In a proposed rule distributed on Sept. 1, 2023, the Centers for Medicare and Medicaid Services (CMS) created new staffing rules for nursing homes. So far, the rules are only a proposal, but nursing homes have until Nov. 6, 2023, to respond with comments.
The Pandemic's InfluenceMany healthcare problems that existed at nursing homes were exposed during the pandemic. The USAToday reports that during COVID-19, more than 200,000 nursing home residents and staff died. Not long ago, business firms started buying homes and reducing staff and care to ensure more profits. They also said that nonprofit nursing homes are three times more likely to provide quality care than for-profit facilities.
The Potential Need for More NursesOne of the biggest reasons for the increase in nurse hours at nursing homes is that it would reduce health problems and emergency hospital visits if nurses gave each patient more time. An increased presence of nursing staff would allow a more careful evaluation of each patient's needs.
The Required HoursThe new requirements establish set hours that medical staff must give each patient. A registered nurse must attend to each patient for 0.55 hours (35 minutes), and nurse assistants must give each patient 2.45 hours of care per day. In addition, each nursing home facility must have a registered nurse present 24/7.
A Huge ProblemThere are two kinds of nursing homes in the United States—those that are for-profit and those that are nonprofit. While some in both categories have sufficient funds that would enable them to hire more staff, most would not be able to do so.
The Reporting RequirementsEach state will be required to collect information on how each nursing home uses funds from Medicaid. It includes knowing what percentage of Medicaid funds go to pay for their workers. Health and Human Services already has a proposal to understand the hourly pay for workers in home and community-based care to create more uniform pay for those in the industry.
More Trained StaffThe CMS's plan will also help prepare more people to work in the nursing home-care field. There is $75 million available to recruit and train new staff for scholarships and to reimburse tuition costs. Nursing homes already receive about $100 billion from the federal government.
The CriticismAlthough the proposed plan does provide steps in the right direction, many believe they do not go far enough. The New York Times claims there are about 15,000 nursing homes nationwide and about three quarters of them would need to hire more staff.
One of the big questions about the practicality of the proposed rule is where all the new qualified staff will come from. Besides that, nursing homes often pay less than a hospital, and nursing staff work harder than they would at a hospital. It makes it easy for a nurse or nurse's aide to want to start working at a hospital.
After all the comments are in and evaluated, the CMS will issue a final rule on nursing home requirements for staffing. Urban nursing homes will have less time to comply than rural homes.