this post was submitted on 22 Apr 2024
444 points (99.6% liked)

politics

19120 readers
4651 users here now

Welcome to the discussion of US Politics!

Rules:

  1. Post only links to articles, Title must fairly describe link contents. If your title differs from the site’s, it should only be to add context or be more descriptive. Do not post entire articles in the body or in the comments.

Links must be to the original source, not an aggregator like Google Amp, MSN, or Yahoo.

Example:

  1. Articles must be relevant to politics. Links must be to quality and original content. Articles should be worth reading. Clickbait, stub articles, and rehosted or stolen content are not allowed. Check your source for Reliability and Bias here.
  2. Be civil, No violations of TOS. It’s OK to say the subject of an article is behaving like a (pejorative, pejorative). It’s NOT OK to say another USER is (pejorative). Strong language is fine, just not directed at other members. Engage in good-faith and with respect! This includes accusing another user of being a bot or paid actor. Trolling is uncivil and is grounds for removal and/or a community ban.
  3. No memes, trolling, or low-effort comments. Reposts, misinformation, off-topic, trolling, or offensive. Similarly, if you see posts along these lines, do not engage. Report them, block them, and live a happier life than they do. We see too many slapfights that boil down to "Mom! He's bugging me!" and "I'm not touching you!" Going forward, slapfights will result in removed comments and temp bans to cool off.
  4. Vote based on comment quality, not agreement. This community aims to foster discussion; please reward people for putting effort into articulating their viewpoint, even if you disagree with it.
  5. No hate speech, slurs, celebrating death, advocating violence, or abusive language. This will result in a ban. Usernames containing racist, or inappropriate slurs will be banned without warning

We ask that the users report any comment or post that violate the rules, to use critical thinking when reading, posting or commenting. Users that post off-topic spam, advocate violence, have multiple comments or posts removed, weaponize reports or violate the code of conduct will be banned.

All posts and comments will be reviewed on a case-by-case basis. This means that some content that violates the rules may be allowed, while other content that does not violate the rules may be removed. The moderators retain the right to remove any content and ban users.

That's all the rules!

Civic Links

Register To Vote

Citizenship Resource Center

Congressional Awards Program

Federal Government Agencies

Library of Congress Legislative Resources

The White House

U.S. House of Representatives

U.S. Senate

Partnered Communities:

News

World News

Business News

Political Discussion

Ask Politics

Military News

Global Politics

Moderate Politics

Progressive Politics

UK Politics

Canadian Politics

Australian Politics

New Zealand Politics

founded 1 year ago
MODERATORS
 

The Biden administration finalized on Monday the first-ever minimum staffing rule at nursing homes, Vice President Kamala Harris announced.

The controversial mandate requires that all nursing homes that receive Medicare and Medicaid funding provide a total of at least 3.48 hours of nursing care per resident per day, including defined periods from registered nurses and from nurse aides. That means a facility with 100 residents would need at least two or three registered nurses and at least 10 or 11 nurse aides, as well as two additional nurse staff, who could be registered nurses, licensed professional nurses or nurse aides, per shift, according to a White House fact sheet.

Plus, nursing homes must have a registered nurse onsite at all times. The mandate will be phased in, with rural communities having longer timeframes, and temporary exemptions will be available for facilities in areas with workforce shortages that demonstrate a good faith effort to hire.

The rule, which was first proposed in September and initially called for at least three hours of daily nursing care per resident, is aimed at addressing nursing homes that are chronically understaffed, which can lead to sub-standard or unsafe care, the White House said.

you are viewing a single comment's thread
view the rest of the comments
[–] Nurse_Robot 24 points 7 months ago (4 children)

There's a difference. Psychiatric facilities struggle with funding, nursing homes ABSOLUTELY do not. Have you seen the cost of living in even the shittiest nursing homes? It's common practice to be paying upwards of $10,000 per month, per resident. Nursing homes have all the money they could ever want, they're just greedy fucks who purposely utilize dangerously understaffed facilities to maximize profit for those at the top.

[–] just_another_person 8 points 7 months ago

They were lumped together in the Reagan administration culling payments for all times of those though. There are few protections for the elderly even still. You don't need to dig deep and find a zillion hits about these companies raising care rates out of nowhere to vacate tenants. It's absolutely insane, and there should be laws against it top to bottom.

[–] MonkRome 5 points 7 months ago (1 children)

Plenty of states it's much higher, in Minnesota the rate is set by the state according to patient need. It's not unheard of to pay $15k a month as $14k month is the average cost per resident.

[–] michaelmrose 3 points 7 months ago

To aid in contextualizing this they are being asked to spend at least $2,500 of the $14,000 on labor which isn't remotely unreasonable

[–] andros_rex 3 points 7 months ago

Yep, and they pay CNAs subhuman wages so they’re staffed by anyone who can pass a piss test. (My local gas station sells “fetish urine” lol).

