on, you know, you know, Zach, it's, you know, and I encourage others, you know, especially
my staff colleagues, we're always on camera, you know, very disconcerting when you're on camera
and you're speaking to a, you know, just a blank picture, you know, or a voice, you know, especially
when it's a stressful conversation. Yeah, all right, we are just about ready here. Okay, so.
Okay. Earlier this week, Vice President Kamala Harris was in La Crosse to introduce new federal
standards for nursing homes and long-term care facilities. Once finalized, the new rules would
implement a minimum number of hours staff would have to be around patients and require a
registered nurse on site at all times. It would also require 80% of Medicaid reimbursement go
towards employee wages. Vice President Harris noted many of the workers in this industry have
been traditionally underpaid, a factor that leads to staffing shortages. One of the character
trades of real leaders is to have some level of compassion and concern about the suffering of
other people and then want to do something about that to improve their condition.
That's the work of these workers that we're talking about right now and we as a society should value
that. Current law only says facilities need to have, quote, sufficient staffing. While many
nursing homes already meet these new standards, the government says a majority of the country's
15,000 nursing homes would need to add staff in order to come into compliance.
To give us the Wisconsin perspective, we are joined by Rick Abrams, the Executive Director of the
Wisconsin Health Care Association and the Wisconsin Center for Assisted Living. Thanks for your time
today. Zach, it's a pleasure to be here. So let's start with, give me a snapshot of what the long-term
care industry is in Wisconsin. Are there enough beds and workers to provide for a generation of
aging baby boomers? You know, Zach, at this point, there are enough beds. We've got approximately
26,000 nursing home beds in the state. Our average statewide occupancy is about 70%.
So you've got capacity, but the challenge is dedicated workers. You know, the labor shortage
was always a problem in Wisconsin. Certainly it was exacerbated with the pandemic. And from
our perspective, and I'm sure we'll talk more about it, a cookie cutter, black and white,
staffing minimum, just as not the right approach. So yeah, let's talk about what is your reaction
of the new regulations? Are there any particular that seem more onerous or difficult for nursing
homes and long-term care facilities to actually meet? You know, Zach, two things. First,
even though we may disagree with the approach, there's no question that everyone is well-intentioned,
whether you're a federal policymaker, like our vice president is, state policymaker, and certainly
the folks in the sector. But when you look at the requirements of the minimum staffing mandate,
the most difficult to meet is going to be the requirement of having a registered nurse in RN,
if you will, on-site 24 hours a day, seven days a week. That's going to be difficult,
if not impossible, in some cases, to meet simply because there are not enough RNs.
But equally concerning to us is that that 24-7 requirement, if you will,
applies whether you're a 40-bed nursing facility in rural Wisconsin,
or a 500-bed nursing facility in Bronx, New York. That just doesn't make sense to us.
We think there's a better approach. So, I want to read a statement we received from Kim
Marhein, the states on Budsman on long-term care. She says, many ask whether the time is right for
these changes given current staffing stressors facing the long-term care industry,
though there may never be a best time for these changes. Consumer needs and expectations demand
the time is now. What's your response to that statement?
Well, first, I have great respect for Kim. In fact, I got my start in long-term care as a long-term
care on Budsman. But, you know, Zach, in the beginning, in your introduction, you know,
you talked about the current standard. And the current standard is sufficiency,
not only in numbers, but also in expertise. And we think that that is the right approach,
because every nursing home, not only in the state of Wisconsin, but literally every nursing home
in this country has a different patient mix. And the facility is duty-bound to staff
to that patient mix. And we think that that's the right approach.
So, will this result in nursing homes closing down? Will they just not be able to accept people?
What's the bigger implication, especially in rural Wisconsin?
You know, I think there's three implications, two of which you've addressed. I do believe that,
especially in rural areas for our small community-based facilities, they may need to close if they
cannot meet these standards, because not meeting the standards then carries with it substantial
penalties. And a facility can't sustain that. But, you know, if a facility finds that after a good
faith effort, they just cannot staff to the requirement, they're going to then reduce the
number of beds that are occupied. And when that happens, especially in rural areas,
access is challenged. And nobody wants that to happen. But you know, Zach, the third thing,
and this is purely from my perspective, is that if a facility cannot achieve the 3.48 hours per
resident day, if they're not in a position to reduce the number of occupied beds,
what that does is it puts more pressure on the staff that is there. And the biggest concern that
I have with that is that that is going to hasten burnout, and that is going to hasten the exodus
of these good and dedicated people from our sector. And nobody can afford that. So really,
you know, your question was excellent. And for one, two or all three of these reasons,
we just don't think a black and white cookie cutter, however you want to describe it,
minimum staffing standard is the right approach. All right, Rick Abrams, thanks for your time today.
It's my pleasure. Take care.
Thank you so much. That was really helpful. Well, thank you. We appreciate the opportunity.
And you know, and I don't know if we can, if we can talk, but you know, really do appreciate
the opportunity. Always appreciate what you all do. And you know, I always say, you know, whether
we agree on an issue, you disagree on an issue, I think that the, that the respectful discourse
is always worthwhile. All right, well, we may be in touch with you down the road if these
actually become rules and follow up and see what the implications are on the field. But thank you
again. That was great. I appreciate it. Marissa, thanks for your help again. Take care, folks.
Thank you. You too.