(April 25, 2024) – The Centers for Medicare & Medicaid Services announced the final rule related to minimum staffing requirements for nursing homes participating in the Medicare and Medicaid programs. Nursing homes will be required to follow designated nurse staffing standards as listed below:

• Provide residents with a minimum total of 3.48 hours of nursing care per day, which includes at least 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.
• Have a registered nurse on site 24 hours per day, seven days per week, to help mitigate against preventable safety events and deliver critical care to residents at any time.
• Conduct a stronger annual facility assessment than is currently required to improve the planning and identification of the resources and support needed to care for residents based on their acuity during day-to-day operations and emergencies. This process needs to include participation from direct care workers and others.
• Develop a staffing plan to maximize recruitment and retention.

CMS will also require states to collect and report on the percentage of Medicaid payments spent on compensation for direct care workers and support staff delivering care in nursing facilities and intermediate care facilities for individuals with intellectual disabilities. To increase transparency and accountability, CMS will publicly report the data reported by states and require states to report this data for each facility on a state-operated website.

CMS is developing a $75 million national nursing home staffing campaign to increase the number of nurses in nursing homes and enhance residents' health and safety. Through this campaign, CMS will provide financial incentives for nurses to work in nursing homes.

While KHA supports a skilled and caring workforce that delivers high-quality and safe care, the process of staffing any health care facility is much more than achieving an arbitrary number set by regulation. KHA is concerned this could lead nursing homes to reduce capacity or close, and the loss of more nursing home beds could adversely impact patients who have completed hospital treatments and need continuing care in nursing facilities. KHA will continue to work with Congress and the Administration to advance sustainable approaches to bolster the health care workforce and deliver high-quality, safe and accessible care. We will continue to work at the state and federal levels to highlight impacts on existing workforce challenges.