News Release: New Staffing Standards for Nursing Homes Will Protect Healthcare Workers and Patients


April 24, 2024

Carter Dougherty

New Staffing Standards for Nursing Homes Will Protect Healthcare Workers and Patients

Washington, D.C. – New rules on minimum staffing in nursing homes will safeguard patients and health care workers by improving access to consistent and quality care, according to Americans for Financial Reform Education Fund.

The Centers for Medicare and Medicaid Services (CMS) is setting a new comprehensive staffing requirement in its final rule on Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting.

In November 2023, Americans for Financial Reform Education Fund and 21 allied organizations submitted a letter urging CMS to pass the strongest possible rule pertaining to minimum staffing standards for long-term care facilities. As private equity firms make inroads into healthcare, it is more urgent than ever for regulators to address their effects on patient quality and cost of care and on medical professionals employed in private equity health care facilities. Resident safety and survival should be paramount, and private equity falls short on that measure. University of Chicago researchers found that private equity-owned nursing homes had lower staffing ratios than other facilities and its residents experienced a higher probability of mortality.

“Minimum staffing standards means that private equity owners will have to invest resources in improving and maintaining their facilities, rather than extracting those resources for their own profit,” said Robert Seifert, senior policy fellow at AFR-EF. “The rule should also improve quality and safety for residents and the staff who care for them. It might also make nursing facilities less attractive to private equity, but if these firms can’t operate without endangering patients, they should not own nursing homes in the first place.”

The final rule sets new individual minimum staffing standards for RNs and nurse aides, and higher levels of staffing based on the acuity of resident needs (staff hours per resident day or HPRD standard). CMS also requires a registered nurse to be on site 24 hours a day, 7 days a week, something currently only required for 8 hours a day.

The new rule will also require states to collect data on the percent of Medicaid payments spent on compensation of direct care workers and support staff, which is aimed at bringing greater transparency to the unfairly low wages in this critical industry.

“The private equity industry exacerbates structural racism in our health care system,” said Aliya Sabharwal, private equity campaign manager at AFR-EF. We are heartened that CMS is addressing patient care through this new staffing standard and tracking compensation data, two of the many ways private equity owned nursing facilities profit at the expense of patients and care providers.”