{"id":10326,"date":"2024-04-22T15:28:52","date_gmt":"2024-04-22T15:28:52","guid":{"rendered":"https:\/\/wifamily.news\/?p=10326"},"modified":"2024-04-22T15:58:13","modified_gmt":"2024-04-22T15:58:13","slug":"april-healthcare-highlight-while-nursing-homes-struggle-to-meet-need-new-biden-rules-will-make-things-even-harder","status":"publish","type":"post","link":"https:\/\/wifamily.news\/?p=10326","title":{"rendered":"April Healthcare Highlight: While Nursing Homes Struggle to Meet Need, New Biden Rules Will Make Things Even Harder"},"content":{"rendered":"<p>This post originally appeared at <a href=\"https:\/\/will-law.org\/while-nursing-homes-struggle-to-meet-need-new-biden-rules-will-make-things-even-harder\/\">https:\/\/will-law.org\/while-nursing-homes-struggle-to-meet-need-new-biden-rules-will-make-things-even-harder\/<\/a><\/p>\n<p>By Miranda Spindt<\/p>\n<p><span data-contrast=\"none\">Medicaid provides long-term care services for eligible seniors<\/span><span data-contrast=\"none\">1-co<\/span><span data-contrast=\"none\">vering 100% of the costs\u2013 and making up <\/span><a href=\"https:\/\/crsreports.congress.gov\/product\/pdf\/IF\/IF10343#:~:text=In%202021%2C%20Medicaid%20LTSS%20accounted,for%20which%20data%20are%20available).\"><span data-contrast=\"none\">32.1%<\/span><\/a><span data-contrast=\"none\"> of all Medicaid spending. Long-term demographic changes have put the future of this program in jeopardy. By 2030, everyone in the Baby Boomer generation will reach the age of 65 and, for the first time in history, seniors are projected to <\/span><a href=\"https:\/\/www.census.gov\/library\/stories\/2018\/03\/graying-america.html#:~:text=In%20less%20than%20two%20decades,in%202034%20(previously%202035).\"><span data-contrast=\"none\">outnumber children<\/span><\/a><span data-contrast=\"none\"> under the age of 18 by 2034. This means there will be fewer working adults to care for the higher number of seniors. With long-term care facilities struggling to find staff, we are already seeing the consequences.\u00a0<\/span><span>\u00a0<\/span><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"aligncenter wp-image-34682\" src=\"https:\/\/wifamily.news\/wp-content\/uploads\/2024\/04\/Screen-Shot-2024-04-16-at-2.50.27-PM.png\" alt=\"\" width=\"707\" height=\"748\" \/><\/p>\n<p>\u00a0<\/p>\n<p><span data-contrast=\"none\">In Wisconsin, <\/span><a href=\"https:\/\/www.news-shield.com\/news\/free_news\/article_53c00092-a7c2-11ed-a1f9-8b56eda25c3b.html#:~:text=%E2%80%9CWe%20have%20tracked%20facility%20closures,like%20Prairie%20Farm%2C%20Sauer%20added.\"><span data-contrast=\"none\">60 nursing homes<\/span><\/a><span data-contrast=\"none\"> have closed since 2016 largely due to a shortage of Certified Nursing Assistants. <\/span><span data-contrast=\"auto\">A study<\/span> <a href=\"https:\/\/www.leadingagewi.org\/media\/113792\/2022-workforce-report-7-13a.pdf\"><span data-contrast=\"none\">from 2022<\/span><\/a><span data-contrast=\"none\"> highlights some troubling statistics about the future of the long-term care workforce in Wisconsin.\u00a0<\/span><span>\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">The number of unfilled caregiving positions in nursing homes and other elderly care employment was 12.9% in 2016. In 2022, that was more than doubled at 27.8%. That includes certified nursing assistant positions with a vacancy rate of 28.4%. <\/span><span>\u00a0<\/span><\/li>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"none\">The COVID-19 pandemic hit healthcare employment hard, but long-term care facilities have not recovered as well as other sectors such as hospitals and clinics due to having the strictest COVID-19 safety requirements, and inability to compete with private sector employee pay and benefits. <\/span><span>\u00a0<\/span><\/li>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"none\">As the elderly population rises shown in the image below, there is a projected gap of 19,800 registered nurses by 2040 in the long-term care sector.