New Staffing Rule…Again

CMS issued new rules establishing minimum staffing levels for nursing homes. The rules require that all facilities receiving funding through Medicare and Medicaid have staffing equivalent of at least 3.48 hours of nursing care per resident, per day. These facilities must also have a registered nurse on site at all times.

The new rules are the most substantial changes to federal oversight of the nation’s roughly 15,000 nursing homes in 30 years. Unfortunately, they are less stringent than what patient advocates said was needed to provide good quality care. A CMS-commissioned study in 2001 found that the quality of care improved with increases of staff up to a level of 4.1 hours per resident per day — nearly a fifth higher than what CMS will require.

The rules primarily address staffing levels for three types of nursing home workers. Registered nurses, or RNs, are the most educated and responsible for assessments and care plans guiding overall care. Licensed practical nurses work under the direction of RNs and perform routine medical care such as taking vital signs. Certified nursing assistants are supposed to be the most plentiful and help residents with daily activities like going to the bathroom, getting dressed, and eating.

An alarming 73% of the nursing home workforce is facing “intermediate to high levels” of stress – the high risk group representing a rate that is double that of the general population at 34% compared to 17%, according to a new study. Safe staffing will prevent caregiver burnout.

Industry complains they need money but a study published in March by the National Bureau of Economic Research estimated that 63% of profits were secretly siphoned to owners through inflated rents and other fees paid to other companies owned by the nursing homes’ investors.