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Thursday, August 31, 2023

Feds propose the first minimum-staffing rules for nursing homes, and they are weaker than the industry expected

Federal officials' proposed minimum standards for nursing-home staffing are weaker than expected, Bridget Early reports for Inside Health Policy.

The nursing-home industry had anticipated a proposal for about 4.1 hours of employee work time per resident day, meaning that a home with 25 residents would require 18 staffers (times 4.1 hours per resident day = 175 hours per week, divided by 40 hours per week = 17.9 employees).

Instead, Early reports, "The minimum staffing scenarios assessed in the report ranged from 3.3 HPRD to 3.8 HPRD," which would call for 14.4 to 16.625 employees to cover 25 residents.

The regulation could have major implications for rural nursing homes, which generally have more difficulty recruting and retaining staff than those in cities.

The regulation, proposed by the Centers for Medicare and Medicaid Services, "cleared the White House Office of Management and Budget on Tuesday, Aug. 29, the same day a CMS study underpinning the rule was leaked and created a firestorm among stakeholders," Early reports. "The White House budget office also canceled its two remaining stakeholder meetings on the issue in the wake of the leak. The proposed rule had been pending at OMB since May 30. The two meetings were scheduled for the first and second weeks of September. The meetings were requested by the Organization of Nurse Leaders and the Association of Jewish Aging Services."

Early notes, "The nursing-home industry has lobbied hard against staffing minimums and has called for a White House event to explore alternatives, but patient advocates have backed staffing minimums."

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