The South Dakota Association of Healthcare Organizations (SDAHO) presented alarming information to the Sustainability of Long-Term Care Committee at the state legislature earlier this week, Sept. 25, 2023.
The proposed federal staffing standards for nursing homes that accept Medicare and Medicaid could see extreme challenges for facilities across South Dakota, including many of SDAHO’s member facilities if approved.
Hatting shared the CMS Proposed Staffing Mandate Overview presentation with lawmakers, which outlined:
- Implementation timeline if finalized.
- Estimated annual costs.
- South Dakota nursing homes data on ability to meet the proposed standards.
- United States nursing homes currently meeting RN/CNA requirements.
- Board of Nursing RN staffing statistics
- RN Job openings in the state
- Nursing home closures from 2015- 2023
- Hospital statistics on inability to discharge patients due to lack of post-acute beds.
The proposed rule will require every nursing home, rural and urban, to have a registered nurse on duty 24/7 and require each facility to have enough nursing staff to provide each resident with at least 0.55 hours of registered nurse care and 2.45 hours of nurse aid care every day.
Hatting told lawmakers, “The staffing mandate would add to the heavy burden nursing homes have been facing in recent years due to the pandemic and the high costs due to inflation, regulations and expensive travel staff to fill open positions.”
Hatting told lawmakers that SDAHO will push back on several aspects of the proposed standards including:
- Remove the 24/7 registered nurse requirement – or provide funding or telehealth options.
- Include licensed practical nurses (LPN) in the overall staffing hours per resident day.
- Use the HRSA definition of rural vs. the US Census definition, which is currently defined as “at least 2,000 housing units or have a population of at least 5,000 people”. If approved using the US Census data, the following communities across South Dakota will be included.
Hatting warned lawmakers, that the CMS proposed rule for nursing homes is like a tornado siren. “We don’t know if it will hit us or not.”
To learn more about the Study Committee on Sustainable Models for Long-Term Care, 2023, visit the SD Legislative Research Council Page here.