The Biden administration has finalized the first-ever minimum staffing rule at nursing homes. The controversial mandate requires that all nursing homes that receive Medicare and Medicaid funding provide a total of at least 3.48 hours of nursing care per resident per day, including defined periods from registered nurses and from nurse aides.
This means that a facility with 100 residents would need at least two or three registered nurses and at least 10 or 11 nurse aides, as well as two additional nurse staff, who could be registered nurses, licensed professional nurses or nurse aides, per shift. Plus, nursing homes must have a registered nurse onsite at all times.
The mandate will be phased in, with rural communities having longer timeframes, and temporary exemptions will be available for facilities in areas with workforce shortages that demonstrate a good faith effort to hire.
The rule, which was first proposed in September and initially called for at least three hours of daily nursing care per resident, is aimed at addressing nursing homes that are chronically understaffed, which can lead to sub-standard or unsafe care.
Nursing home operators strongly objected to the minimum staffing proposal in September, saying they already struggle to fill open positions. Such a requirement could force some facilities to close.
Meanwhile, some consumer advocates were also dissatisfied with the proposed rule, saying it doesn’t go far enough.
The proposed staffing mandate has also split Congress, whose approval is not required. A bipartisan Senate bill and similar legislation introduced by House Republicans would prohibit the Department of Health and Human Services from finalizing the rule.
