New Federal Rules Could Be Big Ask for Nursing Homes

They're described by NPR as "the most substantial changes to federal oversight" of America's nursing homes in some 30 years. But implementing the new rules on minimum staffing levels that were finalized Monday could prove challenging—or even an "impossible task," as one industry group puts it. The AP reports the changes were spurred by the COVID pandemic, which "exposed grim realities in poorly staffed facilities." More on the rules, and the reaction to them:

• Today: Current law states that nursing homes have "sufficient" staffing, but it leaves it to the states to determine what is sufficient.
• In the future: The new rules enshrine a minimum number of hours: 3.48 hours of staffing per resident per day, with just over 30 minutes of it coming from registered nurses (RNs). The government said that would mean a 100-bed facility would need two or three RNs, 10 or 11 nurse aides, and two additional staffers per shift.
• The asterisk: The US average actually sits at 3.6 hours per resident per day, with RN staffing just above the half-hour mark, but the government said the new rules would require a majority of America's roughly 15,000 nursing homes to add staff.
• The ideal: The numbers are below what proponents of the increase had wanted; a landmark 2001 study recommended 4.1 hours of nursing care per resident per day.
• Critics say: The American Health Care Association lobbies for the nursing home industry, and its CEO, Mark Parkinson, called the new rules an "unfunded mandate." He continued, "It is unconscionable that the administration is finalizing this rule given our nation's changing demographics and growing caregiver shortage. Issuing a final rule that demands hundreds of thousands of additional caregivers when there's a nationwide shortfall of nurses just creates an impossible task for providers."
• Echoing that point: The AP flags comments made by Wisconsin state GOP Rep. Tony Kurtz, who noted an 80-bed nursing home in the rural town of Elroy would need to bring on six more nurses. "We simply don't have the bodies." Facilities in rural homes will be granted more time to come into compliance.
• The economics: NPR reports the staffing increases will cost an estimated $6 billion a year, and the feds aren't ponying up any of that. Nursing homes say they've already upped wages 27% since February 2020 but still have a tough time wooing workers. RNs are paid an average of $40 at nursing homes, while assistants make an average $19 per hour.

(More nursing homes stories.)