Nursing Homes Face Potential Closures and Financial Strains Due to New Staffing Requirements.
The Centers for Medicare & Medicaid Services (CMS) has finalized a staffing mandate for nursing homes, requiring them to meet minimum staffing standards. The rule, which is set to be published on May 10 and go into effect on August 9, mandates a minimum of 3.48 hours per resident per day (HPRD) of total staffing, with specific allocations for registered nurses (RN) and nurse aides.
CMS officials acknowledged that some nursing homes may struggle to meet the requirements, leading to potential closures or waivers. However, they emphasized that the current status quo of inadequate staffing is unacceptable and has resulted in poor quality care. The agency plans to implement the rule in three phases, with the first phase beginning within 90 days of publication.
The rule allows for some exemptions, including facilities located in areas with a low RN-to-population ratio or those that can demonstrate "good faith efforts" to hire and retain staff. However, these exemptions are limited in scope and temporary, and providers will be required to report information quarterly if they avail themselves of the exceptions.
Despite the phased implementation and exemptions, nursing home advocates have expressed concerns about the financial and logistical hurdles to enforcing the mandate. The federal government has allocated $75 million for nurse training, but advocacy groups consider this amount inadequate. Additionally, a KFF Health News analysis found that nearly 80% of nursing homes would not meet the minimum staffing standards.
CMS plans to partner with states to bolster nurse recruitment and will use existing survey processes to enforce the requirements. The agency also expects other states to join in funding the program, which is still being developed.
The finalized rule has been met with opposition from industry leaders, who have called it an "extinction event" for nursing homes. However, CMS views the exemptions and phased implementation as a way to ease the growing pains of the mandate.