Advocacy in Action (May 2024): Nursing Home Minimum Staffing Rule

Libby Hastings • May 15, 2024

Recently, we have been disheartened by legislative actions that undermine efforts to improve staffing standards in nursing homes, particularly in Kansas. H.R. 5796, co-sponsored by Representatives Tracey Mann, Jake LaTurner, and Ron Estes, seeks to disapprove a federal staffing standard minimum rule that would greatly benefit residents of nursing facilities. Similarly, S.3410, co-sponsored by Senators Roger Marshall and Jerry Moran, aims to address the same issue in the Senate. If passed, these legislations would prohibit the Secretary of Health and Human Services from implementing the final settings rule for minimum staffing in nursing facilities. 

 

The Nursing Home Minimum Staffing Rule finalized on April 22nd will require all nursing homes that receive federal funding through Medicare and Medicaid to have 3.48 hours per resident per day (hprd) of total staffing, including a defined number from both registered nurses (0.55 hprd) and nurse aides (2.45 hprd). It will also require facilities to have a registered nurse onsite 24 hours a day, seven days a week.

 

At the heart of this issue is the need for adequate staffing levels in nursing homes. Research consistently shows that higher staff-to-resident ratios lead to better outcomes for residents, including reduced rates of infections, fewer falls, and improved overall quality of life. By opposing the implementation of a federal staffing standard minimum rule, these legislators are failing to prioritize the well-being of vulnerable older adults in Kansas and across the nation.

 

Additionally, it's disappointing to see the nursing home industry diverting attention away from the real issue at hand. Instead of lobbying against essential staffing regulations, they should be directing their efforts towards hiring and retaining qualified staff, ensuring fair wages, and creating supportive work environments. Working in a nursing facility is a skilled job that deserves respect, and addressing the staff shortage requires dedicated time and attention.

 

However, amidst these challenges, we find hope in the actions of the Biden administration and advocacy organizations who have pushed for measures to improve staffing standards in nursing homes. We applaud their commitment to addressing this critical issue and urge them to continue their efforts.

 

In Kansas, the Medicaid program spends $95,000-$108,000 annually per resident for often sub-standard care. The state allocates approximately $862 million to long-term care facilities, yet Kansas ranks 46th in addressing the shortage of nurses and nurse aides. Taxpayers deserve greater value for their money, and older Kansans deserve improved long-term care options given the consistently poor performance of many in this industry.

 

We cannot afford to ignore this problem any longer. To effectively address the staffing shortage problem in Kansas, we must also look to other states for guidance and best practices. By learning from successful initiatives implemented elsewhere, we can tailor solutions to suit the unique needs of our state's long-term care facilities. Furthermore, it's crucial to foster a collaborative effort that includes the voices of long-term care residents and staff in these discussions. By actively involving those directly impacted by staffing challenges, we can develop more comprehensive and effective strategies to ensure quality care for all individuals in nursing homes.

 

We encourage our readers to act. Contact your Kansas Congressional delegates and share your stories about why staffing is critical to improving quality metrics across the board.

 

Your voices matter, and together, we can make a difference in the lives of countless individuals in long-term care facilities.

 


By Lenette Hamm February 25, 2025
A nursing home’s failure to meet a Federal participation requirement is defined as a deficiency. Examples of deficiencies include a nursing home’s failure to adhere to proper infection control measures and to provide necessary care and services. Each deficiency is given a letter rating of A through L based on the State agency’s determination of the scope and severity of the deficiency. See chart below.
By Libby Hastings February 25, 2025
KABC is raising the alarm over proposed federal cuts to Medicaid that could strip away as much as $2.5 trillion from the program. This is not just a budgetary adjustment—it is a direct threat to the well-being of thousands of older Kansans who rely on Medicaid for their long-term care needs. Dan Goodman, Executive Director of KABC, spoke out against these proposed cuts, emphasizing the urgent need for Kansans to take action: “I have no sense that this will deter the Federal Administration from taking action on this program, but rather the hope is to illuminate this issue for those Kansans that are paying attention and bring about a more calibrated approach. We must get Kansans to think about what long-term care looks like for Older Kansans with lesser Medicaid funding. I’m here to urge you to protect Older Kansans, protect Medicaid.” Goodman was invited to speak at the Kansas Statehouse in Topeka on Monday, February 24, 2025, to address the recent movement by Congressional leaders to cut federal Medicaid funding. The informal gaggle took place in the east wing of the ground level of the Kansas Statehouse and gained statewide media attention. Other speakers included April Holman, Executive Director of the Alliance for a Healthy Kansas; Rocky Nichols, Executive Director of the Disability Rights Center of Kansas; and Adrienne Olejnik, Vice President of Kansas Action for Children. Medicaid: A Lifeline for Older Kansans Most Kansans over 65 rely on Medicare for their healthcare needs, but it is Medicaid that ensures access to long-term care services, whether at home or in nursing facilities. For thousands of seniors in Kansas, Medicaid is the only option that allows them to age with dignity in their own homes, receiving essential support services. However, the impact of these proposed federal cuts would be catastrophic. Kansas already suffers from a critical shortage of direct care workers, and nearly 85,000 Older Kansans live in areas with limited access to care. Slashing Medicaid funding will only deepen this crisis. Rural communities, where healthcare access is already strained, will be hit the hardest. Short-term savings from these cuts will be overshadowed by the long-term damage—weakening the home and long-term care infrastructure, driving more providers out of the workforce, and placing tens of thousands of Older Kansans at risk. Who Will Care for Older Kansans? More than half of Kansas nursing home residents depend on Medicaid to afford care, which costs an average of $7,700 per month for a semi-private room. These older adults have already depleted their assets before qualifying for Medicaid, leaving them with no other options. Many have no family to step in, and even when family is available, they may not have the ability to provide the level of care required. Without Medicaid, who will care for them? And how will Kansas taxpayers fill the financial void left by the loss of federal funding? This is not just a question of policy—it is a question of morality and responsibility. Take Action Now We cannot afford to wait and see what happens. Kansans must act now. Contact your federal representatives ( Find Your Members in the U.S. Congress | Congress.gov | Library of Congress ) and tell them: Medicaid is not just another federal program to be gutted—it is a lifeline for older Kansans. Do not allow reckless budget cuts to dismantle a system that so many depend on.  Stand up. Speak out. Demand that Medicaid funding is protected before it is too late. The future of long-term care in Kansas depends on it. Protect older Kansans. Protect Medicaid.
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