RI Nursing Homes Ask For Extension Ahead Of New Staffing Law

PROVIDENCE, RI — With Rhode Island's new law about minimum staffing set to get into effect Jan. 1, two organizations representing nursing homes are calling for a one-year delay in enforcement.

The Rhode Island Health Care Association and LeadingAge Rhode Island together represent 75 of the 80 nursing homes in the state.

John Gage, the president of the Health Care Association, said it would be "impossible for our homes to meet these new requirements" given the circumstances of the COVID-19 pandemic, employee burn out and reimbursements for facilities.

"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," Gage said. "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."

The problem "will only grow" if facilities are forced to lower their populations under the new law, Gage continued, saying the one-year moratorium is needed 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," he concluded.

The new law, signed by Gov. Dan McKee in May, requires that facilities provide at least 3.58 hours of resident care per day. In 2023, the requirement rises to 3.81 hours per day.

Patrick Quinn, a spokesperson for SEIU 1199 New England, said that more support and better standards are "the only way to turn the corner on Rhode Island’s nursing home staffing crisis." The union is a member of Raise the Bar on Resident Care Coalition, an advocacy group that pushed for the legislation.

"The Nursing Staffing and Quality Care Act ensures that increased Medicaid funding is spent where it should be — on safe staffing for residents and higher wages to recruit and retain qualified caregivers," Quinn said in a statement. "Now is the time to make fundamental changes in the long term care system; that starts with demanding greater accountability for how the nursing home industry spends public dollars."

According to the two organizations, there are nearly 2,000 open positions in nursing homes across the state. Under the new regulations, "very few, if any, nursing homes will be compliant with the new law while maintaining their present resident populations," the statement read.

Jim Nyberg, the executive director of LeadingAge Rhode Island, said that nursing homes cannot meet the new requirements at this time.

"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," he said. "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."