Arizona's 143 nursing homes are subject to new federal staffing mandate. What happens now?
Download mp3 (1.52 MB)Last week, the federal government announced it would require minimum staffing levels at nursing homes that receive funds from the Centers for Medicare and Medicaid Services. KJZZ spoke with one policy expert about the new rule and what it means.
David Grabowski is a professor of health-care policy at Harvard Medical School. He's a little like Switzerland when it comes to staffing mandates.
"I think at a high level, it's a really important step forward. Is the rule perfect? No, of course not," Grabowski said.
But something is better than nothing, he said.
"And so I think we've had a lot of complaints from the industry; we've had a lot of complaints from advocates about the rule. One interpretation is, that means that CMS has done something where everybody's upset, meaning that you're doing something right," Grabowski said.
But not everything. A concern for Grabowski is how licensed practical nurses could be affected. LPNs fall in between RNs and certified nursing assistants, and they play a critical role in nursing homes. The rule requires a minimum number of hours that RNs and CNAs spend with residents. LPNs weren’t included in the calculations.
"So, I worry a little bit that this is going to lead to nursing homes after to recruit more RNs, fewer LPNs, and they're going to fill up the remainder with CNAs," Grabowski said.
Another area of concern for Grabowski is when it comes to transparency.
"If you talk to nursing homes, they claim they can’t afford this. If you talk to advocates, they say there's plenty of money in the system. And so I think one of the things I like to argue about this rule is that it should be part of a broader package of reforms. And part of that package should be getting greater transparency or accountability in terms of how nursing homes are spending our public dollars," Grabowski said.
And understanding what a nursing home can afford or what additional dollars are necessary in order to maintain certain mandatory staffing levels is important information.
"We don't want to put any any facilities out of business; on the other hand, we don't want them hiding profits," Grabowski said.
Arizona has 143 nursing homes. The state’s more than 2,000 assisted living facilities are not affected by this rule.
