By: Katie Smith Sloan, President & CEO, LeadingAge

USA Today on December 1, 2022 published an investigative report examining staffing levels in nursing homes (“Many nursing homes are poorly staffed. How do they get away with it?”). This piece is one of several national media stories on nursing homes staffing pegged to the soon-to-be-released staffing mandates promised by the Biden Administration. LeadingAge was not contacted by USA Today reporters for this piece; had they done so, we would have made the points below clear, as we did in a letter submitted to the editor:  

• USA Today’s reporting on workforce shortages in nursing homes presents a narrow and inaccurately skewed explanation of the complex interplay of staffing levels and regulations.  
• The story does a disservice to readers by mischaracterizing the intention and commitment of thousands of workers in the aging services sector who care for older adults and families. 
• All nursing homes are not the same. Quality care and staffing go hand in hand and the hallmarks of our mission-driven, nonprofit provider members are higher-than-average staffing levels, transparency of ownership, and an unwavering commitment to providing excellent care.  
• Indeed, we have a well-documented history of sector leadership in developing quality standards; our members, for instance, led efforts to reduce and eliminate the use of physical restraints in nursing homes (which the USA Today story suggests is a result solely of regulatory crackdown).  
• Improvement and change, such as the elimination of physical restraints, happen through collaboration and support. Our members know how to provide good care.  
• We strongly favor adequate staffing. The question is, what is the appropriate complement of staff based on the needs of the residents at any given time? Resident composition and care needs vary, from home to home. So staffing requirements must have some adjustment mechanism to accommodate that.  
• Once requirements are determined, adequate funding through fair reimbursement is critical to pay a livable wage to hire and retain workers. Right now, there are simply not enough people to fill open jobs. Regulation must include provisions that allow an employer to demonstrate they have tried in good faith to hire workers, but no one has applied. When that is the case, providers should not be cited. 

But this is not just about regulation. On workforce, we have raised our voice repeatedly to the Biden Administration, CMS, Congress and other stakeholders. We have presented plans and policies that will address chronic staffing needs in the sector. America needs an adequate system of funding, support and policies that address the workforce crisis.  

That includes raising Medicaid reimbursement rates to cover the cost of care, government commitments to investments in programs to increase the pool of potential workers coupled with Administration-supported policies on immigration reform, passed by Congress. And finally, there must be sustained prioritization of our too-long-ignored aging services system and the professional caregivers who serve older adults and families. 

Finger pointing and blame helps no one. It’s time for a clear-eyed, fact-based approach to ensure older Americans and families can access the quality nursing home care they deserve.