Powell Valley Healthcare's Care Center leaders are looking for support from the board to fight back against a proposed federal rule they say would cripple care centers across the country, including in Powell.

Nicole Ostermiller, CFO and director of The Heartland assisted living facility, and Michelle Petrich, acting nursing home administrator, said a proposed rule by Centers for Medicare and Medicaid would not be feasible by especially rural nursing homes like those in Powell as far as staffing mandates and an increase in paperwork.

Petrich said the most concerning proposed standard is requiring 24-hour RN coverage on the floor.

She said with the extra cost of RNs over LPNs and the shortage of RNs a national issue, they can’t see how they could comply with that standard.

“You can't make things just carte blanche work for everybody,” Petrich said, adding, “We don't make enough in a day from Medicare and Medicaid to cover our costs right now.”

She said Powell is actually generally above the staffing levels the new rule would require — and well above the current staffing minimum from the state of 2.25 resident hours per day, which Petrich said was too low for safety — aside from the RN requirement.

“Putting a mandate in doesn’t mean we'll be able to achieve it,” Ostermiller said.

The current requirement is one eight-hour RN shift per 24 hours.

Petrich said with 60 residents in long term care under the new rules, some of which would be phased in over three years, it would require hiring more CNAs and RNs, at a time when the two positions are some of the most sought after nationwide by hospitals, many of whom don’t have enough of either.

Petrich said even if they were able to fully staff as per the proposed regulations, staff leaving would leave them scrambling.

“And if I lose staff, I still have 50 residents and I still have to take care of them,” she said. “We could safely discharge, but that’s not good for families or residents.”

The two asked for board members to send in comments opposed to the rule, and multiple members questioned the wisdom of a rule that would be so hard for many institutions to follow.

“Our staffing is better than a lot of them, but this will cripple facilities and they will close,” Ostermiller said, adding, “That’s why we have to help educate them on reality.”