Vice President Harris to reveal final rules mandating minimum standards for nursing home staffing

The federal government will require nursing homes to have minimum staffing levels for the first time after the COVID-19 pandemic exposed the grim reality in poorly staffed facilities for elderly and disabled Americans.

Vice President Kamala Harris will announce the final rules on Monday during a trip to La Crosse, Wisconsin, a state where she is holding her first campaign event focused on abortion rights, a White House official said.

President Joe Biden first announced his plan to fix nursing home staffing levels in his 2022 State of the Union address, but his administration has taken longer to enact a final rule as the shortage of healthcare workers are plaguing the sector. Current law only requires nursing homes to have “sufficient” staff, leaving that up to the states for interpretation.

The new rule would introduce a minimum number of hours that staff will spend with residents. It also requires a registered nurse to be available 24 hours a day at the facilities, which are home to about 1.2 million people. Another rule would require that 80% of Medicaid payments for home care providers go to employee wages.

Allies of older adults have sought regulation for decades, but the rules are sure to draw resistance from the nursing home industry.

The event marks Harris’ third visit to the state this year and is part of Biden’s effort to earn the support of union workers. Republican challenger Donald Trump caused a stir among workers with his victory in 2016. Biden regularly calls himself the “most pro-union” president in history and has received support from leading labor groups such as the AFL-CIO, the American Federation of Teachers and the American Federation of State, County and Municipal Employees.

Harris will gather nursing home care workers at an event Monday, joined by Chiquita Brooks-Lasure, administrator of the Centers for Medicare and Medicaid Services, and April Verrett, secretary-treasurer of the Service Employees International Union.

The coronavirus pandemic, which has claimed more than 167,000 nursing home residents in the U.S., exposed poor staffing levels at facilities and prompted many workers to leave the industry. Advocates for the elderly and disabled reported that residents were neglected, left to live without meals and water, or left in dirty diapers for too long. Experts say staffing levels are the most important measure of quality of care.

The new rules require a staffing of 3.48 hours per resident per day, with just over half an hour of that coming from registered nurses. The government said this means a facility with 100 residents will need two or three registered nurses and ten or eleven nursing assistants, as well as two additional nurses per shift to meet the new standards.

The average nursing home in the U.S. already has a staffing ratio of about 3.6 hours per resident per day, including RN staffing just above the half-hour mark, but the government said a majority of the nation’s roughly 15,000 nursing homes are staffing should add under the new regulations.

The new thresholds are still lower than those advocates long looked at after a landmark 2001 study funded by the Centers for Medicare and Medicaid Services (CMS) recommended an average of 4.1 hours of nursing care per resident per day .

The government will allow the rules to be phased in, with longer deadlines for nursing homes in rural communities and temporary exemptions for places with labor shortages.

When the rules were first proposed last year, the American Health Care Association, which lobbies for health care facilities, rejected the changes. The association’s president, Mark Parkinson, a former governor of Kansas, called the rules “inscrutable” and said he hoped to convince the administration never to finalize the rule.