Proposal for more nursing-home staff seen as unattainable by many owners; resident advocates say it's not enough

Nursing homes may not be ready for 'tsunami' of baby boomers.
(Photo by G.A. Pflueger, Unsplash)

Nursing homes have struggled for decades to find a sustainable business model that provides optimal staffing numbers for resident care. Now federal officials have released "a proposed rule requiring the nation’s nursing homes to hire minimum numbers of front-line caregivers, a long-anticipated response to decades of complaints about neglect and abuse in an industry that critics say is unprepared for the tsunami of seniors heading its way from the baby boom," reports Christopher Rowland of The Washinton Post.

The Centers for Medicare and Medicaid Services proposed "minimum nurse staffing standards . . . per resident for registered nurses and . . . nurse aides," as well as a requirement to have a registered nurse at the nursing home around the clock. Many industry stakeholders consider the proposal futile. Rowland explains, "Without a supply of prospective workers, it will be impossible to meet the requirements of minimum staffing, the industry has argued. They also contend that Medicaid reimbursement rates need to be significantly increased if more workers are required in facilities." Nathan Schema, president and chief executive officer of the Evangelical Lutheran Good Samaritan Society, which operates a large chain of nonprofit nursing homes, told Rowland: "I just can’t understand how CMS is effectively trying to fix the roof while the house is on fire. It’s the beginning of the end for small-town nursing homes."

Rowland adds, "A fifth of nursing homes would have to hire registered nurses to meet the requirement, the government estimates." LeadingAge, the largest association for nonprofit nursing homes, told USA Today that the proposed regulation would be impossible for many nursing homes to meet. “There are simply no people to hire—especially nurses,” said Katie Smith Sloan, the group's president and CEO. “America’s under-funded, long-ignored long-term care sector is in a workforce crisis.” Sloan said nursing homes would have to “reduce admissions or even close” if the rule takes effect.

"While the industry reacted negatively to the proposed rule’s release, the guidelines also disappointed advocates for better treatment of residents in chronically short-staffed nursing homes, who contend the rule does not go far enough and enshrines substandard levels of care," Rowland reports. "Advocates for better quality care in nursing homes say the industry’s high staff turnover rates point to the true problem: insufficient pay and poor working conditions."