The Biden administration is pushing for increasing federal nursing home staffing requirements. That effort has entered the important rulemaking phase, which will determine what the staffing requirements will be.
But now these crucial questions are being asked: How much will it cost, and who is going to pay for it?
As is well known, Covid hit elderly populations the hardest with more than 154,000 deaths among U.S. nursing home residents and staff.
As a result, the Biden administration issued a proposal for mandatory minimum staffing levels, which would fulfill a decades-long quest to shore up the quality and uniformity of care in the nation’s 15,000-plus nursing homes.
However, some industry critics say the facilities should pay the entire cost for any needed staff additions.
As reported by Bloomberg Government News, industry officials, citing low Medicaid reimbursement rates, say staffing requirements are unworkable and unrealistic, especially during a time of staffing shortages, rising labor costs, depressed occupancy, and costly infection-control measures. They say higher Medicaid payments, or some other federal funding is needed.
Better staffing in nursing homes, especially among registered nurses, has been linked to improved quality of care and infection control. A 2020 study of Connecticut’s 215 nursing homes found that in facilities with at least one confirmed case of Covid-19, every 20-minute increase in RN staffing—per resident, per day—was associated with 22% fewer infections and 26% fewer Covid deaths.
In 2001, the Center for Medicare and Medicaid Services (CMS) recommended a minimum standard of 4.1 nursing hours per resident each day to prevent harm and ensure the safety of long-term residents. That broke down to 2.8 hours from certified nursing assistants; 0.75 hours from registered nurses, and 0.55 hours from licensed practical nurses.
Only 25% of nursing homes, however, report providing that recommended level of 4.1 hours per resident per day.
The CMS will conduct a study to determine the appropriate level of mandatory care and how to finance it before announcing its plan next year. In the meantime, it has asked those affected by the pending decision to share their thoughts on the proposal.
