The Centers for Medicare and Medicaid Services (CMS) has finalized rules establishing minimum staffing requirements for nursing homes.

The Centers for Medicare & Medicaid Services (CMS) has finalized minimum staffing requirements for nursing homes with the goal of ensuring safe and quality care in long-term care facilities. The final rule establishes a minimum of 3.48 hours per resident day (HPRD) of direct nursing care, with at least 0.55 HPRD provided by a registered nurse (RN) and 2.45 HPRD provided by a nurse aide.

Additionally, the final rule requires that at least one RN be onsite 24 hours a day, seven days a week, to provide skilled nursing care. The rule also establishes enhanced facility assessment requirements and staffing plans to maximize workforce recruitment and retention. Nursing homes will have varying timeframes to implement these requirements, with those in non-rural areas having two years to meet the 24/7 RN requirement and three years for other staffing requirements.

Nursing homes in rural areas will have more time to implement the requirements, with three years to meet the 24/7 RN requirement and five years for other staffing requirements. The final rule provides possible exemptions for qualified nursing home facilities based on workforce unavailability and other factors. The CMS received over 46,000 public comments on the proposed rule, which was issued in September.

The implementation timeframe for these requirements will begin on May 10, 2024, when the final rule is expected to be published. Nursing homes that fail to meet these minimum staffing requirements may face penalties and other consequences. The CMS aims to improve patient care and safety by establishing these minimum staffing standards.