There are issues when it comes to people wanting to work at
assisted living facilities, with them not recovering employment levels like
other parts of the medical community after the government shutdown of the
nation. Now the Biden Administration wants to kick them while they are down by
bringing in new rules that will now limit people’s access to these facilities. Members
of the House Committee on Energy and Commerce held a hearing and had a
response.
Medicaid Rule
Here, via a Centers for Medicare and Medicaid Services press release, is the Medicaid rule change on helping those needing assistance.
Requires that in three years, states report on their readiness to collect data regarding the percentage of Medicaid payments for homemaker, home health aide, personal care, and habilitation services spent on compensation to the direct care workers furnishing these services; and in four years, states report on the percentage of Medicaid payments for homemaker, home health aide, personal care, and habilitation services spent on compensation to the direct care workers furnishing these services, subject to certain exceptions.
Requires that, in six years, states generally ensure a minimum of 80% of Medicaid payments for homemaker, home health aide, and personal care services be spent on compensation for direct care workers furnishing these services, as opposed to administrative overhead or profit, subject to certain flexibilities and exceptions (referred to as the HCBS payment adequacy provision).
Staffing Rules
Here, via another CMMS press release, is the changes to staffing rules for facilities.
Minimum Nurse Staffing Standards
Staffing in LTC facilities has remained a persistent concern. CMS’ new minimum nurse staffing standards in this rule set a national and broadly applicable baseline that will significantly reduce the risk of unsafe and low-quality care for residents across all LTC facilities. CMS is finalizing a total nurse staffing standard, based on public comment feedback, that requires facilities to provide a minimum of 3.48 HPRD of total direct nursing care to residents, of which at least 0.55 HPRD of care must be provided by RNs and 2.45 HPRD of care provided by nurse aides. Facilities may use any combination of nurse staff (RN, licensed practical nurse (LPN) and licensed vocational nurse (LVN), or nurse aides) to account for the additional 0.48 HPRD needed to comply with the total nurse staffing standard. A total nurse staffing standard provides for more hours of direct care to residents while also allowing facilities to utilize other direct care nurse staff, such as LPNs/LVNs — an important group of direct care nurses — in meeting the minimum standard.
While these are minimum staffing standards, CMS expects LTC facilities to use the updated and newly strengthened facility assessment to determine whether their staffing needs to be set above these minimums, based on resident acuity and individual care needs. CMS is committed to continued examination of staffing thresholds, including work to review quality and safety data resulting from initial implementation of these finalized policies, as well as robust public engagement.
Improving the RN On-Site Requirement
LTC facilities provide care for residents with increasing medical complexity and acuity of health conditions who require substantial resources and care provided or supervised by an RN. While the finalized minimum staffing standards described above seek to build on existing requirements, by creating consistent and broadly applicable standards that significantly reduce the risk of unsafe and low-quality care across LTC facilities, the RN onsite 24 hours a day, seven days a week requirement ensures that there is an RN available to help mitigate, and ultimately reduce, the likelihood of preventable safety events, particularly during evenings, nights, weekends, and holidays.
Therefore, CMS is finalizing, with revisions to its proposal, the requirement for an RN to be onsite 24 hours a day, seven days a week, and available to provide direct resident care. The 24/7 RN onsite can be the Director of Nursing (DON); however, they must be available to provide direct resident care.
Hearing Remarks
Here, via the Energy and Commerce hearing page, is what Rep.
Cathy Rodgers had to say about these rule changes.
LIMITING ACCESS TO CARE
“I’ve been troubled by recent proposals from the Biden administration that, while likely well-intentioned, would further undermine this workforce.
“The administration proposed the so-called 'Medicaid Access Rule', which would require home health agencies to pass through a minimum of 80 percent of all reimbursements directly to the direct care workforce.
“State Medicaid Directors and advocates, however, have raised concerns, stating that such a high threshold is out of reach for most agencies and would require agencies to have to reduce service and staff to be able to ensure that they could comply with the rule.
“Put simply, this proposal would actively undermine access to care, running counter to the very name of the rule.
“Additionally, just last month, the administration followed the Access Rule with a proposal to require minimum staffing levels for nursing homes.
“Like the Access Rule, this Minimum Staffing Rule would set unrealistic staffing threshold.
“Independent analyses have found that as many as 80 percent of all nursing homes would be unable to meet the requirements of the rule, meaning facilities would have to increase costs for residents, reduce censuses and stop accepting new residents, or potentially even close.
“We all believe in access to high quality care, but proposed requirements that are untenable for four out of every five nursing homes do not represent a serious solution.
“And those who rely on skilled nursing care deserve better than a proposal that could dramatically curtail their care.
“These top-down approaches are not the way forward in supporting seniors and people with disabilities, and it’s my hope that today will begin a conversation on ways to find more meaningful solutions to help those in need.
“We cannot let this rule simply go into effect and watch idly as individuals with disabilities and seniors lose the support they need to maintain their independence. We do not want to see people forced into hospitals for chronic conditions that could have been avoided.”
It would seem that the Biden Administration is too busy
attempting to put their fingerprints on everything without understanding what
they are doing. Or, they do understand what it is, but they need to help the
unionized direct care people who pay dues that go towards the Democrat Party. Then
again, the Republican Party will not make changes when they get into office,
unless mandated by the courts.
My e-book: https://freedomvn-games.itch.io/founding-freedom-primer
See my content at: https://www.facebook.com/PaulShannonRamblings/
Help support me at: https://www.patreon.com/FreedomVN
Comments
Post a Comment