CMS Proposal to Implement Staffing Ratios Met with Industry Resistance
Whenever you hear about a wrongful death or personal injury lawsuit filed against a nursing home, one of the main allegations made by plaintiff’s attorneys is that the nursing home was understaffed leading to a lapse in the quality of care. Seniors and their grieving families all across the country have filed lawsuits against nursing homes after residents died due to preventable ailments such as bedsores. Several lawsuits cite a significant lapse in the quality of care that led to seniors dying as a result of infected bedsores. The solution? The Centers for Medicaid and Medicare (CMS) believe that implementing staffing ratios will ensure that there are enough nurses and doctors on hand to meet the needs of their residents. However, the healthcare industry is citing staffing shortages as a major problem impacting the quality of care. There may simply not be enough workers to currently meet the demands of residents in nursing homes.
CMS issued the staffing order on September 1, 2023. While the CMS can issue the new rule at any time, nursing home advocates said that they did not expect a final ruling until after 2024. They cited grave concerns about the lack of workers and funding for the minimum staffing rule.
Could a minimum staffing rule reduce access to long-term care?
The nursing home lobby vehemently opposes measures to implement a minimum staffing rule. The staffing rule would be unfunded meaning that the nursing homes themselves would have to absorb the costs of higher employment overhead. This, they say, would have a detrimental impact on seniors’ access to long-term care.
Nursing home advocates cite problems such as chronic workforce challenges and inadequate funding that does not cover the cost of the care and services they provide. Further, nursing homes compete with hospitals and other healthcare industries for workers. Forcing employees into the nursing home industry would create shortages elsewhere. It could also prevent workers from taking jobs in home and community-based care services, an issue that is important to seniors who want to remain in their homes.
The CMS proposal would call for all Medicaid- and Medicare-certified nursing homes to provide a minimum of 0.55 hours of care from a registered nurse per resident per day. The proposal would also call for a minimum of 2.45 hours of care from a nurse aide. Non-rural nursing homes would have three years to implement the changes. Rural nursing homes would have five years.
Many lawmakers are urging CMS to scrap the proposal as pressure from the nursing home industry mounts. Meanwhile, access to quality care depends heavily on where you live. CMS says it remains “laser-focused” on increasing the quality of care for seniors. But can the industry bear the brunt of minimum staffing requirements?
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