woman posts help wanted sign
(Credit: YinYang / Getty Images)

Assisted living communities are at risk of losing staff members following the first-ever proposed federal staffing mandate for nursing homes, released Friday, according to senior living experts.

Competition for workers, especially nurses and other caregivers, may increase at a time when all providers already face recruiting and retention challenges.  

The Centers for Medicare & Medicaid Services released its expected draft rule last week. It calls for US nursing homes to ensure that each resident receives a minimum of 0.55 hours of registered nurse care and 2.45 hours of nurse aide care each day. Nonrural nursing homes would have three years to comply, and rural facilities would have five years. A requirement for around-the-clock registered nurse coverage, triple the current standard, would go into effect two years after the rule is finalized for urban providers, with another year granted to rural providers.

Many assisted living providers continue to deal with staffing shortages, whereas others have almost rebuilt their workforce back to pre-pandemic staffing levels, National Assisted Living Center Executive Director LaShuan Bethea told McKnight’s Senior Living

“Assisted living communities are at risk of losing staff,” Bethea said. “No matter where an assisted living community sits on this continuum, a federal minimum staffing mandate threatens to take away the essential staff on which these communities depend to provide high-quality care for hundreds of thousands of residents.”

With the current workforce shortage in the long-term care industry at a critical juncture, Jeanne McGlynn Delgado, American Seniors Housing Association vice president of government affairs, told McKnight’s Senior Living, the timing of the proposed rule is “misguided, not to mention unfunded.

“While not directed at the senior living industry, there will certainly be communities — such as continuing care retirement communities with a nursing component, and those who participate in the Medicaid home- and community-based services program — impacted if the proposed CMS rule is implemented,” Delgado said.

The healthcare sector overall, she added, has been “desperately” trying to fill positions lost to COVID-19 and its subsequent effects, including retirements, career changes and childcare needs. “The administration should redirect its efforts on ways to increase the workforce pipeline for the long-term care industry,” she said.

At the top of that list, Delgado said, should be fixing the broken immigration system and allowing foreign workers to fill these “in demand and essential positions” to meet the needs of the aging population.

Argentum agreed that the proposed rule would have a “potentially devastating impact” on the long-term care industry, which needs to attract more than 20 million workers by 2040, Senior Vice President of Public Affairs Maggie Elehwany told McKnight’s Senior Living. Needs in the senior living industry alone will account for 3 million of those workers, according to the association.

Earlier this year, a survey of assisted living and personal care home owners by the Pennsylvania Health Care Association revealed those communities’ worries about losing staff members to nursing homes if the skilled nursing staffing mandate was adopted. All of the surveyed owners of assisted living residences and personal care homes in Pennsylvania said they had that concern.

PHCA President and CEO Zach Shamberg at the time told McKnight’s Senior Living that the mandate “could pull even more workers away from an already shallow labor pool, exacerbating both the workforce and access concerns” of the senior living and care profession.