The Biden administration announced on Friday new federal minimum staffing requirements for nursing homes, which the Centers for Medicare and Medicaid Service estimated would require nearly 75% of facilities to increase their staff sizes.
“Establishing minimum staffing standards for nursing homes will improve resident safety and promote high-quality care so residents and their families can have peace of mind,” Health and Human Services Secretary Xavier Becerra said. “When facilities are understaffed, residents suffer. … Comprehensive staffing reforms can improve working conditions, leading to higher wages and better retention for this dedicated workforce.”
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CMS’s proposed requirements, which will not take effect until this fall, would require a minimum of 0.55 hours of care per resident per day from a registered nurse and 2.45 hours from a nurse’s aide, “exceeding standards in nearly all states,” according to the Department of Health and Human Services. Nursing homes will also be required to have a registered nurse working at the facility at all times.
The initiative comes as a fulfillment of President Joe Biden’s efforts announced in February 2022 to improve the quality of care for seniors in nursing homes after the failures of the coronavirus pandemic, during which nearly 1 in 4 COVID-19 deaths were either patients or workers in nursing homes.
AARP Chief Advocacy Officer Nancy LeaMond told the Washington Examiner that the pandemic highlighted “the lack of standards and poor-quality care in too many of America’s nursing homes is deadly. Far too many Americans died in those facilities, which have been plagued with problems for many years.”
Mark Parkinson, the president of the American Health Care Association, which represents over 14,000 nursing homes and long-term care facilities, by contrast, said in a press statement that the proposed rules are “unfathomable.”
Parkinson said the rule “requires nursing homes to hire tens of thousands of nurses that are simply not there. It then penalizes us and threatens to displace hundreds of thousands of residents when we can’t achieve the impossible. Already, hundreds of nursing homes across the U.S. have closed because of a lack of workers.”
The proposed regulations are also meant to increase wages for nursing home employees, especially for entry-level positions, which the department said will help with recruitment and retention difficulties.
The agency said more than 500,000 workers provide direct care in nursing homes and that their work is performed primarily by minority women and is undervalued.
“Wages are an important part of job quality and drive challenges in recruitment and retention of direct care workers,” said Miranda Lynch-Smith, senior official performing the duties of the assistant secretary for planning and evaluation. “Our research shows that in many places, these workers can earn higher wages doing other entry-level work.”
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As of April 2021, the nursing home industry market was worth $146.9 billion, with approximately 1.6 million employees. HHS estimates that 1.2 million people live in nursing homes across the country.
During the public comment period, Parkinson said that the AHCA will attempt “to convince the administration to never finalize this rule as it is unfounded, unfunded, and unrealistic.”
