In a historic move responding to the profound public health impacts of the COVID-19 pandemic, the US federal government has taken the unprecedented step of announcing its intention to regulate staffing levels in nursing homes across the nation. This groundbreaking decision, marking the first of its kind, has been met with both praise and criticism from various stakeholders.
The revelation of this proposed threshold came during a holiday weekend, a strategic timing that some speculate was chosen to minimize immediate backlash from long-time advocates for nursing home residents and the nursing home industry. US Health Secretary Xavier Becerra underscored the significance of this development, referring to it as “an important first step” toward enhancing the safety and well-being of residents within nursing homes.
The proposed regulations outline a requirement for staffing levels equivalent to 3 hours per resident per day, with slightly over half an hour dedicated to registered nurses, and a crucial provision for 24/7 access to registered nurse staff. This standard would have far-reaching implications, impacting the majority of the country’s 15,000 nursing homes. However, it falls short of the aspirations held by advocates who have long called for more substantial improvements.
Advocates point to a pivotal 2001 study that recommended an average of 4.1 hours of nursing care per resident daily, suggesting that even this benchmark would not adequately address residents’ quality of life. President Joe Biden’s mention of the move in his 2022 State of the Union address reignited the opposition, further fueled by a CMS study inadvertently released, asserting that there is “no obvious plateau at which quality and safety are maximized.”
Critics have voiced concerns about potential enforcement issues and have accused the government of endorsing under-staffed nursing homes. Richard Mollot of the Long Term Care Community Coalition labeled the move as “completely inadequate” and argued that it failed to align with evidence regarding residents’ needs. Katie Smith Sloan of LeadingAge, representing nonprofit nursing homes, highlighted the workforce crisis and the difficulty of finding qualified personnel, rendering the proposed regulations ineffective. She called President Biden’s stance on this matter “heartbreaking” and a “dereliction of duty.”
Currently, US law requires nursing homes to maintain “sufficient” staffing levels, but it leaves the interpretation of this requirement largely to individual states. Of the thirty-eight states that have established their own staffing regulations, many have struggled to enforce them effectively.
Data from the Bureau of Labor Statistics paints a grim picture, revealing a reduction of 218,200 nursing home employees compared to February 2020, when the pandemic initially struck. This decline underscores the industry’s deep-seated challenges.
While the American Health Care Association has consistently cited multiple factors hindering hiring and expressed concerns that mandated staffing increases could exacerbate these problems, critics argue that the primary issue is the inadequacy of compensation for nursing home staff. They contend that a solution lies in improving salaries to attract qualified individuals.
Despite these contentious debates, the government is moving forward with its initiative. Following a comment period, the rules are expected to take several years to come into full effect. This extended timeline has raised concerns about the potential for prolonged delays in improving the quality of life for nursing home residents.
As the healthcare industry awaits the outcome of this groundbreaking policy shift, it is clear that the systemic challenges faced by nursing home residents in the United States remain a major obstacle to their overall quality of life.
Source: AP News
