John E. Gage, President of the Rhode Island Health Care Association stated, “With an unprecedented staffing crisis due to a decade of drastic cuts to nursing home reimbursements, the prolonged Covid-19 pandemic, and employee burn-out, it will be impossible for our homes to meet these new requirements. As much as we all desire to have a full complement of staff, the applicants simply do not currently exist to meet these new requirements. The resultant actions that nursing homes would have to take, such as further reducing or limiting admissions from area hospitals, will tax an already overburdened hospital system. These actions will be necessary for the homes to avoid crippling fines and to prevent certain closures. This problem will only grow if the homes are forced to reduce their populations due to this law. We need a one-year moratorium of this law to assess the needed structural changes to assure long-term success. This would include improved workforce training efforts; appropriate and much needed adjustments to the Medicaid reimbursement system; and physical upgrades to our homes to meet future pandemic challenges.”
While it is clear the staffing shortage has been exacerbated by COVID, other contributing factors include a lack of childcare, vaccine mandates, bureaucratic red tape in licensing new workers and a chronic lack of funding to recruit new workers.
At present there are:
1,920 vacant positions in RI nursing homes.
This is a 18.3% vacancy rate based on the existing base of 10,495 employees needed to service RI’s nursing homes.
Under the proposed new legislation, the total number of new employees needed January 1 would require the hiring of an additional 475 individuals to meet the mandate.
This estimated staff shortfall of 2,395 will be impossible to accomplish during these highly trying times. Very few, if any, nursing homes will be compliant with the new law while maintaining their present resident populations.
The direct effect on the industry is clear:
4 nursing homes have already closed since the start of the pandemic.
28 facilities have shut down rooms, wings or units due to the inability to staff.
23 facilities have closed to new admissions at some point within the last three months.
71% of all RI facilities are now limiting the number of admissions they will accept based on their daily staffing.
Jim Nyberg, Executive Director of LeadingAge Rhode Island, concluded, “The implementation of these new requirements simply cannot be met in this environment. Without proper funding, adequate training and available CNA testing sites in the state, the workforce challenges facing the industry will only get worse, not better in the short-term. This crisis does not only affect operators of our facilities, but their local communities as well. With staff shortages being insurmountable, the threat of looming fines, payment freezes, admission bans and potential closures, Rhode Island’s most frail residents will have no place to go if these requirements are put in place. A delay of the requirements is a far more prudent policy for the state to pursue at this time.”