The Centers for Medicare & Medicaid Services (CMS) published its controversial final rule imposing minimum staffing requirements for long term care facilities (the “Final Rule”).
When it took effect on June 21, 2024, the Final Rule required minimum levels of nursing staff, including 24/7 on-site RN coverage and a 3.48-hour minimum of total nurse staffing per resident per day (HPRD), of which 0.55 hours must be provided by RNs and 2.45 hours provided by nurse aides, or CNAs. Facilities may provide the remaining 0.48 hours with a combination of nursing staff (RNs, licensed practical nurses, licensed vocational nurses, or nurse aides).
This new federal rule could save nearly 13,000 lives a year, researchers say, despite pushback from nursing home officials who argue the updated staffing standards could lead to home closures.
How does Alabama nursing home staffing measure up under the new rule?
Using fourth quarter data from 2023, estimates show that only 13% of Alabama nursing home staffing will meet the 24/7 RN requirement of the Final Rule; 48% will meet the 0.55 RN HPRD requirement; 51% will meet the 2.45 CAN requirement; and 70% will meet the 3.49 total HPRD requirement. It further predicts an annual cost of $61.1 million for Alabama facilities to meet all of the requirements, which will necessitate hiring an additional 712 CNAs and 306 RNs across the state. Of that cost, the required increase in CNAs will cost $31.5 million annually. Additional RNs to meet the 0.55 hours per resident day and 24/7 RN requirement will cost $28.8 million annually.
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