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CMS is finalizing a total nurse staffing standard, based on public comment feedback, that requires facilities to provide a minimum of 3.48 HPRD of total direct nursing care to residents, of which at least 0.55 HPRD of care must be provided by RNs and 2.45 HPRD of care provided by nurse aides.
The proposed rule consists of three core staffing proposals: 1) minimum nurse staffing standards of 0.55 hours per resident day (HPRD) for Registered Nurses (RNs) and 2.45 HPRD for Nurse Aides (NAs); 2) a requirement to have an RN onsite 24 hours a day, seven days a week; and 3) enhanced facility assessment requirements.
Since the passage of the 1987 Nursing Home Reform Law, nursing homes have been required to have sufficient staff to ensure that each of their residents receives the services that they need to attain and maintain their highest practicable physical, mental, and psycho-social well-being as individuals. .
The Biden administration has unveiled a historic new rule mandating minimum staffing requirements for nurses and CNAs in nursing homes that receive federal Medicare or Medicaid funding.
The Biden administration has set minimum staffing levels for nursing homes for the first time under a rule announced Monday, which establishes comprehensive staffing requirements and requires facilities to have a registered nurse on site at all times.
Nursing homes would need to provide residents with a minimum of 0.55 hours of care from a registered nurse per resident per day, and 2.45 hours of care from a nurse aide per resident per day, exceeding existing standards in nearly all states.
Within three years, most nursing homes will need to provide daily RN care of at least 0.55 hours per resident and 2.45 hours from aides. Nursing homes in rural areas will have longer to staff...
CMS’ one-size-fits-all minimum staffing rule for nursing homes creates more problems than it solves and could jeopardize access to all types of care across the continuum, especially in rural and underserved communities that may not have the workforce levels to support these requirements.
Under the final rule, federally funded nursing homes must maintain enough nursing staff to provide each resident with a total of at least 3.48 HPRD (inclusive of the .55 HPRD from RNs and 2.45 HPRD from NAs).
In September 2023, CMS issued a proposed rule that would establish the first minimum staffing levels for nursing facilities. The rule would require 24/7 RN staffing and set HPRD requirements for RNs and CNAs, but does not include requirements for LPNs or LVNs.