<\/span><span>\u00a0<\/span><\/li>\n<\/ul>\n<p>\u00a0<\/p>\n<p><span><img decoding=\"async\" loading=\"lazy\" class=\"aligncenter wp-image-34683\" src=\"https:\/\/wifamily.news\/wp-content\/uploads\/2024\/04\/Screen-Shot-2024-04-08-at-1.25.13-AM.png\" alt=\"\" width=\"1233\" height=\"540\" \/><\/span><\/p>\n<p><span>\u00a0<\/span><\/p>\n<p>\u00a0<\/p>\n<p><span data-contrast=\"none\">The quality of care suffers as facilities are understaffed and employees are overworked. The number of complaints against nursing homes has been <\/span><span data-contrast=\"auto\">rising in recent years as the staffing shortage has worsened. This is especially problematic in rural areas where older adults are a <\/span><a href=\"https:\/\/www.pewresearch.org\/social-trends\/2018\/05\/22\/demographic-and-economic-trends-in-urban-suburban-and-rural-communities\/\"><span data-contrast=\"none\">higher share of the population<\/span><\/a><span data-contrast=\"auto\"> compared to urban or suburban areas, and they already struggle finding workers in multiple healthcare sectors with many counties designated as <\/span><a href=\"https:\/\/www.dhs.wisconsin.gov\/primarycare\/maps.htm\"><span data-contrast=\"none\">Health Professional Shortage Areas<\/span><\/a><span data-contrast=\"auto\"> for primary, dental and mental care.<\/span><span>\u00a0<\/span><\/p>\n<p>\u00a0<\/p>\n<p><span><img decoding=\"async\" loading=\"lazy\" class=\"aligncenter wp-image-34681\" src=\"https:\/\/wifamily.news\/wp-content\/uploads\/2024\/04\/Screen-Shot-2024-04-18-at-9.41.39-AM.png\" alt=\"\" width=\"1067\" height=\"1096\" \/><\/span><\/p>\n<p>\u00a0<\/p>\n<p>\u00a0<\/p>\n<p><span data-contrast=\"auto\">The Biden Administration <\/span><a href=\"https:\/\/www.whitehouse.gov\/briefing-room\/statements-releases\/2023\/09\/01\/fact-sheet-biden-harris-administration-takes-steps-to-crack-down-on-nursing-homes-that-endanger-resident-safety\/#:~:text=This%20means%20that%20a%20facility,one%20shift%20during%20the%20day.\"><span data-contrast=\"none\">proposed a rule<\/span><\/a><span data-contrast=\"auto\"> last September that would require minimum staffing levels at to attempt to improve the q<\/span><span data-contrast=\"none\">uality of long-term care. But like most well intentioned federal government rules, this could actually have the exact opposite effect. The rule would require a registered nurse to be on-site 24 hours a day, and for each resident, there must be 33 minutes of registered nurse care and 147 minutes of nurse aid care each day. This means that a facility with 100 residents and 8-hour shifts must be staffed with two or three registered nurses and about ten nurse aides each shift. If this rule is passed, <\/span><a href=\"https:\/\/www.wpr.org\/economy\/wisconsins-elder-care-facilities-face-staffing-financial-challenges-threaten-care\"><span data-contrast=\"none\">3 in 4 facilities<\/span><\/a><span data-contrast=\"auto\"> in Wisconsin would<\/span> <span data-contrast=\"none\">be forced <\/span><span data-contrast=\"auto\">to hire<\/span> <span data-contrast=\"none\">additional staff or shut down entirely if they can\u2019t meet those standards.\u00a0<\/span><span>\u00a0<\/span><\/p>\n<p><span>\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">While this proposed rule could spell disaster for nursing homes, Wisconsin has options to improve the pipeline of nursing aides working in long-term care facilities, thus raising quality without ruining the industry. Currently, Wisconsin requires Certified Nursing Assistants (CNA) to complete 120 hours of training before they can enter the workforce. The federal government only requires states to have 75 hours of training, a standard that <\/span><a href=\"https:\/\/www.phinational.org\/advocacy\/nurse-aide-training-requirements-state-2016\/\"><span data-contrast=\"auto\">19 states follow<\/span><\/a><span data-contrast=\"auto\">, including our neighbors Michigan, <\/span><span data-contrast=\"none\">Minnesota and Iowa. The additional hours put Wisconsin at a regional disadvantage and pose a barrier to entering the field because it complicates the hiring process and adds to the overall cost of training. In 2019, the legislature introduced <\/span><a href=\"https:\/\/docs.legis.wisconsin.gov\/2019\/proposals\/ab76\"><span data-contrast=\"none\">AB 76<\/span><\/a><span data-contrast=\"none\"> which would have reduced the required hours to 75 hours, bringing Wisconsin in line with our neighboring states. However, Governor Evers vetoed the legislation.\u00a0<\/span><span>\u00a0<\/span><\/p>\n<p><span>\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Ironically, in 2020, Governor Evers issued an emergency order to encourage more people to become CNA\u2019s during the pandemic which<\/span><a href=\"https:\/\/www.dhs.wisconsin.gov\/covid-19\/natp-etp-dsps.pdf\"><span data-contrast=\"none\"> included reducing<\/span><\/a><span data-contrast=\"none\"> the minimum number of training hours from 120 to 75, and he even had over <\/span><a href=\"https:\/\/www.dhs.wisconsin.gov\/news\/releases\/031022.htm\"><span data-contrast=\"none\">200 national guard members<\/span><\/a><span data-contrast=\"none\"> trained as CNA\u2019s during this time. Unfortunately, this rule was withdrawn on June 6th, 2022. This begs the question, why were reduced training<br \/>\nhours okay during the height of the pandemic, but not okay afterwards?