, but the proposed staffing mandate is not the right approach. Senator Sinema has recognized the flaws of this proposal. Now I hope Senator Kelly will do the same and ask the Biden Administration to rescind this harmful proposal. Thousands of Arizona seniors rely on nursing home care, and we must do everything we can to protect it.

Editor’s Note: Adam Brake is the administrator of Haven of Douglas, a skilled-nursing facility in Douglas, Arizona, and a member of the Arizona-Mexico Commission.

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