Biden Administration Sets Nursing Home Staffing Minimums

TUESDAY, April 23, 2024 (HealthDay News) — The first-ever minimum staffing rule has been set for nursing homes, the Biden administration announced Monday.

Central to the final rule, first proposed in September, is a requirement that a registered nurse be in every skilled nursing facility 24 hours a day, seven days a week.

It also mandates that there be enough staff to provide every resident with at least 3.48 hours of care each day. Last but not least, it strengthens rules for assessing the care needs of every resident, which should boost care for sicker residents.

“When facilities are understaffed, residents may go without basic necessities like baths, trips to the bathroom and meals — and it is less safe when residents have a medical emergency,” the White House said in a statement announcing the new rule. “Understaffing can also have a disproportionate impact on women and people of color who make up a large proportion of the nursing home workforce because, without sufficient support, these dedicated workers can’t provide the care they know the residents deserve.”

To be phased in over the next few years, the new rule will replace a vague standard that gives nursing homes wide latitude on staffing.

The nation’s 15,000 nursing homes are regulated by the federal government, which pays for the majority of resident stays through the Medicare and Medicaid health insurance programs.

While the administration said the rule will improve care, industry groups took issue with the change.

“We are extremely disappointed and troubled that the Biden Administration is resolved to issue this unfunded staffing mandate despite overwhelming concerns from experts, stakeholders and policymakers on both sides of the aisle,” American Health Care Association President and CEO Mark Parkinson said in a statement released Monday. “While it may be well-intentioned, the federal staffing mandate is an unreasonable standard that only threatens to shut down more nursing homes, displace hundreds of thousands of residents and restrict seniors” access to care.”

“It is unconscionable that the Administration is finalizing this rule, given our nation”s changing demographics and growing caregiver shortage,” Parkinson added. “Issuing a final rule that demands hundreds of thousands of additional caregivers when there”s a nationwide shortfall of nurses just creates an impossible task for providers. This unfunded mandate doesn”t magically solve the nursing crisis.”

The scope of the crisis is significant, U.S. health officials noted.

The administration received over 46,000 comments on the rule since it was proposed last September, according to the U.S. Centers for Medicare and Medicaid Services.

The comments included reports of people lying in their own filth for hours, not being fed appropriately and being left on the floor too long after falling, U.S. Secretary of Health and Human Services Xavier Becerra told the Washington Post.