Minimum-Staffing Rule for Nursing Homes Finalized

The White House on Monday, April 22, announced that the nursing home minimum-staffing rule has been finalized.

Effectively, the rule requires all nursing homes that receive Medicare and Medicaid funding to maintain a certain staffing threshold at all times. The U.S. Centers for Medicare & Medicaid Services (CMS) first proposed the minimum-staffing requirement last fall.

“Medicare and Medicaid pay billions of dollars per year to ensure that 1.2 million Americans that receive care in nursing homes are cared for, yet too many nursing homes chronically understaff their facilities, leading to sub-standard or unsafe care,” a White House fact sheet from Monday stated.

While minimum-staffing rule does not apply to home health agencies, it is something that all home-based care providers should be aware of, as its finalization will likely complicate labor dynamics in the post-acute care sector. In-home care providers and nursing homes often go head-to-head on hiring for clinical roles in their markets, and nursing homes may now be forced to act more aggressively in recruiting and retaining staff.

Home Health Care News last year confirmed that CMS had no immediate plans to put forward a similar staffing-related proposal for home-based care providers. The minimum-staffing rule is primarily meant to improve the care of nursing home residents, but the Biden administration also hopes it will offset worker burnout.

“This rule will not only benefit residents and their families, it will also ensure that workers aren’t stretched too thin by having inadequate staff on site, which is currently a common reason for worker burnout and turnover,” the fact sheet continued.

Specifically, the rule mandates a minimum of 3.48 hours per resident per day of total staffing for nursing homes, with specific allocations for registered nurses (RN) and nurse aides. For every resident per day, the staffing requirements include -.55 hours from registered nurses and 2.45 hours from nurse aides.

This translates to facilities with 100 residents needing a minimum of two to three RNs, plus 10 to 11 nurse aides per shift, along with two additional nurse staff members, who could be registered nurses, licensed professional nurses, or nurse aides.

Learn more about this rule here.