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Improving Care for Older Adults
In Their Own Words
Why Nursing Homes Should Provide More Nurses and Aides to Residents
CMS Raised Staffing Minimums in Nursing Homes Last Year, Marking a Major Improvement. Now These Rules Are Under Threat
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The following excerpt is from an op-ed that first appeared in The New York Times on February 7th, 2025.
For anyone who lives in a nursing home, the adequacy of the nursing staff is a life-or-death issue. That’s why the Biden administration issued federal rules last year setting minimum standards for staffing. By our estimate, they will save 13,000 lives a year. But those rules are now under attack.
The Trump White House should defend them, not reverse or weaken them as part of its larger effort to roll back regulations across government.
The rules, which were finalized last April, represent some of the most significant reforms in nursing home care in decades. They will also cost most nursing facilities more to operate by increasing staffing, and that is why the rules are now in grave danger. But it will be money well spent on the industry’s core mission: caring for residents.
President Trump’s choice to head the Department of Health and Human Services, Robert F. Kennedy Jr., told lawmakers at a confirmation hearing last week that although the rules “were well intentioned,” they would be a “disaster,” especially for nursing homes in rural areas. Twenty Republican state attorneys general have gone to federal court to quash the rules. So have nursing home industry groups.
This amounts to an assault on some of our most vulnerable Americans, the roughly 1.3 million people who live in nursing homes, where understaffing and turnover are major problems. The rules, which are being phased in over the next several years, require a registered nurse to be on site 24 hours a day, seven days a week, and mandate a minimum of 3.48 hours of nursing care per resident per day, mostly from nursing aides.
That may not sound like a lot, but most nursing homes in the United States don’t meet those basic minimums. Staffing levels at 83 percent of nursing homes fell below the new requirements in the first half of 2023, according to our analysis.
As researchers who have studied nursing homes for decades, we know how crucial nursing home staff members are — and why efforts to roll back the new minimum staffing rules pose such a threat to the residents and their families who rely on these staffers….
Read the entire op-ed here.
Authors
Norma B. Coe, PhD
Director, Research and Co-Director, Health Economics Data Analyst Pool (HEDAP), Penn LDI; Professor, Medical Ethics and Health Policy, Perelman School of Medicine
Rachel M. Werner, MD, PhD
Executive Director, Penn LDI; Robert D. Eilers Memorial – William Maul Measey Professorship in Health Care Management and Economics, Wharton School; Professor, Medicine, Perelman School of Medicine
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