Staffing Mandate

In April 2024, the Centers for Medicare and Medicaid Services (CMS) issued a final rule on minimum staffing requirements for nursing homes. There has been strong opposition from nursing homes, other health care sectors, and lawmakers on both sides of the aisle who have raised concerns that the unfunded mandate jeopardizes access to care for our nation’s seniors.

The below provides a dedicated hub for resources and new information focused on the federal staffing mandate for nursing homes to help facilities stay informed and navigate these new regulations.

WHAT'S IN THE RULE

The staffing mandate requires a minimum standard of 3.48 total nursing staff hours per resident day (HPRD), including 0.55 hours to be delivered by registered nurses (RNs) and 2.45 hours by nurse aides. The remaining 0.48 hours may be filled by any combination of nurse aides, RNs, and licensed practical or vocational nurses (LPN/LVNs). Additionally, nursing homes will be required to have an RN on-site 24 hours a day, 7 days a week.

Implementation Timeframe

What's in the Rule Resources

AHCA Resources

AHCA Member Webinar

CMS Documents

the impact

The AHCA/NCAL Research department analyzed the final rule's impact looking at the latest federally available data on nursing homes. It found that nursing homes would have to hire an additional 102,000 nurses and nurse aides to comply with the mandate. If they cannot find these additional workers, nearly one-quarter of residents may be at risk for displacement.

view the analysis

Provider Resources

One part of the staffing mandate included an expansion of the Facility Assessment Requirements. Effective August 8, 2024, facilities must comply with the updated requirements. AHCA offers multiple resources on ahcancalED to help providers prepare for these new requirements (member log-in required).

ADVOCATE

We’re all for increasing the nursing home workforce, but “one-size-fits-all” mandates are not how you achieve this. Help us urge Congress to support and advance bipartisan legislation that would block the mandate as well as develop meaningful policies and investments that would help grow the long term care workforce.

Advocacy Resources

Advocacy Toolkit

Better Solutions

LEGAL ACTION

AHCA, joined by LeadingAge, the Texas Health Care Association (THCA) and several Texas long term care facilities filed a lawsuit in May in the Northern District of Texas against the U.S. Department of Health and Human Services (HHS) and CMS for exceeding their statutory authority and arbitrarily and capriciously issuing the Minimum Staffing Standards for Long-Term Care Facilities final rule.

“We cannot stand idly by when access to care is on the line and federal regulators are overstepping their authority. Hundreds of thousands of seniors could be displaced from their nursing home; someone has to stand up for them, and that's what we're here to do."

- Mark Parkinson, Past President & CEO of
AHCH/NCAL