New U.S. Nursing Home Staffing Requirements

Author

Ruby Care Senior Living Advisors

For more information about the author, click to view their website: Ruby Care Senior Living Advisors

Posted on

Mar 03, 2024

Book/Edition

Texas - Dallas, Collin, SE Denton & Rockwall Counties

share-this
Share This

Originally Posted September 15, 2023


Long-term care facilities, also referred to as Nursing Homes

 

Working to improve the quality of care for elderly residents, the Biden Administration has given CMS the authority to implement new regulations that mandate nursing homes participating in Medicare and Medicaid to maintain minimum staffing levels and promote transparency.  Outlined in a report from The White House, the new regulations target the long-standing concerns of understaffing and the impact it has on the quality of life and care of vulnerable residents in nursing homes. In this blog, we will discuss implications of the new rules and their potential to make an impact on long term care in the United States.

 

Understaffing Problem

For years understaffing has been an ongoing issue in U.S. nursing homes, with consequences being inadequate care to elderly neglect and abuse.  The COVID-19 pandemic called attention to the vulnerabilities our loved one’s face in these facilities, over 200.000 lives were lost in long-term care facilities (npr.org), which prompted a call for systemic change.  As nursing homes struggled to cope with the demands of the pandemic, the need for more personnel and better staffing ratios became glaringly evident.  

 

New Regulation Focus

The Centers for Medicare & Medicaid Services (CMS) has introduced new regulations requiring nursing homes to meet minimum staffing requirements, in an ongoing effort to improve the quality of care for Medicaid and Medicaid recipients and are expected to have a profound impact on the industry.

 

New Regulations Key Provisions

 

·  Minimum Staffing Levels: Nursing homes are now required to maintain a minimum staffing level, ensuring there are enough nurses and other staff members to meet residents’ needs adequately. These levels will vary depending on the size and needs of the facility.

·  Staffing Ratios: Facilities must now have an appropriate number of registered nurses (RNs) on staff 24/7 to provide skilled nursing care to residents.

·  Transparency: Nursing homes must be transparent about their staffing levels and retention, making this information readily available to residents and their families.  As staffing levels and turnover have shown to be directly correlated with quality of care

1.  CMS database of nursing home owners and operators.

2.  Improve transparency of facility ownership and finances.

3.  Enhance nursing home Care Compare rating website.

4.  Examine the role of private equity investors in the nursing home sector

· Accountability: CMS will enforce these regulations through regular inspections and assessments. Nursing homes failing to meet the requirements may face serious penalties of lose their eligibility to Medicare and Medicaid funding

Potential Impact

 

There are several positive changes these new regulations are expected to make in the long-term care industry

 

· Improved Quality of Care: Appropriate staffing levels mean better care for residents, as their needs will be addressed more promptly.  When a resident’s need is met in a timely manner it can lead to preventable medical complications and overall improvement in the resident’s quality of life. (PubMed)

 

· Improved Resident Safety: Incidents of neglect and abuse may decline with more staff members available, ensuring a safer environment.

 

· Better Staff Retention: CMS is investing $75 million in financial incentives, in things like tuition reimbursement to help improve retention at nursing homes. (npr.org) When a facility is staffed adequately it can reduce burnout and stress, leading to less staff turnover and hopefully as a result will attract more skilled professionals to the industry.

 

· Informed Choices and Transparency: Nursing Home Five-Star Rating System will aid families in making informed decisions when choosing a facility for their loved ones.

 

· Government Accountability: Oversight and government enforcement are critical in ensuring nursing homes are held accountable and lead to systemic positive changes.


Challenges and Concerns


Implementation: Due to nationwide shortages in nursing and healthcare supportive staff, nursing homes participating in Medicare and Medicaid may struggle to meet the new regulations standards.

