Presently there are no mandatory federal regulations setting minimum staffing levels for Skilled Nursing Facilities also known as nursing homes. The federal regulations states that facilities simply must have sufficient staff to meet the needs of the residents. However, nursing homes have historically mainly used the number of residents to determine their staffing levels instead of taking into account how much staff is actually needed to meet the needs of the facility’ resident population or census. Presently, Medicare is attempting to impose staffing regulations and requirements for a minimum of staffing level in nursing homes. https://www.cms.gov/newsroom/fact-sheets/medicare-and-medicaid-programs-minimum-staffing-standards-long-term-care-facilities-and-medicaid-0
Among other things, these regulations would establish a minimum number of staff for Certified Nursing Assistance (CNAs) and Registered Nurses (RN). The regulations would also require a Registered Nurse to be on site at the facility twenty-four hours a day, a requirement that does not presently exist. Unfortunately, the regulations do not go far enough as far as their requirements. There are a number of exemptions that facilities can apply for to be exempt from these regulations. Furthermore, the purposed minimum regulations by Medicare would require facilities to have enough staff to provide only 3.48 hours per resident day. In other words, there should be sufficient staff for each resident to receive approximately 3.48 hours of care between LPNs, RNs, and CNAs. However, the current national average for staffing in nursing homes is 3.78 hours per resident day. As a result, the regulations would require less staff than the average facility in the United States. However, while these regulations are not sufficient, they are better than no requirements as many facilities have staffing at levels less than the average.
Unfortunately, the nursing home industry and some members of Congress have increased their efforts to block Medicare’s attempts to impose these regulations. The efforts in Congress would not only prevent the rule from being implemented but would prevent Medicare from ever issuing a rule requiring a minimum staffing in nursing homes. The nursing home industry is using both Legislative and legal tactics in court to try to prevent these rules from being implemented. We would encourage anyone with any interest in providing and making use that nursing homes are a safe place for our vulnerable elderly and disabled population to contact your Legislatures in support of the purposed regulations and requesting stronger regulations on nursing homes. Otherwise, with no requirements, the nursing home industry will continue to place profits over people and understaff their facilities to the detriment of the residents and patients.