AARP Backs Effort to Create Minimum Staffing Rules for Nursing Homes

En Español | AARP is strongly supporting a federal effort to set minimum staffing standards for the nation’s nursing homes for the first time.

While we applauded the effort in comments submitted to the Centers for Medicare & Medicaid Services (CMS) on Nov. 6, we also suggested steps the agency could take to strengthen and better enforce the proposed new requirements.

Under the federal proposal, nursing homes that are funded through Medicare or Medicaid would be required to provide every resident with at least 0.55 hours of care from a registered nurse, plus 2.45 hours of care from a nurse aide each day. The new rules also call for nursing homes to have a registered nurse on site around the clock and would require facilities to provide more hours of care to residents with higher staffing needs.

The changes would apply to most of the nation’s 15,000 nursing homes. They come after more than 180,000 residents died in nursing homes during the COVID-19 pandemic, casting a national spotlight on long-standing problems such as inadequate staffing.

“Standards to ensure nursing homes are adequately staffed will help give family caregivers peace of mind, knowing their loved ones are getting the quality of care they deserve,” wrote David Certner, AARP legislative counsel and legislative policy director.

Our suggestions to CMS include:

• Incorporate licensed practical nurses (LPNs) into the minimum staffing standard and increase the overall minimum staffing level. 

• Place stronger “guardrails” around exemptions. This includes offering exemptions sparingly and requiring more oversight for facilities that receive them. Nursing homes operating under an exemption should not be permitted to accept new residents, we told the agency.

• Make clear that the required on-site registered nurse must be available for the purpose of providing direct care to residents and that the care should be provided in person, not through telehealth. Under the current wording, an administrator with RN credentials could satisfy the requirement on paper without providing direct care to residents, we wrote.

Read our comments and learn more about the proposed federal nursing home staffing standards.