Elderly Care
Biden Administration Proposes New Rules Requiring Staffing Boost in Nation’s Nursing Homes
With nursing homes facing significant challenges, the general agreement is that the proposed rule needs to be more supportive of the cause.
Challenged by the nursing home industry’s struggle during COVID-19, which claimed the lives of 200,000 residents, the Biden administration is suggesting novel criteria that would force understaffed nursing homes to employ more staff. The regulations could induce the most noteworthy national nursing home policy transformation in 30 years. Patient advocates and the industry agree that the CMS’ proposed changes do not fully address the demands of the approximately 1.2 million Americans residing in nursing homes.
Specifically, CMS has suggested that all nursing homes increase their staff to meet specific minimum standards. However, no budget is allocated to cover hiring additional employees. CMS predicts that around 75% of the 15,000 national nursing homes would require more staff, but for some, this increase would be modest as they already have nurses and aides meeting the desired levels.
Despite recognizing some merits in the proposed standards, critics contend they must further enhance healthcare provision. While some experts acknowledge the positives they convey, they argue that the proposed measures are inadequate. One such critic, David Grabowski, a healthcare policy professor at Harvard Medical School, expresses dissatisfaction with the administration’s efforts, feeling that there was room to do more, specifically in setting higher staffing levels.
“The standards are a lot lower than what a lot of experts, including myself, have called for over the years,” said David Grabowski, a professor of health care policy at Harvard Medical School.
Nursing homes may have to restructure their staffing plans under the proposed government proposal. The draft stipulates a daily average nurse staffing level of 0.55 hours per resident, implementing a ratio of one registered nurse per 44 residents. This benchmark adopts a lower standard than the current federal of 0.66 hours per resident (1:36 ratio). As a significant change, one registered nurse must be on-call around the clock, differing from the current condition of eight consecutive hours of nursing coverage.
The government’s proposition requires that each resident receives 2.45 hours of attention from a nurse aide daily, meaning that about one aide should be present for every ten individuals. Even though there are no fixed criteria at the federal level regarding required staffing numbers for nurse aides, homes presently offer roughly 2.22 hours of attention each day by a nurse aide, with an average ratio of about 1:11.
With more resources from the two federal insurance programs that typically cover nursing home care, industry experts feel it is possible to attain the financial means necessary to hire more staff. Administration members have stated a considerable shortage of qualified workers, particularly those in nursing positions. As a result, it is deemed challenging to adhere to the suggested staffing levels.
Richard Mollot, Executive Director of Long Term Care Community Coalition, joins the cohort of critics of the proposed standards for nursing homes being wholly inadequate to do justice to the residents’ requirements. Katie Smith Sloan, President and CEO of LeadingAge, an association advocating for nonprofit nursing homes, calls the mandate pointless when staffing levels are unattainable due to a lack of available workers.
In nursing homes, it is essential to have a strong team of medical professionals consisting of registered nurses, licensed practical nurses, and nurse aides, each with their own unique responsibility. Registered nurses supervise assessments and tackle intricate clinical tasks, whereas licensed practical nurses handle more straightforward clinical duties as needed. On the other hand, nurse aides help residents with fundamental tasks such as bathing, getting up from bed, and feeding. With this nurturing staff, patients will receive the highest quality care possible.
With nursing homes facing significant challenges, the general agreement is that the proposed rule needs to be more supportive of the cause. The Biden administration has submitted a proposal that includes the distribution of $75 million in scholarships and tuition. The established plan will remain open for public commentary over 60 days before its official implementation.
