Biden administration proposes minimum staffing levels for nursing homes

The White House on Friday announced a round of new initiatives aimed at improving nursing home safety, including one to establish a 24/7 “federal floor” on staffing levels to ensure homes are properly staffed.

“The nursing home industry receives nearly $100 billion annually from American taxpayers, yet too many nursing homes chronically understaff their facilities — resulting in poor, substandard care that endangers residents,” the White House said in a statement.

The Department of Health and Human Services (HHS) detailed several actions it would be taking, including setting minimum staffing levels for nursing homes and enforcing existing standards.

President Biden named nursing home safety as an issue where he wanted to seek improvements in his 2023 State of the Union address.

“We’re protecting seniors’ life savings by cracking down on nursing homes that commit fraud, endanger patient safety, or prescribe drugs that are not needed,” he said at the time.

The proposed rule for a federal floor on staffing levels would require facilities to have a registered nurse on site 24/7 as well as a minimum number of registered nurses and nurse aides. The Centers for Medicare and Medicaid Services (CMS) is proposing that this requirement be carried out in phases to allow facilities enough time to hire the necessary staff.

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. CMS estimates about 75 percent of nursing homes would need to strengthen their staffing.

Observed improvements in health outcomes were cited in the White House’s announcement, including one study that associated an additional 20 minutes of staffing of a registered nurse per resident with 22 percent fewer COVID-19 cases and 26 percent fewer COVID-19 deaths.

“In recent years, there has been a disturbing trend towards private equity firms and other large corporate owners purchasing nursing homes and slashing levels of staff as a way to maximize profits,” the White House statement read. “Research suggests the result is more illness and more deaths in those homes”

The administration also announced a $75 million investment into expanding the nursing workforce. CMS will partner with the Health Resources and Services Administration to help “recruit, train, retain, and transition workers into nursing home careers.”

“CMS is proud to be leading the President’s initiative to improve the lives of over 1.2 million residents who reside in Medicare and Medicaid-certified long-term care facilities, and those who will need that care in the future,” CMS Administrator Chiquita Brooks-LaSure said.