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this post was submitted on 22 Apr 2024
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There's a difference. Psychiatric facilities struggle with funding, nursing homes ABSOLUTELY do not. Have you seen the cost of living in even the shittiest nursing homes? It's common practice to be paying upwards of $10,000 per month, per resident. Nursing homes have all the money they could ever want, they're just greedy fucks who purposely utilize dangerously understaffed facilities to maximize profit for those at the top.
They were lumped together in the Reagan administration culling payments for all times of those though. There are few protections for the elderly even still. You don't need to dig deep and find a zillion hits about these companies raising care rates out of nowhere to vacate tenants. It's absolutely insane, and there should be laws against it top to bottom.
Plenty of states it's much higher, in Minnesota the rate is set by the state according to patient need. It's not unheard of to pay $15k a month as $14k month is the average cost per resident.
To aid in contextualizing this they are being asked to spend at least $2,500 of the $14,000 on labor which isn't remotely unreasonable
Yep, and they pay CNAs subhuman wages so they’re staffed by anyone who can pass a piss test. (My local gas station sells “fetish urine” lol).
My boyfriend had to put in some hours at a long term care facility as part of nursing school. Absolutely disgusting stuff happens there - the CNAs do not give a fuck (which makes sense, it’s not like you’re making that much better than Macca’s)
$120K per year per resident isn't that much revenue to cover 24 hour availability of care, food, lease, etc.
I'm not saying it is unworkable, but with the requirement for 3.5 hours of nurse care or resident per day, that means the maximum total cost of a Nurse is $95 per hour, or about $190K.
That really isn't much - typically employees cost a business twice their base salary. So the nurses can be paid $100K per year while leaving almost $0 for any other expenses..
How are you getting $95 an hour?
3.5 hours of nurse care per resident per day (from the bill).
Resident pays $120K per year to stay at the facility.
There are 365*3.5 hours in a year they need nursing care = 1277 hours of nursing care per year per client.
$120K per year / 1277 hours per year = $94/ hr maximum cost for each nurse - assuming there are no other expenses for the facility.
Must have mistyped to get $95, but that is the math.
Okay, now I understand what you meant by maximum cost. It should be noted that the nurses will likely be paid closer to $30 / hour, give or take depending on the area.
The $94/hr isn't a salary, it's the cost to the business. Employees generally cost a business 1.3-1.5X their salary - since insurance, payroll taxes, PTO, etc. all also need to be paid for.
Again this is not considering any other cost for the facility: utilities, food, other staff, medical equipment, maintenance, insurance, rent...
I'm not worried about their profits tbh. Nursing homes had total net revenues of $126 billion and a profit of $730 million (0.58%) in 2019. They can afford to staff properly and fairly and still make a disgusting amount of profit.
That is an insanely small margin, and directly contradicts your claim that they can staff properly.
Let's take the entire profit for the industry and hire nurses. Let's say reach nurse costs $80K ( $60K salary, $20K for taxes/insurance/other benefits).
That pays for 9600 more nurses. Which, given the nursing requirements in the bill (3.48 hours per day per resident), only covers staffing for 22K residents.. a rounding error to the more than 1.2 million nursing home residents in the country.
There are ~15K nursing homes in the US, each of them getting 0.6 more nurses doesn't help anything.
I'm no economist, but if the business can't afford to perform its function (such as a care home taking care of its residents) then the business shouldn't exist.
And that is a valid opinion. Unfortunately what do you do with all these people if the homes close because they can't afford staff?
The intent of the bill is to prevent neglect in nursing homes - that is a worthy and important goal. The mandate doesn't actually help make that happen.
It doesn't provide funding the care providers to increase staff, it doesn't add incentives for individuals to get certified and help address the personnel shortage, it doesn't put a cap on administrative costs for care facilities, it doesn't actually DO anything to help solve the problem.
Good mandates also provide an avenue to meet them.
The government is already providing funding, this just makes that funding dependent on having enough staff.
If a business needs the government to hold its hand every step of the way to be successful then it should be a government facility instead of a private business.
We get it, you don't like nursing homes.
You don't seem to be engaging with the substance of the matter, so I'll leave it here.
I like nursing homes. I don't like nursing homes that don't take care of their residents.
That is the substance of the matter here. I don't care how profitable the business is if the residents aren't being properly cared for.
The businesses are hardly profitable. For every dollar they get from housing a resident, they get just above half a penny of profit.
As I showed above, you can take the entire profit and put it into hiring more staff and it won't actually make a difference. They either need to raise prices, cut costs elsewhere (maybe administration? I'm not familiar enough to know), or pay people less.
That's what the numbers say.
Again: I don't find the argument "we can't take proper care of our residents because it's not profitable" to be compelling.
No one seems to be arguing that the care being asked for is unnecessary, just that it's expensive. And in that case I just don't care.
Again, it doesn't matter whether you find the argument about compelling.
If care cannot be provided profitably, it won't be provided at all. That is reality. Somehow, the care must be paid for.
Those who need care are not better off if these facilities close.
Their asshole
Most of that labor can be filled by nurses aids which make on average $17 an hour not $90