Biden Administration Considers Minimum Staffing Mandate for Nursing Homes

AHCA/NCAL cite ongoing labor shortage as why minimum staffing mandate could be challenging.

By HFT Staff
December 14, 2022

In a statement released by AHCA/NCAL, the Biden administration is considering a federal minimum staffing mandate for nursing homes, which would impose staffing ratios that would be impossible for providers to meet considering the current labor shortage and lack of government funding.  

A federal staffing mandate has been considered by policymakers in the past. The Centers for Medicare & Medicaid Services (CMS) under the Obama administration previously warned how a “one-size-fits-all” staffing minimum would not improve quality of care in nursing homes.  

One of the potential unintended consequences of minimum staffing requirements is the increased use of agency staff. As nursing homes continue to struggle to recruit and retain full-time staff, facilities may feel pressured to hire temporary staff to fill shifts and meet quotas. However, the use of agency staff is costly and is associated with poorer care. 

Nursing homes are already grappling with a historic labor crisis, as more than 200,000 caregivers have left the field since the beginning of the pandemic. Federal data shows that due to staffing shortages, the proportion of nursing hours clocked by agency staff have more than tripled since early 2020 and continues to increase. A federal staffing mandate would compound this growing trend. 

“A federal staffing mandate without the necessary workforce available and full funding would have negative consequences for nursing home residents,” says Holly Harmon, RN and Senior Vice President of Quality, Regulatory & Clinical Services for the American Health Care Association (AHCA). “Policymakers should once again recognize that implementing a one-size-fits-all requirement is not the solution and instead prioritize resources and develop programs to rebuild the nursing home workforce. Lawmakers must invest in long term caregivers to ensure America’s seniors have access to customized care delivered by trained, devoted professionals.” 

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