CMS Finalizes Nursing Home Staffing Requirements Amid Industry Concerns
The Centers for Medicare & Medicaid Services (CMS) has finalized minimum staffing requirements for nursing homes that participate in Medicare and Medicaid. The final rule, which was proposed in September, requires nursing homes to provide a minimum of 3.48 hours of nursing care per resident day, including 0.55 hours of care from a registered nurse per resident day and at least 2.45 hours of care from a nurse aide per resident day. Additionally, the rule mandates 24/7 onsite RN services.
The American Hospital Association (AHA) has expressed strong opposition to the final rule, arguing that it creates more problems than it solves and could jeopardize access to care across the continuum, especially in rural and underserved communities. The AHA believes that a skilled, caring workforce is integral to delivering high-quality, safe care, but that safely staffing any healthcare facility requires clinical judgment and flexibility to account for patient needs, facility characteristics, and the expertise and experience of the care team.
The AHA warns that the final rule could lead nursing homes to reduce capacity or close outright, resulting in a loss of beds that could adversely impact patients who need continuing care in nursing facilities. This, in turn, could lead to longer lengths of stay for hospital patients waiting for post-acute care placements and disrupt care for other patients awaiting elective surgeries or scheduled procedures. Furthermore, the AHA believes that the final rule could exacerbate existing shortages of nurses and skilled healthcare workers across the care continuum.
The AHA has called on Congress and the Administration to advance sustainable approaches to bolstering the healthcare workforce and delivering high-quality, safe, and accessible care. The organization is working with lawmakers to develop legislation that would prevent enforcement of the nurse staffing mandate and instead focus on developing more patient- and workforce-centered approaches to ensuring safe staffing in nursing facilities.