Kamala Harris announces new national minimum staffing requirements for nursing homes during La Crosse visit

Apr. 23—New rules aimed at establishing safe, reliable and high-quality long-term care were the focus of a Monday visit to La Crosse by Vice President Kamala Harris.

Federal rule changes will impact the future of long-term care for both residents of nursing homes and caregivers, primarily addressing staffing and pay concerns.

At the Hmong Culture and Community Center on the South Side of La Crosse, Harris spoke with Medicaid Services Administrator Chiquita Brooks-LaSure, Service Employees International Union Secretary-Treasurer April Verrett and three union caregivers about two new rules intended to improve access to affordable long-term care for residents of nursing homes and provide more support for care workers.

"Today is about recognizing the gift that home health care workers and care workers give to us as a society," Harris said. "The two announcements that we are making today recognize that we owe you, those workers, so much more than applauding you. We owe you more than that structurally and in our system. So, for the first time we are establishing — the first time in the history of our country — we are establishing national minimum staffing standards for federally funded nursing homes."

Nursing home minimum staffing

About 1.2 million Americans live in federally funded nursing homes, and 75% of those nursing homes are reportedly understaffed according to the Center for Medicare & Medicaid Services (CMS), which leads to sub-standard or even unsafe care.

"Understand what that means for the residents of that nursing home," Harris said. "It means that there may be no one available to help them out of bed. It means there may be no one available when they fall. It means that they will receive less medical attention because the care workers in that facility are going from room to room, from resident to resident."

The new nursing home minimum staffing rule, the first new federal requirement finalized on Monday, requires all Medicare and Medicaid-funded nursing homes to provide residents with 3.48 hours of care. This includes a minimum defined amount of care from a registered nurse of 0.55 hours and 2.45 hours with a nurse aide per resident daily. Additionally, they must have a nurse onsite at all times to ensure nursing home safety.

The new rule requires a facility with 100 residents to have at least two or three registered nurses and at least 10 or 11 nurse aides, in addition to two additional nurse staff per shift to meet the minimum staffing standards. Addressing the understaffing aims to help relieve the burden that many women and people of color disproportionately face.

"Most of the people that do work in the care infrastructure — it's women, it's women of color, it is immigrant women," Verrett said. "When we center women's work, we are changing their lives, for their families. The rule around pay is huge. We have an opportunity to transform work that used to be done by enslaved women to family-sustaining work. And that will have ramifications for our society that go beyond our wildest imagination."

'Ensuring access to Medicaid services'

Medicaid currently pays $125 billion per year to home health care companies, which provides work for thousands. Until Monday, home care companies were not required to report how federal dollars were spent.

The second rule finalized Monday will increase home workers' pay by requiring at least 80% of Medicaid payments for home care services be dedicated to workers' wages.

"For caregivers, it means that in the midst of this noble and selfless work that they do, that they don't get paid enough for the kind of work that they need to cover. And it means that they have less ability to do what they want to do, and frankly, their life calling which is to care for other people," Harris said. "The value of this work not only to the individual they're caring for, but the value of this work to that individual's family and to us as a society cannot be understated. I am so grateful to our home health care workers, to our care workers, to the members of SEIU for the work you do every day. And again, I say it's about time that we start to recognize your value and pay you accordingly."

The new federal rules stem from President Joe Biden's statement in his 2022 State of the Union address, when he promised to improve care for seniors and people with disabilities and provide better support for care workers.

"We are answering that call with groundbreaking roles rooted in the president and vice president's vision bolstered by your voices, your dedication and your partnership," said Brooks-LaSure. "These new regulations were born out of feedback from thousands of clinicians, health care workers like yourselves, advocates and most importantly, the people who receive nursing home care health care in nursing homes or in their homes."

The administration hopes the new rules will improve access and quality of care for residents and greatly improve the ability and resources available to caregivers.

Understaffed and underpaid

Harris spoke with several Service Employees International Union members and leaders at Monday's event. The union represents about two million members and over 800,000 caregivers across the country.

"The incredible work that caregivers do each and every day is a vital part of the health and well-being of millions of people in this country," Verrett said. "It's essential work, it's important work, it's meaningful work, it is 365 24/7 kind of work. It is emotionally, mentally and physically taxing ... care workers across the country are united and our demand for safe staffing levels, better quality care and employer accountability for our nation's nursing homes."

Nurses who spoke with Harris at the press conference echoed the importance of the efforts made to improve the care industry. On and off the clock, the nurses are thinking about their residents — many of whom have begun to feel like family.

"You're there for their happy times or bad times, or when no one comes to visit them on holidays or birthdays. You are there to be able to share those moments with them," said Aryanna Arnone-White, a CNA who spoke on the panel. "Being short-staffed makes it very difficult to be able to get to a personal level and interaction with them. You don't want to treat them like a job because they're not — they're a person."

Arnone-White said understaffing and underpaying limits the care available to patients and takes a toll on caregivers. She believes the new rules will create less turnover and a safer environment for residents.

"Whether it be in the WNBA or recognizing that the traditional work of women — nurses and teachers — remains underpaid, especially when you measure it based on the value of the work," said Harris. "One of the character traits of real leaders is to have some level of compassion and concern about the suffering of other people, and then want to do something about that to improve their condition. That's the work of these workers that we're talking about right now and we as a society should value that and I just can't thank you all enough."

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