Build Back Better Could Require 150,000 New Senior Caregivers — Is Plan Realistic Given Staffing Shortages?

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The top official at the nation’s largest nursing home association estimates that President Biden’s Build Back Better plan might require hiring at least 150,000 new senior caregivers, a figure that is all but impossible to reach given the industry’s extreme labor shortage.

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Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), told Fox Business that the lack of available workers in senior and nursing care could be exacerbated by a couple of provisions included in the Build Back Better plan.

One of them would require a registered nurse (RN) to be on hand 24 hours a day at nursing homes. That’s something industry groups support. However, they’ll need the government’s help to get there because of the number of employees the nursing home industry has lost over the past couple of years.

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In a report released last week, the AHCA/NCAL noted that the industry’s employment level has fallen by 14% — or 221,000 jobs — since the beginning of the COVID-19 pandemic. Among the report’s other findings:

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  • ​86% of nursing homes and 77% of assisted living providers said their workforce situation has gotten worse in recent months
  • 58% of nursing homes are limiting new admissions
  • 78% of nursing homes and 61% of assisted living communities are concerned workforce challenges might force them to close

In a press release accompanying the report, Parkinson said that many caregivers “are getting burned out by the pandemic,” and that workers are leaving the field for jobs in other healthcare settings or other industries altogether.

“Chronic Medicaid underfunding, combined with the billions of dollars providers have spent to fight the pandemic, have left long term care providers struggling to compete for qualified staff,” he added. “We desperately need the help of policymakers to attract and retain more caregivers, so that our nation’s most vulnerable have access to the long term care they need.”

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For now, nursing homes are required to have an RN on staff for at least eight hours a day, Fox Business noted. Upping that figure to 24 hours would require the industry to hire an additional 21,000 RNs and cost an estimated $2.5 billion a year.

The other provision in the BBB plan that would have in impact is a requirement that nursing homes accommodate regulation changes based on staffing ratio surveys conducted by the Department of Health and Human Services within one year. Meeting this provision means hiring 150,000 new caregivers, Parkinson told Fox Business.

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“Nursing home providers are doing all they can to attract and retain new workers, but the applicants simply aren’t there,” he said. “The provisions in this bill do nothing to help us strengthen our workforce and will only force thousands of nursing homes to further limit the number of residents they can serve.”

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About the Author

Vance Cariaga is a London-based writer, editor and journalist who previously held staff positions at Investor’s Business Daily, The Charlotte Business Journal and The Charlotte Observer. His work also appeared in Charlotte Magazine, Street & Smith’s Sports Business Journal and Business North Carolina magazine. He holds a B.A. in English from Appalachian State University and studied journalism at the University of South Carolina. His reporting earned awards from the North Carolina Press Association, the Green Eyeshade Awards and AlterNet. In addition to journalism, he has worked in banking, accounting and restaurant management. A native of North Carolina who also writes fiction, Vance’s short story, “Saint Christopher,” placed second in the 2019 Writer’s Digest Short Short Story Competition. Two of his short stories appear in With One Eye on the Cows, an anthology published by Ad Hoc Fiction in 2019. His debut novel, Voodoo Hideaway, was published in 2021 by Atmosphere Press.

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