Promises to upgrade nursing home care made a cameo appearance in President Joe Biden’s State of the Union address for the second year running. But a cornerstone of his plan faces strong opposition as updated regulations begin to roll out.
Central to Biden’s plan are more caregivers – nurses as well as the assistants who do the bulk of the day-to-day work with residents.
People who run nursing homes say the president’s proposal to set stringent staffing requirements is impractical, arguing the real problem is that the government doesn't pay enough to hire the number of care workers currently recommended under federal guidelines. Some advocates for seniors say many nursing homes have plenty of money – they just need to spend more of it on staffing.
Both have a point.
Fixing senior care will come down to a blend of money and oversight, data and recent analyses suggest. And finding the right mix will require government leaders to better track tax dollars paid to nursing homes. Without understanding the profits and costs driving the decisions made by these businesses and nonprofits, experts say, changes to payment rates and staffing rules are a guessing game.
An academic study expected later this year could provide detailed insight into nursing home budgets. The federally funded effort will be the first time that researchers have examined how the unique payment structure of each state’s Medicaid program factors into the facilities’ costs and profits.
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