The Biden administration finalized nursing home staffing rules Monday that will require thousands of them to hire more nurses and aides — while giving them years to do so.
The new rules from the Centers for Medicare & Medicaid Services are the most substantial changes to federal oversight of the nation’s roughly 15,000 nursing homes in more than three decades. But they are less stringent than what patient advocates said was needed to provide high-quality care.
Spurred by disproportionate deaths from covid-19 in long-term care facilities, the rules aim to address perennially sparse staffing that can be a root cause of missed diagnoses, severe bedsores, and frequent falls.
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The rules primarily address staffing levels for three types of nursing home workers. Registered nurses, or RNs, are the most skilled and responsible for guiding overall care and setting treatment plans. Licensed practical nurses, sometimes called licensed vocational nurses, work under the direction of RNs and perform routine medical care such as taking vital signs. Certified nursing assistants are supposed to be the most plentiful and help residents with daily activities like going to the bathroom, getting dressed, and eating.
While the industry has increased wages by 27% since February 2020, homes say they are still struggling to compete against better-paying work for nurses at hospitals and at retail shops and restaurants for aides. On average, nursing home RNs earn $40 an hour, licensed practical nurses make $31 an hour, and nursing assistants are paid $19 an hour, according to the most recent data from the Bureau of Labor Statistics.
Nursing homes get thousands a month for every patient there. They can afford to pay more, but that’s only half the problem. There simply aren’t enough nurses in the US, and their won’t be any time soon.
The nursing homes don’t even need more RN’s. RN’s take a lot of time and work and clinical hours to get certified. A whole lot.
They just need more competent staffing that’s allowed to be there and want to help care for patients, and recognize when something isn’t right. EMT-B’s could do a great job if things, would be more cost effective, and there’s a bigger hiring pool. Simply having more staff is needed more than just a couple more nurses. Emts can take vitals, move patients around, assist with patients taking meds, and recognize a lot of issues to bring to an RN’s attention.