State legislation that would hike pay rates for certified nursing assistants, would require nursing home caregivers to spend more time with each resident and would mandate additional training for nursing home employees is already garnering a lot of attention.
A union-backed group of nursing home employees, residents and community members says CNAs are underpaid and overworked in Rhode Island, and that residents don’t get enough daily time with caregivers.
Many nursing homes agree that wages are too low but contend that there is no money to increase pay. Low Medicaid reimbursements, combined with glitches in the state’s computer system that manages Medicaid approvals and payments, have drained cash reserves, according to groups that represent Rhode Island’s nursing homes.
The bill to be introduced by Sen. Maryellen Goodwin, D-Providence, on Feb. 25 calls for bumping pay rates for CNAs up to $15 an hour, for nursing home caregivers to spend at least 4.1 hours a day with each resident and additional employee training.
“I think it would be impossible to do, quite honestly, unless [nursing homes] cut staff, and then they would bump into the minimum staffing ratios,” said James Nyberg, executive director of LeadingAgeRI, which represents nonprofit facilities.
The Rhode Island Health Care Association, which represents for-profit nursing homes, plans to lobby against the bill, according to CEO and President Scott Fraser.
Pay raises are “only half of the equation. The other half is where is that money going to come from,” Fraser said.
Goodwin spoke at a Statehouse rally earlier this month in support of the measure and called it one of her “No. 1 priorities.”
Goodwin and Rep. Scott A. Slater, D-Providence, worked with Service Employees International Union District 1199 New England on the bill, called the Nursing Home Staffing and Quality of Care Act. The union-organized group Raise the Bar on Resident Care has lobbied for the changes for months.
The bill’s backers would like to secure funding for wage increases from the state budget, but it’s too early to say where the money would come from, how much is needed or the chances of success, Goodwin said.
Nursing homes appear ready to give some pushback.
“Everyone would love to [raise wages] but they’d need to be able to pay for it,” Nyberg said. “The money just isn’t there. Raise the Bar makes it appear that nursing homes are sitting on a bunch of money, but they’re not.”
Adanjesus Marin, Raise the Bar’s coordinator, argued that spending at some nursing homes does not prioritize patients or caregivers.
“We know many nursing homes divert funds from the bedside to high administrative spending,” Marin said.
Nyberg and Fraser also noted that although Rhode Island does not require a minimum amount of time that caregivers must spend with residents, the U.S. Centers for Medicare & Medicaid Services report that facilities in the state average 3.6 hours. That’s higher than what most states require, Nyberg said.
Raise the Bar pointed to a report by the Long Term Care Community Coalition, a New York-based nonprofit, that says Rhode Island nursing home residents get 3.2 hours per day with caregivers. The average is the lowest in New England, according to the coalition.
Elizabeth Graham is a PBN staff writer. Contact her at Graham@PBN.com.
