According to the Associated Press, the federal government for the first time will dictate staffing levels at nursing homes, responding to systemic problems bared by mass COVID-19 deaths.
While such regulation has been sought for decades by allies of older adults and those with disabilities, the proposed threshold is far lower than many advocates had hoped. It immediately drew ire from the nursing home industry as well, which said it amounted to a mandate that couldn’t be met.
The proposed rules, which now enter a public comment period and would take years more to fully take effect, call for staffing equivalent to 3 hours per resident per day, just over half an hour of it coming from registered nurses. The rules also call for facilities to have an RN on staff 24 hours a day, every day.
The average U.S. nursing home already has overall caregiver staffing of about 3.6 hours per resident per day, according to government reports, including RN staffing just above the half-hour mark. Still, the government insists a majority of the country’s roughly 15,000 nursing homes, which house some 1.2 million people, would have to add staff under the proposed rules.
The new thresholds are drastically lower than those that had long been eyed by advocates after a landmark 2001 CMS-funded study recommended an average of 4.1 hours of nursing care per resident daily. Most U.S. facilities don’t meet that threshold. Many advocates said even it was insufficient, not taking into account quality of life, simply determining the point at which residents could suffer potential harm.
Current law requires only that homes have “sufficient” staffing, but it leaves nearly all interpretation to states. Thirty-eight states and the District of Columbia have their own staffing regulations. Some are so low that advocates say they’re meaningless, and, across the board, enforcement is often toothless.
