Biden administration to set a new standard for staffing levels in nursing homes

The Biden administration issued a proposed rule on Friday requiring the nation's nursing homes to hire a minimum number of front-line caregivers. The proposed rule was issued  in  response to decades of complaints about neglect and abuse in an industry that critics say is unprepared for the coming tsunami of seniors from the baby boom generation.
If implemented as proposed, the new rule will fulfill a promise made by Biden in his 2022 State of the Union address 18 months ago. Its release has been delayed for months due to a fierce lobbying campaign by industry trade groups, who claim that a chronic labor crisis renders necessary staff levels impossible and prohibitively expensive.
The majority of the rule would be implemented in three years for urban facilities and five years for rural facilities. While the industry responded adversely to the proposed regulation's announcement on Friday, the recommendations also frustrated campaigners for improved treatment of residents in chronically understaffed nursing facilities, who claim the plan is insufficient and enshrines subpar standards of care.
The rule would require each resident to receive 2.45 hours of care from a nursing assistant per day, in addition to 0.55 hours from a registered nurse. The combined three hours falls short of the 4.1 hours per day recommended by a government study two decades ago as the best level for appropriate care. It also falls short of the 3.76 total hours that nursing homes already deliver on average, according to a federal study.
In the United States, around 15,000 nursing homes house over 1.2 million inhabitants. Only 10 of the 35 states have mandated minimum staffing levels for nursing homes that exceed three hours each day.
The new rule would also require nursing homes to have a registered nurse on duty at all times, which the administration claims is a significant improvement, particularly on nights and weekends when staffing is at its lowest. Nurses aid to reduce the incidence of bedsores and falls, ensure that medications are administered correctly, and make choices about whether to call a doctor or admit a resident to the hospital.
According to the government, one-fifth of nursing homes would have to hire registered nurses to meet the criteria.
To address concerns in rural areas where workers are scarce, the Biden administration has given a number of exemptions in the rule for facilities that can prove they are unable to locate staff despite making good faith efforts to recruit and retain workers. It intends to invest $75 million in programs aimed at increasing the nursing home staff, such as scholarships and tuition reimbursement. The proposed rule will now be subject to public feedback.