Safety Mandate

AARP is strongly supporting a federal effort to set minimum staffing standards for the nation’s nursing homes for the first time. Under the federal proposal, nursing homes that are funded through Medicare or Medicaid would be required to provide every resident with at least 0.55 hours of care from a registered nurse, plus 2.45 hours of care from a nurse aide each day.

In a subcommittee hearing of the House Energy & Commerce Committee, Shelly Hughes, a nursing home CNA from Washington state spoke:

“On average, nursing assistants support 13 residents during a typical shift, but I’ve spoken with CNAs who have been responsible for upwards of 30 residents — alone,” she said. “The math doesn’t add up. How can you care for 30 individuals in just 12 hours?”

Ranking member Anna Eshoo (D-CA) said unsafe staffing have been plaguing the industry for decades, noting that the National Academy of Medicine called for a minimum staffing standard in 1986.  Almost 40 years later, and the residents are still waiting.

“One of the members mentioned walking into a nursing home and the smell of urine,” she said. “Well, you know what, if you don’t have enough people, [there’s not enough people to] take care of the people that we all say we love.”

Fifteen state attorneys general and 12 US senators have submitted separate group letters strongly supporting the proposed nursing home staffing mandate from the Centers for Medicare & Medicaid Services. The AGs’ letter was detailed and evidence-based in pushing back against opposition to the safe staffing mandate.

The AGs supported setting the minimum requirements in the CMS mandate, but noted that the proposal for 3.0 total nursing hours per day falls short of the generally accepted safe standard of 4.1 HPRD benchmark set by a peer-reviewed, CMS-commissioned study in 2001.