Few Nursing Homes Found to Comply with Proposed Staff Rules by Biden Administration, Analysis Reveals

Few nursing facilities currently meet staffing requirements proposed by the Biden administration earlier this month — and over 80% of them would have to go on a hiring spree to meet the new federal bar, a startling analysis found.

The non-profit Kaiser Family Foundation study released Monday estimated 19% of nursing facilities would currently meet the minimum RN and nurse aide hours-per-resident-per-day staffing standards. The remaining 81% would need to hire more RNs or nurse aides.

Under suggested requirements provided by the Centers for Medicare and Medicaid Services, increased hours for registered nurses and aides would be needed to strengthen “staffing assessment and enforcement strategies,” the study stated.

The study noted low staffing levels have sparked concerns in the past, though their effects were far more visible during the COVID-19 pandemic.

“The adequacy of staffing in nursing homes has been a long standing issue,” the study authors wrote.

“The high mortality rate in nursing facilities during the COVID-19 pandemic highlighted and intensified the consequences of inadequate staffing levels.”

The analysis found 90% of for-profit facilities did not hit proposed staffing levels, while 60% of nonprofit or government-affiliated facilities would have to hire more nurses to meet requirements.

Results varied across states, the study showed, with Alaska’s nursing homes already compliant with the proposed staffing levels, but only 1% of the facilities in Louisiana meet them.

In over half of states, less than a quarter of facilities would meet the hours-per-resident-per-day staffing provisions in the proposed rule, the findings showed.

For example, the study stated, in six states, over half of facilities would meet these provisions, and in the remaining 16 states, 25-49% of facilities would meet the provisions.

Current law requires only that nursing homes have “sufficient” staffing, but leaves nearly all interpretation to states. Thirty-eight states and the District of Columbia have their own staffing regulations. But some are so low advocates say they are meaningless, and that across the board enforcement is poor.

The study examined more than 14,000 nursing home facilities that care for more than 1.2 million people.