Costs: Hiring additional staff equates to increased costs which are often passed on to the residents. The American Health Care Association believes that the proposal will worsen current conditions and cost nursing homes billions. (Associated Press)

Monitoring and Enforcement: Effectiveness of the new regulations will rely on regular monitoring and enforcement by CMS. With 75% of nursing homes nationwide being impacted, this could potentially lead to closures and additional struggles, especially in remote areas. (Associated Press)

Not Enough: Leader of Long-Term Care Community Coalition, Richard Mollot, called the measures “completely inadequate”. While admitting that the 24/7 nursing requirement may make small improvements in some of the worst facilities. (Associated Press)

There is no question that we all want quality care in a safe environment for our elderly and loved ones.  While there will be many challenges to overcome implementation, the benefits in enhanced quality care, resident safety, and transparency outweigh the concerns. Only time will tell if these new regulations will truly be able to aid nursing homes in making changes that yield positive long-term outcomes for residents. Families being able to make better and more informed choices as to where their loved ones receive care is a step in the right direction. After decades of caring for loved ones, there is nothing that can compare to having a family member or friend that checks in on their person regularly. Being present and knowing you’re coming has a positive impact not only on the residents but the staff too. Long-term care is a team effort and taking an active role to be a positive part of that team can make a significant difference. 

 

'Britt Hemsell | Senior Living Advisor & Blog Contributor


Resources:

The Associated Press by Matt Sedensky: reader.dallasnews.com/infinity/article_popover_share.aspx?guid=87cfddf9-73c6-4259-a88b-e6e912921658

The White House: FACT SHEET: Biden-Harris Administration Announces New Steps to Improve Quality of Nursing Homes | The White House

NPR: Biden New Federal Standards for Nursing Home Care : NPR

PubMed: The association between nurses' burnout and objective care quality indicators: a cross-sectional survey in long-term care wards - PubMed (nih.gov)

