Nursing homes will now need to have a minimum number of front-line caregivers for the first time under a new mandate announced by the Biden administration on Monday.
The final policy, revealed by Vice President Harris, is being implemented despite strong efforts by the nursing home industry and bipartisan lawmakers to oppose it, saying a federal standard is not possible due to a nationwide staffing shortage worsened by the COVID-19 pandemic.
In his 2022 State of the Union address, President Biden announced a series of reforms for nursing homes and pledged that staffing minimums would be part of them. Advocates have been pushing for this requirement for more than twenty years, stating that residents are more secure and receive better care with more staff.
Much of the final policy is similar to what the administration suggested last September. All nursing homes that receive federal funding through Medicare and Medicaid will need to have a minimum number of hours that staff members spend with residents.
Current law only demands that nursing homes have “sufficient” staffing to meet the nursing needs of residents. The “sufficient” rule is too vague, according to experts and advocates, and facilities have not been held to a high enough standard.
The final rule will also require facilities to have a registered nurse on staff around the clock, seven days a week, among other provisions.
Nursing homes would also be required to provide residents with at least 0.55 hours of care from a registered nurse every day, as well as 2.45 hours of care from a nurse aide.
The combined three hours falls short of what a key federal study from 2001 found; at a minimum, it said facilities should provide 4.1 hours of direct care per resident per day to ensure they’re safe from falls and other harms.
But most U.S. nursing homes don’t meet that standard, and advocates said residents are generally sicker and need more care now than 20 years ago.
The requirements of the rule will be introduced in stages, with longer timeframes for rural communities. Limited, temporary exemptions will be available for both the 24/7 registered nurse requirement and the underlying staffing standards for nursing homes in workforce shortage areas that demonstrate a good faith effort to hire.
Advocates have been pushing for this requirement for more than twenty years, stating that residents are safer and receive better care with more staff, but the industry had successfully resisted.
Then the coronavirus pandemic hit. More than 200,000 nursing home residents and staff died from the virus, exacerbating the existing concerns and forcing federal officials into action.
