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HHS Proposed Disappointing Minimum Staffing Standards


The U.S. Department of Health and Human Services through the Centers for Medicare & Medicaid Services (CMS) released the long-anticipated Notice of Proposed Rule Making (NPRM) that would implement a minimum staffing standard in nursing homes.

and this is disappointing to say this least.


While HHS (not to be confused with Texas HHS) is calling these "comprehensive staffing requirements for nursing homes", they are underwhelming compared to the administration's promises revealed in the 2022 State of the Union speech for an overhaul of systemic failures revealed in the nursing industry during the pandemic.


And, as expected, nursing home provider representatives (who say staffing standards will destroy the nurisng home industry) criticized even the watered down standards as STILL too excessive. They address only fiscal issues, not the high rates of emergency hospitalizations, pressure ulcers, urinary tract infections, falls, and, as we all know, more potential for abuse and neglect and assorted failures and deficiencies in care.


Mark Parkinson, president of the American Health Care Association said, “We hope to convince the administration to never finalize this rule as it is unfounded, unfunded, and unrealistic.”

Well, let's take a look . . .

  • Nursing homes would be required to provide only 3 hours of direct care per resident per day. This requirement would include only .55 hours of Registered Nurse (RN) care and 2.45 hours of certified nurse aide (CNA) care. National Consumer Voice reminded us in the resource linked below that the rule failed to propose a minimum for licensed practical nurses (LPNs) who play a critical role in nursing home care.

  • Facilities would be eligible for waivers.

  • Implementation would be phased in over a 3-year period.

  • Facilities would be required to have an RN on staff 24 hours a day, 7 days a week. Right now, it's eight hours per day.

Twenty-years ago a CMS study found that each nursing home resident required at least 4.1 hours of direct care. Since then, patient outcome statistics HAVE NOT IMPROVED. and yet they are proposing fewer hours of direct care.

  1. LOWER RATIO RECOMMENDED THAN 20 YEARS AGO

  2. WAIVER OPTION

  3. THREE YEARS TO COMPLY.

Health Secretary Xavier Becerra said in a statement. “When facilities are understaffed, residents suffer.”


That's for certain and we know those waivers will be granted in droves.


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