New Minimum Staffing Requirements in Nursing Homes
On the 22nd of April 2024, through the Centers for Medicare & Medicaid Services, the U.S. Department of Health and Human Services issued a new rule on elder care regarding minimum staffing requirements for Nursing Homes. This rule aims to support family caregivers and increase compensation and job quality in nursing homes. It also aims to expand and improve care options and improve safety and quality care. The requirements of the rule will gradually be implemented over five years.
Everyday, over 1.2 millions residents receive care at Medicare- and Medicaid certified nursing homes. CMS considered 46,000 public comments, including those from nursing home residents, their families, workers, advocates and the industry. Many of these comments made it clear that when there isn’t enough staff, residents don’t get the necessary care.
New Nurse Staffing Standards
Nursing homes participating in Medicare and Medicaid will be required to follow nurse staffing standards outlined below.
- Nursing homes will need to provide residents with a minimum of 0.55 hours of care from a registered nurse per resident per day, and 2.45 hours of care from a nurse aide per resident per day.
- A registered nurse must be on-site 24 hours a day, 7 days per week.
The above changes will go into effect in 2 years for urban nursing home and 3 years for rural nursing homes. Right now, fewer than 1 in 5 nursing facilities meet these nursing standards.
- Nursing homes will need to do a more thorough staffing assessment to better identify resources and supports needed to properly care for the residents and then implement plans to attain those goals. Assessments will be conducted by nursing facility staff, residents’ families or legal representatives. The first phase of this new rule will be audits that will take effect 60 days after publication of the final rule.
- Create a staffing plan to maximize recruitment and retention.
Per Kaiser Family Foundation, 90 percent of for-profit facilities will need to hire more nursing staff and 60 percent of nonprofit and governmental facilities will need more nursing staff. The goal of this effort is to improve resident safety and provide a higher quality of care to the residents.
CMS’ Responsibilities
- Expand audits of the direct care staffing data nursing homes must report. Goal is to have accurate information online at Nursing Home Care Compare and CMS’ website for families and prospective residents to use to learn about the nursing homes.
- Evaluate state inspection findings to make sure any deficiencies receive an appropriate consequence.
- Ensure taxpayer dollars are being used for safe, high-quality care. One way this will be accomplished is that Medicaid agencies will be required to report on the percent of Medicaid payments for institutional long-term services and supports (LTSS) that go toward the compensation for direct care workers and support staff.
- Improve resident safety when faced with emergencies. One effort to meet this objective will be conducting a national study of how prepared nursing homes are for emergencies, which will also define what the key challenges are and identify how to strengthen protections for residents.
Will It Be Difficult for Nursing Homes to Meet these Terms?
According to a Kaiser Family Foundation study, nursing home administrators point to a shortage of registered nurses and aides as being an obstacle to achieving the goals of the rule. In an effort to overcome that hurdle, CMS’s plan includes spending $75 million to incentivize nurses to work in nursing homes by using scholarships and tuition reimbursement.
Planning for Long-Term Care
Long-term care is one of the largest expenses many seniors face. Nursing home costs in the Boston area average $14,000 per month. Many families are unable to afford these services as costs continue to increase. MassHealth will cover the cost for Massachusetts seniors who are financially limited and need nursing facility-level care. We can help you navigate the confusing and burdensome application process for MassHealth long-term care benefits. Contact us today to schedule a consultation.
