During a House Ways and Means Committee hearing held before the congressional recess, Rep. David Kustoff (R-TN) questioned witnesses about how workforce shortages in the healthcare sector are affecting patient access to care.
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NewsTranscript
00:00Mr. Kostoff, you're recognized.
00:03Thank you, Mr. Chairman.
00:04Thank you for holding today's hearing, and I do want to thank the witnesses also for
00:07appearing today.
00:08Mr. Fleece, if I could, with you, in your opening testimony, you talked about the workforce
00:16shortages in the healthcare sector and how those shortages are affecting access to care.
00:25I mean, in your experience, how common is it for somebody to enter the workforce as
00:31a CNA to pursue a higher level of nursing, like becoming a licensed practical nurse or
00:38a registered nurse?
00:42Thank you, Congressman Kostoff, for that great question.
00:45I will share, as the CEO of a hospice and home-based care organization that employs
00:51over 3,400 workers a day, that those healthcare workers are my first and foremost attention
01:00every day.
01:02And after the great resignation in healthcare that occurred during the pandemic, the runaway
01:08inflationary pressures that have hit healthcare since, and going on forward since then, the
01:16pressures to hire, retain, and recruit staff are immense.
01:22We are absolutely reinvesting in workforce development as an organization at EMPath,
01:28and certainly always very grateful for Congress's support for funding workforce development
01:34efforts.
01:35But it is a major healthcare crisis in the United States today.
01:38Across the entire system is adequate staffing in healthcare.
01:44Mr. Donageli, if I could with you, if a skilled nursing facility receives certain high-level
01:50deficiencies or a fine up to a certain dollar amount, as I understand that facility probably
01:57can't offer or will not be able to offer CNA classes for a certain period, I think it's
02:02two years, so hypothetically, if Madonna were to lose that ability to hold CNA classes,
02:11how would that affect your ability to be able to staff your facility?
02:15How would you be affected?
02:16Well, it would impact negatively our ability to have the CNA staff that we need in order
02:25to provide the patient care we're known for.
02:29So it's important, and we would hopefully not find ourselves in that position.
02:35Sure.
02:36The district that I represent is a mostly rural district in West Tennessee.
02:42So in my district, there are a number of counties where the local nursing facility might be
02:49the only place that somebody could obtain or take CNA classes.
02:56So would you say it's fair to say that for a nursing home, maybe like the kind that I
03:02just described, that losing the ability to hold those CNA classes would inhibit or impair
03:08their ability to be able to improve the quality of service?
03:12Yes, I would say it would.
03:16Thank you very much.
03:17Dr. Madison, I know that Medicare reimbursement for remote patient monitoring services is
03:25subject to price modification based on average cost to operate in a given geographic area.
03:32This takes into account factors like employees' wages, office space, equipment, and the cost
03:41of offering remote monitoring, not necessarily cheaper in rural areas like the kind that
03:47I represent.
03:48In fact, it might even present additional challenges like connectivity or broadband
03:54or longer travel times to set up equipment.
03:58Can you talk about how home health services like yours offer rural RPM if reimbursement
04:06for these services was in line with the national average?
04:09Does that make sense the way I asked that?
04:12I can tell you as a home health agency that we're currently offering remote patient monitoring.
04:17We offered blood pressure, weight, and glucometers for our patients.
04:22We do not get reimbursed at all for those services currently, but we feel like it's
04:27necessary in order to provide better care, especially because we can see if there's an
04:34issue a lot faster.
04:39The devices that we use, we've not had trouble with conductivity.
04:42It's Bluetooth, and it's much easier than it was 10 years ago, let me put it that way.
04:48Thank you, Dr. Madison.
04:49Thank you to the witnesses, and Mr. Chairman, I yield back.