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New Law to Mandate Minimum Standard for Nursing Home Staffing

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The issue of proper nursing home staffing levels seems to be raging these days. In the aftermath of COVID and with the reality of chronic labor shortages, nursing home staffing – or the lack of it – has been blamed for a host of ills in the long-term care industry. With wages low and turnover high, many nursing homes have struggled to maintain a level of staffing that ensures proper patient care and safety. What’s the solution?

The Biden administration seems to have at least one answer to the problem of nursing home staffing. In this article from The Hill, reporter Joseph Choi writes that the White House is proposing a minimum safe staffing level that all nursing homes will have to meet from now on. The new proposal isn’t law yet – in fact, it’s just a proposal at this point. But according to the report in The Hill, if the new regs are passed, estimates are that 75 percent of the nation’s nursing homes will have to add staff in order to be in compliance.

Nursing Home Staffing Tied to Patient Safety

“The White House on Friday announced a round of new initiatives aimed at improving nursing home safety,” Choi writes in his article. The new guidelines include a regulation establishing what the article calls “a 24/7 ‘federal floor’ on staffing levels to ensure homes are properly staffed.”

According to The Hill, the administration’s statement was blunt. “The nursing home industry receives nearly $100 billion annually from American taxpayers, yet too many nursing homes chronically understaff their facilities — resulting in poor, substandard care that endangers residents,” the White House said.

In the announcement, administration sources said that the Department of Health and Human Services (HHS) would be taking several actions to protect nursing home residents, including (according to The Hill) “setting minimum staffing levels for nursing homes and enforcing existing standards.”

Nursing Home Staffing Linked to 2023 Presidential Priorities

“President Biden named nursing home safety as an issue where he wanted to seek improvements in his 2023 State of the Union address,” Choi writes. The article quotes President Biden when he said. “We’re protecting seniors’ life savings by cracking down on nursing homes that commit fraud, endanger patient safety, or prescribe drugs that are not needed.”

The new regulations establish what seems to be a common-sense standard for resident care. “The proposed rule for a federal floor on staffing levels would require facilities to have a registered nurse on site 24/7 as well as a minimum number of registered nurses and nurse aides,” says Choi. “The Centers for Medicare and Medicaid Services (CMS) is proposing that this requirement be carried out in phases to allow facilities enough time to hire the necessary staff.”

On top of the new staffing rules, the proposal sets standards for how much daily care each resident will be required to receive. “Nursing homes would also be required to provide residents with at least 0.55 hours of care from a registered nurse every day,” says The Hill, “as well as 2.45 hours of care from a nurse aide.”  That translates into a daily minimum of 3 hours of actual nursing care daily.

Nursing Home Staffing Rules Affect 75 Percent of Facilities

The effects of this new set of regulations appear sweeping. “CMS estimates about 75 percent of nursing homes would need to strengthen their staffing,” says the article.

In the article for The Hill, Choi writes that the new proposal is based on “observed improvements in health outcomes” related to higher staffing levels. The White House’s announcement cited one study demonstrating that 20 minutes per day per resident of additional staff time by a registered nurse cut COVID-19 cases by 22 percent and COVID-19 deaths by 26 percent.

The announcement also puts nursing home operators on notice. “In recent years, there has been a disturbing trend towards private equity firms and other large corporate owners purchasing nursing homes and slashing levels of staff as a way to maximize profits,” the White House statement read. “Research suggests the result is more illness and more deaths in those homes”

In answer to the obvious question – where will the new workers come from? – the White House is offering a partial solution in the form of a $75 million investment into expanding the nursing workforce. According to The Hill, CMS will partner with the Health Resources and Services Administration to help “recruit, train, retain, and transition workers into nursing home careers.”

This is clearly a developing story. As we read more, we’ll share the details with you here.

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(originally reported at

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