​The California Association of Health Facilities (CAHF) is calling on the state to provide a living wage for certified nursing assistants (CNAs) who work in skilled nursing homes by 2025. The “Drive to 25” campaign is part of a series of reforms needed to deal with a crippling workforce shortage that is threatening access to skilled care in nursing homes.

CAHF is requesting that the Medi-Cal program establish a nursing home CNA minimum wage that will grow to $25 per hour in the next 3 years.

Fifty one percent of direct care staff, the backbone of care delivery in nursing homes, are eligible for public assistance according to a report by the California Labor and Workforce Development Agency.

Craig Cornett“For too long skilled care workers have been overlooked, overworked and underpaid,” said CAHF CEO Craig Cornett. “This reform is focused 100 percent on strengthening and developing the nursing home caregiver workforce and will not enrich facility operators.”

Cornett noted almost 80 percent of the state’s direct care workforce is comprised of women. Fifty percent are immigrants, and many are single mothers.

“A living wage will help workers, increase caregiver retention and benefit resident care,” he added.

The SNF Medi-Cal reimbursement level has never adequately provided for the sickest, poorest and often oldest Californians. The Medi-Cal program reimburses the average nursing home $250 a day to provide an individual 24 hours of care. By comparison, the state pays the average IHSS worker about  $130 a day to cover one 8-hour shift to support an IHSS resident in their own home, without the delivery of any nursing care, meals, utilities or rent.

Skilled nursing facilities (SNFs) in California are almost 100 percent government funded, with most SNFs receiving approximately 66 percent of their funding from the Medi-Cal program (the remaining funding comes almost exclusively from Medicare). The government payments that SNFs receive provide funding for wages for nursing staff (RNs, LVNs, CNAs, etc.), wages for support staff (janitorial, housekeeping, food service, and office support), payment for operating expenses including utilities, supplies, food and rent to pay for resident housing costs.

Under the proposal, SNFs will pay a specified minimum wage with Medi-Cal covering the costs of approximately two thirds of the wage increases. The rest will be covered by facility funds. The Medi-Cal share of this cost will be funded as a direct pass-through from the state to facility employees. The new “CNA living wage” will not be discretionary but required to be paid to all CNAs.

In addition to the minimum wage proposal, CAHF also supports additional reform proposals, including enhanced registered nursing in skilled nursing facilities, workforce investment in skilled nursing facilities, and a two-year study to establish evidence-based standards for specific minimum care requirements during times of normal and emergency nursing home operations.
For more information contact CAHF Director of Public Affairs, Deborah Pacyna, or visit the California Association of Health Facilities website.