My boyfriend had to put in some hours at a long term care facility as part of nursing school. Absolutely disgusting stuff happens there - the CNAs do not give a fuck (which makes sense, it’s not like you’re making that much better than Macca’s)

[–] [email protected] 0 points 7 months ago (2 children)

$120K per year per resident isn't that much revenue to cover 24 hour availability of care, food, lease, etc.

I'm not saying it is unworkable, but with the requirement for 3.5 hours of nurse care or resident per day, that means the maximum total cost of a Nurse is $95 per hour, or about $190K.

That really isn't much - typically employees cost a business twice their base salary. So the nurses can be paid $100K per year while leaving almost $0 for any other expenses..

[–] Nurse_Robot 5 points 7 months ago (2 children)

How are you getting $95 an hour?

[–] michaelmrose 1 points 7 months ago
[–] [email protected] 1 points 7 months ago (1 children)

3.5 hours of nurse care per resident per day (from the bill).

Resident pays $120K per year to stay at the facility.

There are 365*3.5 hours in a year they need nursing care = 1277 hours of nursing care per year per client.

$120K per year / 1277 hours per year = $94/ hr maximum cost for each nurse - assuming there are no other expenses for the facility.

Must have mistyped to get $95, but that is the math.

[–] Nurse_Robot 3 points 7 months ago (1 children)

Okay, now I understand what you meant by maximum cost. It should be noted that the nurses will likely be paid closer to $30 / hour, give or take depending on the area.

[–] [email protected] 1 points 7 months ago* (last edited 7 months ago) (1 children)

The $94/hr isn't a salary, it's the cost to the business. Employees generally cost a business 1.3-1.5X their salary - since insurance, payroll taxes, PTO, etc. all also need to be paid for.

Again this is not considering any other cost for the facility: utilities, food, other staff, medical equipment, maintenance, insurance, rent...

[–] Nurse_Robot 3 points 7 months ago (1 children)

I'm not worried about their profits tbh. Nursing homes had total net revenues of $126 billion and a profit of $730 million (0.58%) in 2019. They can afford to staff properly and fairly and still make a disgusting amount of profit.

[–] [email protected] 2 points 7 months ago (1 children)

That is an insanely small margin, and directly contradicts your claim that they can staff properly.

Let's take the entire profit for the industry and hire nurses. Let's say reach nurse costs $80K ( $60K salary, $20K for taxes/insurance/other benefits).

That pays for 9600 more nurses. Which, given the nursing requirements in the bill (3.48 hours per day per resident), only covers staffing for 22K residents.. a rounding error to the more than 1.2 million nursing home residents in the country.

There are ~15K nursing homes in the US, each of them getting 0.6 more nurses doesn't help anything.

[–] [email protected] 1 points 7 months ago (1 children)

I'm no economist, but if the business can't afford to perform its function (such as a care home taking care of its residents) then the business shouldn't exist.

[–] [email protected] 2 points 7 months ago (1 children)

And that is a valid opinion. Unfortunately what do you do with all these people if the homes close because they can't afford staff?

The intent of the bill is to prevent neglect in nursing homes - that is a worthy and important goal. The mandate doesn't actually help make that happen.

It doesn't provide funding the care providers to increase staff, it doesn't add incentives for individuals to get certified and help address the personnel shortage, it doesn't put a cap on administrative costs for care facilities, it doesn't actually DO anything to help solve the problem.

Good mandates also provide an avenue to meet them.

[–] [email protected] 2 points 7 months ago (1 children)

The government is already providing funding, this just makes that funding dependent on having enough staff.

If a business needs the government to hold its hand every step of the way to be successful then it should be a government facility instead of a private business.

[–] [email protected] -1 points 7 months ago (1 children)

We get it, you don't like nursing homes.

You don't seem to be engaging with the substance of the matter, so I'll leave it here.

[–] [email protected] 2 points 7 months ago (1 children)

I like nursing homes. I don't like nursing homes that don't take care of their residents.

That is the substance of the matter here. I don't care how profitable the business is if the residents aren't being properly cared for.

[–] [email protected] 1 points 7 months ago (1 children)

The businesses are hardly profitable. For every dollar they get from housing a resident, they get just above half a penny of profit.

As I showed above, you can take the entire profit and put it into hiring more staff and it won't actually make a difference. They either need to raise prices, cut costs elsewhere (maybe administration? I'm not familiar enough to know), or pay people less.

That's what the numbers say.

[–] [email protected] 1 points 7 months ago (1 children)

Again: I don't find the argument "we can't take proper care of our residents because it's not profitable" to be compelling.

No one seems to be arguing that the care being asked for is unnecessary, just that it's expensive. And in that case I just don't care.

[–] [email protected] 0 points 7 months ago (1 children)

Again, it doesn't matter whether you find the argument about compelling.

If care cannot be provided profitably, it won't be provided at all. That is reality. Somehow, the care must be paid for.

Those who need care are not better off if these facilities close.

[–] [email protected] 1 points 7 months ago

If a business needs the government to hold its hand every step of the way to be successful then it should be a government facility instead of a private business.

[–] michaelmrose 3 points 7 months ago

Most of that labor can be filled by nurses aids which make on average $17 an hour not $90