Biden Administration sets new rules for federally funded nursing homes
Vice President Kamala Harris announced new rules for federally-funded nursing facilities and home health care companies to improve quality of care.
Three U.S. Senators and two U.S. Representatives have called out the corporate spending of three large nursing home companies amid the industry’s opposition to the Biden administration’s rule to set minimum staffing levels.
In letters sent Sunday to executives of three large chains, Sens. Elizabeth Warren, Bernie Sanders, and Richard Blumenthal and U.S. Reps. Jan Schakowsky and Lloyd Doggett questioned the nursing homes’ spending on executive compensation, stock buybacks, and dividends as the industry protests a new staffing rule for nursing homes.
The letters, signed by the four Democrats and Sanders, a Vermont Independent, said National Healthcare Corp., the Ensign Group, Inc., and Brookdale Senior Living Inc. spent nearly $650 million on executive pay, stock buybacks and dividends since 2018. The lawmakers said such spending undermines “the claim that nursing homes cannot afford to pay for enough staff” to meet the new rule.
Industry group objects to federal minimum staffing level
Last month, the Biden administration announced a new rule that requires nursing homes that receive federal payments for care to meet minimum staffing requirements for registered nurses and nurse aides. The rule mandates nursing homes to provide each resident a minimum of 0.55 hours of care from a registered nurse and 2.45 hours from a certified nursing assistant every day.
The minimum staffing levels will be phased in over two to three years.
Biden administration officials said the new rule is necessary to limit cases of resident neglect or delays in care, a lingering issue that was exposed when more than 200,000 nursing home residents and staff died from COVID-19 in the first two years of the pandemic. A USA TODAY analysis found just 160 skilled nursing facilities out of about 14,500 would have met the new requirements every day last summer.
The nursing home industry group, American Health Care Association, vowed to defend nursing homes and explore all available options in response to the federal rule. Mark Parkinson, president and CEO of AHCA, said the new rule creates “an impossible task” for nursing homes which would need to hire “hundreds of thousands of additional caregivers” amid a nationwide nursing shortfall.
Even representatives of nonprofit nursing homes and facilities said the new minimum federal staffing standards will be difficult to implement. LeadingAge, an association of nonprofit providers of aging services, said workforce shortage and the cost of recruiting, training, and retaining staff could make it difficult for facilities to meet the federal staffing rule.
“This rule’s outcome may well exacerbate existing issues older adults and families face in trying to access nursing home care −limited admissions, fewer beds, and, worse yet, nursing home closures,” said Katie Smith Sloan, president and CEO of LeadingAge.
‘Most important’ reform in decades: Nursing homes must meet minimum federal staffing levels under Biden rule
Demanding answers on corporate spending, nurse compensation, and turnover
Despite industry concerns about nursing and caregiver shortages, the three senators and two representatives said the number of nurses passing licensing tests has grown steadily since 2017.
“Turnover is high due to poor working conditions, understaffing of facilities, and low pay – conditions that you are in position to rectify,” the letters said.
According to the letter, the three publicly traded nursing home chains spent the following amounts from 2018 through 2023 on non-care expenses:
- National HealthCare Corp. spent more than $210 million on stock buybacks and dividends and $26.5 million on executive compensation.
- Ensign Group spent $145.2 million on stock buybacks and dividends and $144.8 million on executive compensation
- Brookdale Senior Living spent $67.7 million on stock buybacks and dividends and $48.9 million on executive compensation.
The senators and representatives demand the three companies answer how they determine executive pay and bonuses and whether such compensation is influenced by quality of care or profits. The letter also seeks answers on the three companies’ average pay and tenure for their registered nurses and nurse aides.
The letters also demand the companies provide any complaints or comments submitted by their nurses over staffing levels and pay. The elected officials also asked the companies to detail lobbying or advocacy spending, including payments that may have been used to advocate against a minimum federal staffing rule.
