As resident and industry advocates alike awaited proposed rules on nurse staffing ratios for nursing facilities – a centerpiece of President Biden’s nursing home reform agenda – a report on nurse staffing written by Abt Associates, which was expected to be a major part of the basis for proposed rules, was posted on the website of the Centers for Medicare & Medicaid Services (CMS) on August 29. The contentious report contradicts Abt’s four-volume report, issued in 2001, The Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes, which concluded, after years of research, that facilities needed to provide residents with (at least) 4.1 hours per resident day (HPRD) of nurse staff time in order to prevent avoidable harm to residents and to meet some Requirements of the Reform Law. The 2023 Abt Report makes the case for the need for substantial increases in nurse staffing levels in most nursing facilities nationwide, but then, inexplicably, looks at four possible staffing ratios, all below 4.1 HPRD.
CMS virtually immediately pulled the Report from its website, with CMS’s Chief Operating Officer Jonathan Blum explaining that the Report was only a draft. The Office of Management and Budget (OMB) cancelled two September meetings with stakeholders on the proposed staffing rules and then announced, on August 30, that its review of the proposed rules was completed.
The proposed rules are expected imminently. Residents’ advocates will continue to argue for meaningful nurse staffing standards to ensure that the promise and mandate of the 1987 Reform Law is fulfilled: that each resident receives care and services “to attain and maintain the highest practicable physical, mental, and psychosocial well-being.”
August 31, 2023 – T. Edelman