The Biden administration on Friday unveiled its highly anticipated proposed staffing standards for the nation’s nursing homes. Under this plan, U.S. nursing homes would need to meet certain staffing benchmarks for the first time.
Each nursing home will be required to provide every resident with at least 0.55 hours of care from a registered nurse, plus 2.45 hours of care from a nurse aide, each day, according to the proposal from the Centers for Medicare & Medicaid Services (CMS), the agency that regulates Medicare- and Medicaid-certified nursing homes. The vast majority of the country’s roughly 15,000 nursing homes are Medicare- and/or Medicaid-certified.
The new rules also call for all nursing homes, which house roughly 1.2 million residents nationwide, to have a registered nurse on staff around the clock and to complete “robust” assessments of residents’ staffing needs. Facilities would be required to provide more hours of care to residents who have higher staffing needs than the proposed minimum levels.
Approximately three-quarters of nursing homes would have to strengthen staffing to meet the proposed minimums, CMS estimates.
The proposed standards, which will undergo a public comment period but do not require approval from Congress to be implemented, “will improve resident safety and promote high-quality care so residents and their families can have peace of mind,” U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra said in a statement. “When facilities are understaffed, residents suffer.”
The announcement helps push forward President Biden’s broader plan to improve the nation’s nursing homes, after residents were devastated by the COVID-19 pandemic, experiencing more than 180,000 resident deaths. The chaos thrust long-standing problems at nursing homes into the national spotlight, including issues around infection control deficiencies, chronic staffing shortages and inadequate oversight.
In his 2022 State of the Union address, Biden vowed to “set higher standards for nursing homes and make sure your loved ones get the care they deserve and that they expect.” The minimum nursing home staffing requirement is a cornerstone of the 21-point plan. Other goals include reducing resident room crowding, increasing accountability for chain owners of substandard facilities, improving transparency of facility ownership and finances, and examining the growing role of private equity firms as investors in the sector.
“A proposed federal standard is an important and long-overdue step,” said Megan O’Reilly, AARP vice president for federal health and family issues. “It is unconscionable what so many people experience in nursing homes and the lack of adequate staffing and care. The death and devastation we witnessed over the last three years has been a national tragedy and highlighted the existing shortcomings in nursing home standards.”
The desire for better staffing is widespread among consumers, O’Reilly noted, with minimum staffing standards in nursing homes supported by 89 percent of Democrats and 74 percent of Republicans, according to AARP’s recent family caregiving poll.
However, nursing home industry groups said Friday that staffing shortages will make the new standards unachievable.
The American Health Care Association (AHCA), a national lobbying group representing more than 14,000 long-term care providers, issued a statement calling the rule “unfounded, unfunded, and unrealistic.”