RI Gov. Again Delays New Nursing Home Staffing Requirements

PROVIDENCE, RI — Rhode Island Gov. Dan McKee once again pushed off the start of new minimum staffing requirements in nursing homes, prompting outrage from staffing advocates.

The Raise the Bar on Resident Care coalition, an advocacy group, urged the governor to reconsider.

"Governor McKee needs to sit down and hear from frontline caregivers about the impact of short staffing on our residents," said Shirley Lomba, who has served as a certified nursing assistant for nearly two decades. "When one Certified Nursing Assistant has to care for at least 12 nursing home residents, they don’t get the quality of care they deserve. The only way we will end this staffing crisis is to give nursing home workers a better wage rather than paying agency staff twice the amount of frontline caregivers."

The Nursing Staffing and Quality Care Act, signed into law during the last legislative session, requires that facilities provide at least 3.58 hours of resident care per day. In 2023, the requirement will rise to 3.81 hours per day.

The law was supposed to go into effect in January, but was delayed until Feb. 14 by McKee's executive order. On Monday, the governor again extended the order until March 12. With the extension of McKee's emergency executive authority set to expire at the end of March, it's unlikely the order will be extended again.

The order argued that "these critical staff shortages justify a moratorium on enforcement of the financial penalties set forth in the Minimum Staffing Law as imposition of such financial penalties during this crisis will only serve to reduce the state's health care capacity."

In January, the Raise the Bar coalition sent the governor a letter urging him to reconsider the moratorium.

"Delaying implementation of this law in the middle of our generation’s worst public health crisis is exactly the wrong direction for our state’s most vulnerable citizens," the letter read in part. "The only way to end the nursing home staffing crisis is to improve wages and working conditions and make nursing homes safer for staff and residents."

William Flynn, the executive director of the Senior Agenda Coalition of RI, said implementing the law is now even more important amid the COVID-19 crisis.

"We believe that this executive order's elimination of the requirement of minimum staffing standards at nursing homes is irresponsible and cannot be justified in any instance," Flynn said.

McKee's delay of the law came after Rhode Island Health Care Association and LeadingAge Rhode Island, which together represent 75 of the 80 nursing homes in the state, called for the governor to allow facilities an extension to the new staffing requirements.

John Gage, the president of the Health Care Association, said it would be "impossible for our homes to meet these new requirements" given the circumstances of the COVID-19 pandemic, employee burn out and reimbursements for facilities.

"As much as we all desire to have a full complement of staff, the applicants simply do not currently exist to meet these new requirements," Gage said previously. "The resultant actions that nursing homes would have to take, such as further reducing or limiting admissions from area hospitals, will tax an already overburdened hospital system. These actions will be necessary for the homes to avoid crippling fines and to prevent certain closures."