News Release: Public Interest Groups Urge Strong Staffing Standards for Nursing Homes


Nov. 6, 2023

Carter Dougherty

Public Interest Groups Urge Strong Staffing Standards for Nursing Homes

Washington, D.C. – Americans for Financial Reform Education Fund and 21 allied organizations submitted a letter urging the Centers for Medicare and Medicaid Services (CMS) to pass the strongest possible rule mandating minimum staffing standards for long-term care facilities (CMS–3442–P). The letter also highlights the role of private equity firms, which own 11% of US nursing homes, and their particularly harmful business practices, like understaffing, that detract from resident care.  

“Private equity firms have been particularly bad actors in nursing home ownership,” said Robert Seifert, senior policy fellow with AFR-EF and author of the organization’s broader policy recommendations on private equity in healthcare. “A private equity owner’s motivation is to take what it can from its investments in profits, fees, and charges, as quickly as possible. Even more than other private ownership models, return on investment is paramount, and there is ample evidence that shows they provide worse care at a greater cost to taxpayers.”

The proposed rule would require a registered nurse to be on site 24/7 (currently required only 8 hrs/day), impose individual minimum staffing standards for RNs and nurse aides, and higher level of staffing based on the acuity of resident needs.

The letter also urges CMS to strengthen the proposed rule to eliminate possible loopholes and opportunities to game the rule, by including a minimum staffing level for Licensed Practical Nurses, establishing clear, measurable, and rigorous criteria for receiving an exemption from the staffing requirements, and shoring up state agencies to ensure rigorous enforcement.