NJ Expert Cheers New Federal Staffing Minimums For Nursing Homes

NEWARK, NJ — A new set of federal staffing rules for nursing homes is a “long overdue” move that will protect residents – and workers – from chronic understaffing at facilities across the nation, according to an expert from Rutgers University in New Jersey.

The White House announced the new rules last week, which will apply to nursing homes that receive federal funding through Medicare and Medicaid.

“Medicare and Medicaid pay billions of dollars per year to ensure that 1.2 million Americans that receive care in nursing homes are cared for, yet too many nursing homes chronically understaff their facilities, leading to sub-standard or unsafe care,” a statement from the Biden administration said, explaining the need behind the new regulations.

“When facilities are understaffed, residents may go without basic necessities like baths, trips to the bathroom, and meals – and it is less safe when residents have a medical emergency,” officials added.

Here's what to know about the new rules, the White House said:

“The Nursing Home Minimum Staffing Rule finalized today will require all nursing homes that receive federal funding through Medicare and Medicaid to have 3.48 hours per resident per day of total staffing, including a defined number from both registered nurses (0.55 hours per resident per day) and nurse aides (2.45 per resident per day). This means a facility with 100 residents would need at least two or three RNs and at least ten or eleven nurse aides as well as two additional nurse staff (which could be registered nurses, licensed professional nurses, or nurse aides) per shift to meet the minimum staffing standards. Many facilities would need to staff at a higher level based on their residents’ needs. It will also require facilities to have a registered nurse onsite 24 hours a day, seven days a week, to provide skilled nursing care, which will further improve nursing home safety.”

“This rule will not only benefit residents and their families, it will also ensure that workers aren’t stretched too thin by having inadequate staff on site, which is currently a common reason for worker burnout and turnover,” officials added.

• See Related: NJ Nurses Say They’re Overworked, Demand ‘Safe Staffing’ Law

Some nursing home providers say the mandate will be difficult to meet when facilities are already grappling with workforce shortages – potentially leading to downsizing or even closures. Nearly all nursing homes in America will have to hire more nurses and aides to meet the new requirements.

A representative of the Health Care Association of New Jersey said the majority of the Garden State’s nursing homes do not currently meet the standards of the new federal staffing rule, and that compliance is “nearly impossible,” NJ Advance Media reported.

But supporters, including Stephen Crystal, the director of the Rutgers Center for Health Services Research, have applauded the new rules.

“The new staffing requirements are a long-overdue reform that can greatly improve quality of life and outcomes for nursing home residents,” said Crystal, a distinguished research professor at the Rutgers School of Social Work.

“In the current under-staffed and under-regulated system, in which funds are too often siphoned off from direct care to profits through related companies, and where care is too often of low quality and indeed unsafe, the new staffing requirements are an essential reform,” Crystal continued.

“It may surprise many to learn that the facilities that we call ‘nursing’ homes often fail to have a registered nurse on premises at many hours of the day or night,” Crystal said. “In the context of the heavy care needs of today’s nursing home patient mix, these newly required levels are indeed essential minimums for patient safety and well-being.”

New Jersey passed a state law regulating staffing levels at nursing homes in 2020. The law requires:

• One CNA to every eight residents for the day shift
• One direct care staff member (RN, LPN, or CNA) to every 10 residents for the evening shift
• One direct care staff member (RN, LPN, or CNA) to every 14 residents for the night shift

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