As the vaccine mandate looms over Rhode Island nursing homes they’re also looking ahead toward another requirement, the staffing mandate that’s now just months away from taking effect.
Industry leaders have attributed staffing shortages to facility closures over the past year and worry the deadline could make matters worse.
Under the Nursing Home Staffing and Quality Care Act, facilities have until January 1st to provide 3.58 hours of direct nursing care per resident, per day, or pay a penalty.
Most nursing homes will have to increase their staff levels to meet the direct care requirement, but many of them are already struggling to maintain current staffing levels.
John Gage is the President of the Rhode Island Health Care Association, which represents more than 80% of the state’s nursing homes.
“Hospitals are offering $20,000 sign-on bonuses for nurses. We can’t compete with that,” he said.
While some nursing home facilities also offer sign-on bonuses, they’re closer to $1,500 to $2,000.
Gage says retaining employees has been an ongoing problem since the pandemic began, and Rhode Island isn’t alone.
According to the American Health Care Association, 94% of nursing homes nationwide have reported staffing shortages over the past month.
Briarcliffe Manor Administrator Akshay Talwar says staffing shortages have directly affected the number of residents they can take in.
“Our ability to take admissions is circumscribed by a lack of staff, so while we have a capacity for 122 beds, we are at about 85 residents at this time," says Talwar.
Briarcliffe currently has 20 to 30 open positions, well above what they had prior to the pandemic.
Nursing home administrators are also bracing for the vaccine mandate, which begins on Oct. 1.
While employees have left over the new rule, Gage says the staffing shortages started well beforehand and in some cases, have led to closures.
“There have been closures, last year alone three. The Ballou Nursing Home up in Woonsocket just announced they are closing, with staffing being one of the challenges that they had," says Gage.
The state approved the sale of the Ballou Nursing Home to a New-York-based company in June, but according to documents the I-Team obtained from the Rhode Island Department of the Health, they later rejected it after learning the buyer had failed to disclose patient care issues at other facilities it owned.
However, the reasons behind the initial sale ultimately came down to finances and staffing, the same issues being faced by other nursing homes.
Gage says they’ve offered possible resolutions to the state, including fully funding the Medicaid inflation index, which has been slashed every year since 2016.
“We have asked for them to fully fund the inflation index, which is meant for reimbursement to keep pace with actual expenses year over year, and then we’ve asked for add-ons to meet the challenges of the staffing mandate," says Gage.
A spokesperson for Gov. Dan McKee says he has heard the concerns of the industry and has been in talks with nursing home groups about staffing shortages and the upcoming January deadline, but didn’t mention any solutions.
With the clock ticking toward January and no staff mandate extension on the table, Talwar says the entire industry could soon be in violation of the new law.
“A significant number of people will fall far short of that number and there’s nothing they can do. They don’t have the resources and the staff is not available," says Talwar.