Federal Government to Regulate Staffing at Nursing Homes for First Time

FRIDAY, Sept. 1, 2023 (HealthDay News) -- Nursing homes will soon have to meet federal minimum staffing requirements, the U.S. Department of Health and Human Services (HHS) announced Friday.

"Establishing minimum staffing standards for nursing homes will improve resident safety," HHS Secretary Xavier Becerra said in an agency news release announcing the proposal. "When facilities are understaffed, residents suffer. They might be unable to use the bathroom, shower, maintain hygiene, change clothes, get out of bed, or have someone respond to their call for assistance. Comprehensive staffing reforms can improve working conditions, leading to higher wages and better retention for this dedicated workforce."

The proposal would set minimum staffing to the equivalent of three hours per resident per day. Just over a half hour of that time would be from a registered nurse. Facilities would be required to have an RN on staff 24 hours a day, every day. Right now, average U.S. nursing home caregiver staffing is 3.6 hours per resident per day, with an RN working for more than a half hour of that time, according to the Associated Press, citing government reports.

Still, officials said most nursing homes would need to increase staffing. "This standard would raise staffing levels for more than 75 percent of nursing homes, bringing more nurse aides to the bedside and ensuring every nursing home has a registered nurse on site 24/7," Becerra aide Stacy Sanders told the AP.

A 2001 study funded by CMS had recommended a much higher threshold of 4.1 hours of nursing care per resident daily, the AP reported. The announcement of these new, but lower than first sought, thresholds disappointed advocates, who have said the requirements only consider the point at which someone could experience harm, not overall quality of life, the AP reported.

On the other side of the issue, the American Health Care Association (AHCA) had lobbied against staffing mandates, citing insufficient Medicaid subsidies, hiring and retention issues, and home closures. AHCA President and CEO Mark Parkinson pointed out that "nursing homes are facing the worst labor shortage in our sector's history, and seniors' access to care is under threat. This unfunded mandate, which will cost billions of dollars each year, will worsen this growing crisis. It requires nursing homes to hire tens of thousands of nurses that are simply not there," he said in an association news release.

The proposed minimum staffing rule now enters a public comment period.

Associated Press Article