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AHCA / NCAL President and CEO Mark Parkinson

The federal government’s proposed minimum staffing requirements for nursing homes could cost the industry $10 billion a year because tens of thousands of additional caregivers would need to be hired, according to a new report from accounting and consulting firm CliftonLarsonAllen.

Further, fewer slots may be available for residents and patients as some facilities reduce their census to meet the staffing requirement, the report maintains. The report was released Tuesday by the American Health Care Association.

The Centers for Medicare & Medicaid Services is considering requiring nursing homes to implement staffing minimum of 4.1 hours per resident day. The proposal comes as part of President Joe Biden’s nursing home reform initiatives.

Minimum staffing levels would further hamper an industry already struggling to keep up with staffing, according to AHCA. Six out of 10 nursing homes reported refraining from admitting new residents due to historic staffing shortages in a survey published last week by the industry advocate. 

According to the CLA report, 94% of nursing homes nationally, representing facilities that care for more than 900,000 residents and patients, would need to increase their staffing levels to meet the new standard. CLA concluded that more than 187,000 nurses and nurse aides would need to be hired, which it said would cost $10 billion annually. Consequently, CLA concluded, 18%, or 205,000, of those 900,000 residents/patients could be at risk of losing their slot in a nursing home, as some facilities might have to reduce their census to meet the staffing requirement.

“This report makes it crystal clear that increasing staffing standards in nursing homes requires substantial and consistent government resources. Even then, nursing homes would have the impossible task of finding another 187,000 nurses at a time when vacant positions sit open without applicants for months on end,” AHCA President and CEO Mark Parkinson said in a press release issued in conjunction with the report. “The unintended consequences of this sort of unfunded mandate would be devastating to hundreds of thousands of vulnerable residents who could be forced out of their nursing home.”

“Many facilities will have to make difficult decisions, such as reducing census, to meet the proposed staffing minimums,” CLA Principal Deb Emerson said.