Nursing homes are being required to hire more staff: Will they?

It’s no secret that many nursing homes are understaffed – despite the efforts of patient advocates to force positive changes.

In April 2024, the Centers for Medicare & Medicaid Services (CMS), finally updatedx the staffing rules in a way that will cause four out of every five nursing homes to hire new workers – eventually. However, uncertainties remain. Some people say that the new rules are even impossible to meet.

What’s changed? Why is there so much pushback?

The old federal mandate hadn’t been updated since the 1980s, and it merely contained vague indeterminate language that required nursing facilities to have “sufficient” staff on board at any given time. 

That wording was vague enough to basically be meaningless, which is why the new rules – which require a certain amount of daily care by registered nurses (RNs) and another set amount by aides. In addition, nursing homes will be required to have an RN at all times, including overnight and on weekends.

However, neither side of the fence on the issue is totally happy with the changes. The current presidential administration and labor unions count the rule changes as a “win,” for nursing home residents. 

However, patient advocates say that the new changes aren’t nearly enough – and they decry the fact that nursing homes will be given two to five years (depending upon the regulation in question and the location of the home) to become compliant. They also say that the new rules still put staffing well below what all reasonable indications say is actually necessary for quality care. 

On the flip side of the issue, the American Health Care Association says that the new standards are unreasonable, in part because they claim that nursing homes are already operating under razor-thin margins (something that is highly disputed) and in part because there simply aren’t enough people to fill the required roles. No mandate can make up for a lack of available employees.

Ultimately, there are no clear answers to the chronic staffing problems seen in nursing homes. Until things change, patients are going to continue to suffer from falls, bedsores and other avoidable injuries. If your loved one is injured due to nursing home neglect, there is legal guidance available.