New federal rules will require nursing homes to increase staffing

MAINE, USA The Biden administration this week finalized new rules for nursing homes that set minimum hours of care for registered nurses and nursing assistants and require a registered nurse on call at all times.

The requirements were met with support and opposition. Advocates praised the rules as a good first step in addressing what a study found to be dangerously low staffing in many nursing homes, but some say the minimums are still lower than studies have found it is necessary to provide quality care. Providers say the mandate will be difficult to meet when nursing homes are already struggling with labor shortages.

Richard Mollot, executive director of the advocacy group Long Term Care Community Coalition, said he applauded the effort to improve the safety and dignity of residents, but the final ruling does not go far enough.

While it may offer relief to residents in very low-staffed facilities, it puts residents in those with higher staffing levels at risk, as those operators are now incentivized to reduce their staffing to the new federal standard, he said. say Mollot

The Maine Health Care Association, which represents the state’s nursing homes, said the new rule will place a financial burden on facilities that are already struggling and unable to find workers, which could force them to downsize or even shut them down.

This unfunded mandate will not magically solve the health care workforce shortage, MHCA President and CEO Angela Cole Westhoff said in a statement. Almost every nursing home in Maine is already trying to hire more employees. The fundamental problem is that there simply aren’t enough nurses to meet these impractical requirements. We need targeted investments, not blanket rules, to grow the long-term care workforce.

Under the new rules, nursing homes that accept Medicare and Medicaid will be required to provide 0.55 hours of care by a registered nurse and 2.45 hours of care by a nursing assistant per resident each day. They must also have a registered nurse on duty at all times.

When the standards were proposed last year, an analysis of The Maine monitor of the latest federal staff data found that nursing homes in Maine were closer to meeting minimum requirements than counterparts in nearly every other state, with only Alaska and Hawaii performing better.

But nursing homes in Maine were still far from meeting the standard every day.

From April to June of last year, only 8 percent of nursing homes in Maine met both standards each day. The national average was 1 percent.

Nursing homes in Maine may be better suited to meet the new standards because the state already has its own staffing requirements, including minimum staffing ratios of at least one direct care staff member for every five residents during the day; one for every 10 residents in the evening; and one for every 15 residents during the night.

But nursing homes in Maine have been struggling, with 11 closings in the past three years, according to the Maine Healthcare Association.

Gov. Janet Mills signed a supplemental budget this week that included $26 million for state nursing homes after long-term care leaders urged lawmakers to provide more support.

I The Maine monitor recently reported that rates of antipsychotic drugs administered to nursing home residents have begun to rise again in recent years, which advocates and experts say may be related to labor shortages , the lack of staff and the dependence of the workforce on temporary agencies.

Advocates for long-term care residents and industry leaders said in December that the requirement to always have a registered nurse on call will be difficult to meet because of labor shortages.

Still, our analysis of payroll data conducted with the help of USA Today and Stanford University’s Big Local News initiative found that Maine is better positioned than other states to meet this requirement.

The Monitor It found that 20 of Maine’s 85 nursing homes at the time, about 24 percent, met the required registered nurse hours each day from April to June of last year, which was better than all others New England states. Nationally, only 6 percent of nursing homes met this standard.

The new federal rules will be rolled out in phases to give nursing homes time to hire the staff needed to meet the requirements.

Within two years, they must meet the requirement of registered nursing 24 hours a day, 7 days a week, and within three years the homes must meet the minimum care hours of registered nurses and nursing assistants. Nursing homes in rural areas will have more time: three years to meet the 24/7 RN requirement and five years to meet the full hours standard per resident per day.

The US Centers for Medicare and Medicaid Services, which regulates nursing homes, is developing a $75 million campaign to provide financial incentives for registered nurses to work in nursing homes, such as reimbursement of enrollment and facilitate enrollment in training programs.

CMS received more than 46,000 public comments on the proposed rule, according to a news release, with many highlighting the ways in which nursing home residents suffer when there are not enough nurses on call.

Everyone should have equal access to the intensive care they need, Health and Human Services Secretary Xavier Becerra said in a press release. Our caregivers, those who care for the people we love, deserve our full respect and support.

This story was originally published by The Maine monitor, a nonprofit, nonpartisan news organization. For regular Monitor coverage, sign up for a free Monitor newsletter here.

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