<\/span><span>\u00a0<\/span><\/p>\n<p><span>\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">It\u2019s important to note that aligning the training standard with the federal requirement does not compromise the quality of training or care provided. CNA\u2019s would still undergo training in eight subject areas, and facilities catering to specialized patient populations can provide additional training as needed. Moreover, the proposal does not mandate changes to existing CNA training programs; those wishing to offer more than the federal standard are free to do so.\u00a0<\/span><span>\u00a0<\/span><\/p>\n<p><span>\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Looking at Minnesota, Michigan, and Iowa, which require 75 hours, there are several quality measures <\/span><a href=\"https:\/\/www.whcawical.org\/files\/2019\/02\/2018-NH-Survey-Statistics.pdf\"><span data-contrast=\"none\">that<\/span><\/a><span data-contrast=\"none\"> they outperform Wisconsin<\/span><span data-contrast=\"none\">. <\/span><span data-contrast=\"none\">Compared across nine quality measures, at least one of these other states outperforms Wisconsin in seven of them. This shows that the number of minimum hours is not a determining factor of quality care. As more people seek the chance to become a CNA and enter the workforce sooner with fewer training hours, quality issues stemming from staffing shortages will be alleviated. <\/span><span>\u00a0<\/span><\/p>\n<p><span> <img decoding=\"async\" loading=\"lazy\" class=\"aligncenter size-full wp-image-34689\" src=\"https:\/\/wifamily.news\/wp-content\/uploads\/2024\/04\/pic4.jpg\" alt=\"\" width=\"771\" height=\"414\" \/><\/span><\/p>\n<p><span data-contrast=\"none\">This is not the only solution to addressing the issues we face with Medicaid and long-term care as our population ages. However, the alignment of training requirements is seen as a crucial step in addressing Wisconsin\u2019s workforce crisis to strengthen the nurse aid pipeline and ensure residents receive the quality care they deserve.\u00a0<\/span><span>\u00a0<\/span><\/p>\n<p><span>\u00a0<\/span><\/p>\n<p><span>\u00a0<\/span><\/p>\n<p>The post <a href=\"https:\/\/will-law.org\/while-nursing-homes-struggle-to-meet-need-new-biden-rules-will-make-things-even-harder\/\">April Healthcare Highlight: While Nursing Homes Struggle to Meet Need, New Biden Rules Will Make Things Even Harder<\/a> appeared first on <a href=\"https:\/\/will-law.org\">Wisconsin Institute for Law &amp; Liberty<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>This post originally appeared at https:\/\/will-law.org\/while-nursing-homes-struggle-to-meet-need-new-biden-rules-will-make-things-even-harder\/ By Miranda Spindt Medicaid provides long-term care services for&#8230;<\/p>\n","protected":false},"author":65,"featured_media":10328,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-10326","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-will"],"_links":{"self":[{"href":"https:\/\/wifamily.news\/index.php?rest_route=\/wp\/v2\/posts\/10326","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wifamily.news\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wifamily.news\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wifamily.news\/index.php?rest_route=\/wp\/v2\/users\/65"}],"replies":[{"embeddable":true,"href":"https:\/\/wifamily.news\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=10326"}],"version-history":[{"count":3,"href":"https:\/\/wifamily.news\/index.php?rest_route=\/wp\/v2\/posts\/10326\/revisions"}],"predecessor-version":[{"id":10333,"href":"https:\/\/wifamily.news\/index.php?rest_route=\/wp\/v2\/posts\/10326\/revisions\/10333"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/wifamily.news\/index.php?rest_route=\/wp\/v2\/media\/10328"}],"wp:attachment":[{"href":"https:\/\/wifamily.news\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=10326"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wifamily.news\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=10326"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wifamily.news\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=10326"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}