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Proposed federal regulations for nursing home staffing get mixed reactions

(WHTM) -- For the first time, the Biden administration is pushing to regulate staffing at nursing homes, proposing new rules Friday. These regulations would apply to nursing homes that participate in Medicare and Medicaid, and they are getting mixed reactions.

Some advocates say these standards are needed, but industry leaders say the proposal is confusing and puts an unnecessary strain on an already struggling field.

"This is another unfunded mandate," said Zach Shamberg, president of the Pennsylvania Health Care Association. "This is a federal mandate, a one-size-fits-all approach."

Shamberg said federal staffing minimums for nursing homes are a bad idea.

"This is setting up providers across the state for failure, in a state with one of the oldest populations in the country," he said.

Shamberg said PHCA and other groups worked with former governor Tom Wolf to establish state standards that work for Pennsylvania, and he said that is where this discussion should be happening -- at the state level.

However, the Biden administration argues overall standards are necessary to fill gaps exposed by the COVID-19 pandemic. Nursing homes were some of the hardest hit during the pandemic.

Health and Human Services Secretary Xavier Becerra said in a statement, "Establishing minimum staffing standards for nursing homes will improve resident safety and promote high-quality care so residents and their families can have peace of mind."

Under the proposed rules, nursing homes would need a registered nurse on site 24/7, and staff would have to provide three hours of care per resident every day.

Shamberg said that would create a mismatch between national and state rules, especially because the national rules do not take into account the different care staff positions in Pennsylvania.

"We're going to have providers across the state who are not going to know which ratios, which standards, which overall PPDs (patient per day) they meet," he said.

Shamberg also argues the regulations do not address the struggle to hire more nurses. Pennsylvania nursing homes have lost over 16,000 jobs since February 2020.

The proposal does outline a plan to invest $75 million in initiatives like scholarships and tuition reimbursement to make it easier for people to work in nursing homes, but Shamberg questions where the money comes from. He is concerned the burden will fall to the states and providers, who might not be able to shoulder it.

"We will see nursing homes take beds offline, we will see nursing homes discharge residents and ultimately, as we've started to see throughout the pandemic, we will see nursing homes close their doors," he said.

It will be years before these regulations could take effect. The proposal now enters a public comment period.

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