An administrative rule to force minimum staffing levels on long-term care facilities has faced heavy resistance since the final version was announced in April 2024. Industry groups American Health Care Association and LeadingAge sued to block the action. Twenty Republican-led states similarly filed suit.
However, the incoming administration may give them faster satisfaction, according to The New York Times. Experts, officials, and researchers say it’s likely that under President-elect Donald Trump, the rule is likely to be rescinded. During his first administration, he took actions like reducing fines for entities that were cited for poor care.
When more than 172,000 skilled nursing residents died during the Covid-19 pandemic, public and governmental reactions insisted that something needed to be done. Back in April, the Centers for Medicare and Medicaid Service issued a final rule that would force long-term care facilities to provide higher staffing levels of registered nurses (RNs) and nurse aids (NAs). That included having registered nurses on-site 24 hours a day. The metric would have been 0.55 RN hours per resident day (HPRD) and 2.45 NA HPRD.
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“Medicare and Medicaid pay billions of dollars per year to ensure that 1.2 million Americans that receive care in nursing homes are cared for, yet too many nursing homes chronically understaff their facilities, leading to sub-standard or unsafe care,” wrote the White House. “When facilities are understaffed, residents may go without basic necessities like baths, trips to the bathroom, and meals – and it is less safe when residents have a medical emergency.”
According to NPR, 80% of skilled nursing facilities would have to increase their staffing. Federal government estimates are that over a decade, costs would increase by 2%, although there would be no increases in Medicare or Medicaid payments, a major source of patient revenue.
“The Trump administration has proven itself really eager to reverse overreaching regulations,” Linda Couch, senior vice president for policy and advocacy at LeadingAge, told The New York Times. “We think it’s got a pretty good chance of being repealed and hope so.”
Beyond issues of expense, there is a question of whether enough nursing home nurses are available to meet staffing levels. The American Health Care Association (AHCA) in March 2024 released the results of a survey of 441 nursing home providers. Of them, 72% said they had fewer total employees than compared to pre-pandemic times and 99% were trying to hire additional personnel, with 89% looking for RNs; 85%, LPNs; and 95%, nurses’ aides.
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