The healthcare industry suffered from chronic understaffing and decades of wear and tear long before the pandemic. Over three years since Covid emerged, the cracks continue to widen. The issue has long since come to a head in nursing homes, where union-propelled initiatives take a band-aid approach for an ever-deepening, institutional-level wound.
Cue a rash of staffing mandates in process and initiatives to boost nursing home wages to attract more workers to the field. One wonders, however, whether swiftly mandated change could exacerbate the issue. After all, increased costs would likely lead to budget trimming elsewhere, program losses, and, eventually, a staff exodus.
To say the issue is complex is an understatement. Still, the unions want quick solutions for problems that demand long-term strategies.
A national mandate on the table: The SEIU and AFL-CIO teamed up in favor of federally-enforced staffing minimums at nursing homes for better worker-to-resident ratios. Yet there’s a question of whether enough qualified nursing home workers actually exist to fill gaps – 191,000 more workers would be required to meet the 4.1 hours per patient standard.
This would cost an estimated $11 billion annually, and Biden has earmarked grants totaling $80 million to train new nursing home workers, but clearly, those ends don’t meet. Due to cost, many facilities will likely seek waivers from the requirements. Those facilities that cannot secure an exemption could be forced to close their doors, which would overload other nursing homes and exacerbate the staffing issue.
On the state level, the mileage of mandates varies:
Pennsylvania’s example: This state’s nursing homes recently began ushering in new staffing ratios projected to take two years to achieve at the cost of $200 million. It’s the first set of such regulations in the state since 1997, and the goal is for facilities to give patients 2.87 direct-care hours daily, rising to 3.2 hours daily in July 2024.
California’s turmoil: LA County nursing home workers launched a series of eight protests against several facilities earlier this month. Key grievances include staffing shortages and demand for 5% raises, and workers seek a statewide staffing mandate.
Let’s close with a pair of general budget-related healthcare updates from trendsetting California:
(1) A union-supported annual cap on hospital executive wages and perks will head to Los Angeles voters in spring 2024. If that passes, we could see exits from healthcare executives, too;
(2) SB 525 would establish a $25 per hour minimum wage for all healthcare workers for a projected cost of $8 billion. After state senate approval, the bill advanced this month at the behest of SEIU. Providers and hospitals oppose the bill, but more notably, the California Nurses Association wants an RN exemption to prevent wage-floor erosion for nurses who already exceed that hourly amount.
There’s no easy cure for what ails healthcare workers, so one-size-fits-all solutions will not work for this industry. Still, unions will do their best to woo more members to increase the size of their cookie jar.
