Nursing home and labor leaders believe more labor organizing will happen in conjunction with the forthcoming federal staffing minimum mandate, as the sector has historically seen a low proportion of workers covered by union contracts.
Having a federal standard in place could begin collective bargaining efforts, or maybe remove this sticking point in labor negotiations, according to an article published in Axios. However, a mandate with waivers could dilute such a rebound in staffing, reform advocates warn.
Only 16% of nursing home workers were represented by labor unions in 2021, according to Adam Dean, a labor politics expert at George Washington University who was cited by Axios. Dean led a study, which was published in Health Affairs, which found facilities with unionized workers saw 10.8% lower Covid death rates among residents and 6.8% lower Covid infection rates for workers.
This was between June 2020 and March 2021.
Meanwhile, President Joe Biden in his State of the Union address last year said he wants the industry to increase its stock of “good-paying, union jobs;” the Biden administration has committed $80 million in grants to help with training the nursing home workforce too.
Unions that already represent nursing home staff believe that the mandate will bring workers back to the industry after years of what the industry has said is crippling labor shortage. As of 2022, the industry has lost more than 200,000 workers, according to the American Health Care Association (AHCA).
Matthew Yarnell, president of SEIU Healthcare in Pennsylvania, said staffing would rebound if union talks could improve workplace conditions Axios reported, citing comments made by Yarnell during a virtual press conference on June 30.
The state revised its staffing guidelines for the first time in decades thanks to talks between the Pennsylvania Health Care Association (PHCA) and SEIU PA – the new standards start this month. Requirements include having a certified nursing assistant (CNA) per 20 residents during the day, and one CNA per 20 residents at night.
One licensed practical nurse (LPN) must be on the floor for every 25 residents; the same rule applies for 30 residents in the evening and 40 at night.
Zach Shamberg, president and CEO of PHCA, said in a previous interview with Skilled Nursing News that the unions and the association worked to find the right staffing ratio – and achieve commensurate funding to include accountability provisions.
The federal mandate, he told Skilled Nursing News, is still a point of contention between unions and operators. Shamberg points to the “one size fits all” of a potential mandate, and the fact that there is no funding tied to the initiative.
Ahead of any announcements, Shamberg hopes CMS will take a page from Pennsylvania’s book and find middle ground through discussions.
Other states including California and Oregon have already imposed staffing minimum requirements – while operators have to limit the number of patients they can take, union organizers say that makes for better living and working conditions among residents and staff.
However, many question the effectiveness given waivers available for operators, according to the Axios article. About 323 California facilities as of April have applied for waivers since the standards took effect in 2018.
And, the state has not been adequately enforcing the mandate, meaning there are still a “significant” number of understaffed SNFs, California Advocates for Nursing Home Reform Senior Staff Attorney Anthony Chicotel said in the Axios article.
Companies featured in this article:
AHCA, Axios, California Advocates for Nursing Home Reform, CMS, George Washington University, Health Affairs, Pennsylvania Health Care Association, SEIU Healthcare PA
