NEW YORK — The federal government will, for the first time, dictate staffing levels at nursing homes, the Biden administration said Friday, responding to systemic problems bared byWhile such regulation has been sought for decades by allies of older adults and those with disabilities, the proposed threshold is far lower than many advocates had hoped. It also immediately drew ire from the nursing home industry, which said it amounted to a mandate that couldn't be met.
The average U.S. nursing home already has overall caregiver staffing of about 3.6 hours per resident per day, according to government reports, including RN staffing just above the half-hour mark. “I would caution anyone who thinks that the status quo — in which there is no federal floor for nursing home staffing — is preferable to the standards we’re proposing,” said Stacy Sanders, an aide to Health Secretary Xavier Becerra. “This standard would raise staffing levels for more than 75% of nursing homes, bringing more nurse aides to the bedside and ensuring every nursing home has a registered nurse on site 24/7.”landmark 2001 CMS-funded studyMost U.S. facilities don’t meet that threshold.
Richard Mollot, who leads the Long Term Care Community Coalition, called it “completely inadequate” and a blown chance of “a once-in-a-generation opportunity” that “flouts any evidence” of what residents need and fails to make good on the heart of Biden’s promise. He begrudgingly acknowledged the 24/7 RN rule could bring small improvements to the worst facilities, but he otherwise was withering in his criticism.
The problem has long been apparent to front-line nurse aides — the low-paid, overwhelmingly female and disproportionately minority backbone of facility staffs —, whose call bells go unanswered, whose showers become less frequent and who lie hungry, awaiting help with meals.