It has become increasingly clear that our federal government is not willing or able to enact laws and rules that go as far as necessary to protect consumers. Recently, the Centers for Medicare and Medicaid Services (CMS) issued final rules with regard to nursing home staffing requirements that are a huge step forward and yet not nearly enough, Jordan Rau reports for KFF Health News. Patient safety and adequacy of care remain a concern, even with these rules.
Under the new rules, most of the 15,000 nursing homes in the US will have to hire more nurses and aides, beginning in 2026. The nursing homes will, on average, need to offer 3.48 hours of care each day to each resident. Today, some four in ten nursing homes do not do so. But, many advocates do not believe that these rules will ensure that nursing homes deliver high quality care.
Without a higher ratio of nurses and aides to nursing home residents, it is challenging for nursing homes to care for their patients, as we saw during the Covid epidemic. Instead, residents end up with bedsores, fall needlessly, are not properly diagnosed for their conditions or take more trips to the emergency room.
At the moment, it’s not clear whether there are enough nurses and aides available for nursing homes to hire. Nursing homes tend to pay less for nurses than hospitals. And, aides can often earn more working in restaurants. If the worker shortage remains, the nursing homes will likely not comply with the new rule.
CMS projects that its rules will cost nursing homes $6 million more a year. CMS does not plan to increase Medicare and Medicaid payments to cover these additional costs. The nursing home industry calls it an “unfunded mandate” and intends to see if it can persuade Congress (or likely the next Administration) to undo it.
And, still, CMS is calling for nursing-home staffing levels that are less than excellent, according to the head of the Long Term Care Community Coalition. The rule is a step forward because the previous rule was not specific as to what constituted a “sufficient” staffing level, only that the staffing level be “sufficient.”
To date, the Office of the Inspector General has found that many nursing homes do not meet many basic staffing requirements.
Critics of the new CMS rule argue that it will lead to many nursing home closures as nursing homes will not be able to hire more workers. Both the cost of hiring them and the scarcity of workers present obstacles. But, a recent study found that, overall, nursing homes are doing extremely well financially. Owners are able to secure substantial profits through all kinds of shenanigans. A while back, the Kaiser Family Foundation explained how owners profit and advised avoiding chain nursing homes.
Here’s more from Just Care:
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