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  • Washington Highlights

    CMS Finalizes Minimum Staffing Requirements for Nursing Homes

    Gayle Lee, Director, Physician Payment & Quality
    For Media Inquiries

    The Centers for Medicare & Medicaid Services (CMS) issued a final rule on April 22 that establishes minimum staffing requirements for nursing homes. It requires nursing homes that receive Medicare and Medicaid funding to provide a minimum of 3.48 hours of nursing care per resident day, including 0.55 hours of care from a registered nurse per resident day and at least 2.45 hours of care from a nurse aide. In addition, a registered nurse must be onsite 24 hours a day, seven days a week.  The requirements in the rule are phased in over a period of three years. Nursing homes in urban areas will have two years to comply with certain provisions in the rule, while those in rural areas will have three years. Temporary exemptions will be allowed for facilities in areas with workforce shortages that show a good faith effort to hire.

    The AAMC provided comments on the proposed rule, raising concerns that mandatory nurse staffing levels could unintentionally have serious negative consequences by exacerbating workforce shortages, resulting in facility closures and decreased access to care. The AAMC urged the CMS to work with Congress and other stakeholders to identify and implement alternative approaches [refer to Washington Highlights, Nov. 3, 2023].