Don’t fall for it: Proposed staffing mandate restricts access to care for everyone

The federal government has proposed a new requirement for skilled nursing facilities (nursing homes), raising the minimum staff-to-resident ratio. Initially, this seems like a good idea. Who wouldn’t want to ensure seniors and those with disabilities have enough staff to care for them? 

Unfortunately — as I know all too well as the administrator at Mt. Baker Care Center — this mandate is unlikely to improve quality of care and would worsen the staffing crisis it aims to address. 

If it takes effect and skilled nursing providers can’t recruit enough staff, they will be forced to reduce the number of available beds. Hospitals rely on discharging patients to skilled nursing facilities, so fewer skilled nursing beds means longer hospital stays — which means fewer resources for others needing hospital care. This domino effect would make already-strained hospitals like PeaceHealth St. Joseph Medical Center less accessible for everyone.  

This mandate’s consequences are far-reaching and pernicious. Having worked in Lynden, I know how rural facilities would be particularly hard-hit. Many already experience disproportionate challenges in recruiting qualified staff, and with this increased burden, would have to significantly reduce available beds or even shut down completely. 

People living in rural communities would be forced to move further away from their families to get the care they need, and seniors everywhere might struggle to find assisted living care as providers face even tougher competition for workers.

We know what happens when staffing mandates aren’t aligned with workforce realities. Facilities throughout Washington are already struggling to meet staffing requirements and are becoming more and more dependent on expensive temporary agency staff. In skilled nursing, where trust and familiarity are critical, this revolving door for caregivers is deeply concerning as it diminishes quality and consistency of care.

This rule also discounts the role of Licensed Practical Nurses, who are the backbone of Washington’s long-term care system. Excluding nurses in staffing ratios doesn’t make sense, as they would be replaced by less-trained individuals. 

There is no denying the staffing problem in long-term care, but this federal mandate won’t help. Solutions must recognize state-specific nuances and address fundamental workforce issues. We must support long-term care workers in Washington by eliminating massive backlogs in caregiver testing and credentialing, investing in vocational training programs, and tackling chronic underfunding in Medicaid reimbursement rates. Local, state and federal leaders must partner with providers to knock down barriers to entry in caregiving professions. 

I encourage Senators Murray and Cantwell to oppose this mandate and help build worker pipelines in long-term care by supporting innovative solutions — like the Care Across Generations Act, which promotes co-located assisted living and child care centers, and the Ensuring Seniors’ Access to Quality Care Act, which strengthens providers’ ability to train caregivers. As long-term care providers prepare to serve an unprecedented number of seniors, our senators’ action is essential.

Catherine Reis-El Bara has been the administrator at Mt. Baker Care Center since 2014 and has 25 years of long-term care experience.