Other Articles You May Like

Managing Parkinson's Symptoms at Home

Managing Parkinsons Symptoms at HomeThis article is part of The Parkinsons Care Compass, an educational series from At Your Home Caregiving of Texas. Managing Parkinsons symptoms at home takes preparation, compassion, and the right support and we are honored to guide families every step of the way.Managing Parkinsons disease at home requires a careful balance of patience, knowledge, and proactive strategies. Parkinsons affects not only mobility but also speech, mood, memory, and overall daily living activities. As symptoms progress, the home environment and caregiving approach must evolve to meet new challenges and ensure that the individuals dignity, comfort, and independence are preserved.At Your Home Caregiving of Texas specializes in providing customized home caregiving solutions that empower families to manage Parkinsons symptoms effectively while preserving the quality of life for their loved ones.The Importance of a Symptom Management PlanParkinsons symptoms are highly individual no two people experience the disease in exactly the same way. Creating a personalized symptom management plan is essential to addressing the patients physical, cognitive, and emotional needs.A well-rounded plan typically addresses: Mobility and fall prevention Medication management Cognitive and emotional changes Speech and swallowing difficulties Nutrition and hydration Daily routines and activities for mental and physical engagement At Your Home Caregiving of Texas helps families design care plans that respond to their loved ones unique symptoms, preferences, and goals.Mobility Challenges and Fall PreventionMobility issues are among the most recognizable symptoms of Parkinsons disease. Slowed movements (bradykinesia), stiffness, and balance problems increase the risk of falls and injuries.Strategies for Safer Mobility: Home Modifications: Remove trip hazards (like loose rugs), install grab bars in bathrooms, and ensure adequate lighting throughout the home. Use of Assistive Devices: Canes, walkers, and specially designed furniture can aid in safe movement. Clear Walking Paths: Maintain wide, unobstructed paths through frequently used areas like bedrooms, bathrooms, and kitchens. Encouraging Movement Techniques: Techniques like "freezing" drills and cueing strategies (using rhythmic music or counting steps) can help when patients feel stuck or rigid. At Your Home Caregiving of Texas caregivers are trained in fall prevention and can assist clients safely with standing, walking, and transferring from beds or chairs.Medication Management at HomeStrict adherence to medication schedules is critical in Parkinsons care. Medications like levodopa/carbidopa must be taken precisely to control motor symptoms and prevent sudden worsening.Medication Management Tips: Use pill organizers clearly labelled with times of day. Set alarms or use medication reminder apps. Keep a written medication schedule visible for caregivers and family members. Monitor for side effects like dizziness, hallucinations, or sudden involuntary movements (dyskinesias). Our professional caregivers ensure that medication regimens are followed accurately, reducing the risk of complications and hospitalizations.Addressing Cognitive and Emotional ChangesCognitive changes such as memory loss, slowed thinking, and difficulty concentrating are common in Parkinsons, especially as the disease progresses. Emotional changes, including depression and anxiety, may also develop.Support Strategies: Cognitive Engagement: Activities like puzzles, reading, and conversation help keep the mind active. Routine and Structure: A consistent daily routine minimizes confusion and frustration. Patience and Understanding: Allow extra time for decision-making and avoid rushing tasks. Mental Health Support: Professional counselling and medication management can help address depression and anxiety. At Your Home Caregiving of Texas, we prioritize emotional support alongside physical care, creating a nurturing environment for both the patient and their family.Managing Speech and Swallowing DifficultiesSpeech difficulties (dysarthria) and swallowing problems (dysphagia) are common but manageable aspects of Parkinsons.Tips for Speech Challenges: Encourage slow, deliberate speech. Use voice exercises, sometimes under the guidance of a speech therapist. Practice reading aloud or singing to strengthen vocal muscles. Tips for Swallowing Challenges: Consult a speech-language pathologist for swallowing assessments. Offer smaller, more frequent meals. Use thickened liquids if needed to prevent choking. Monitor for signs of aspiration, such as coughing during meals. Our caregivers are trained to notice changes in speech and swallowing and can assist with appropriate interventions to maintain safety and nutrition.Nutrition, Hydration, and ExerciseProper nutrition and hydration are vital for maintaining strength, energy, and medication effectiveness. Constipation, a common non-motor symptom of Parkinsons, can often be alleviated through diet.Key Nutrition Strategies: Focus on fiber-rich foods (vegetables, fruits, whole grains). Maintain hydration offer water throughout the day. Time protein intake carefully, as large amounts of protein can interfere with medication absorption (consult with a physician or dietitian). Incorporate antioxidant-rich foods to support brain health. The Role of ExerciseExercise is one of the most powerful non-medication tools for managing Parkinsons symptoms. Regular movement improves: Balance and gait Flexibility and strength Mood and cognitive function Simple exercises like walking, gentle stretching, yoga, and chair exercises can make a significant difference. Specialized programs like Parkinsons-specific boxing or dance classes can also offer tremendous benefits.At Your Home Caregiving of Texas, our caregivers incorporate gentle movement and stretching routines into the daily care plan, promoting physical vitality and emotional well-being.Creating an Emotionally Supportive Home EnvironmentBeyond managing symptoms, creating a positive and emotionally supportive home environment is essential.Key Elements: Respect and Dignity: Involve the patient in decision-making whenever possible. Companionship: Regular conversation, laughter, and shared activities prevent isolation. Patience and Flexibility: Parkinsons symptoms can vary from day to day caregivers must adapt with grace and understanding. Empowerment: Focus on what the patient can do, not what they cant. Celebrating small victories boosts confidence. Families often find it overwhelming to balance these emotional needs with the physical demands of caregiving. Thats where trusted professional caregivers make a tremendous difference.How At Your Home Caregiving of Texas Supports In-Home Parkinsons CareOur specialized Parkinsons care services are designed to ease the burden on families while maximizing the comfort and independence of the individual living with the disease.Our Parkinsons Home Care Includes: Assistance with personal care, mobility, and safety Medication management and reminders Nutrition support and meal preparation Exercise encouragement and participation Cognitive stimulation activities Emotional support and companionship Home safety evaluations and fall prevention Coordination with therapists, physicians, and family members Every care plan is customized, compassionate, and flexible evolving as the patients needs change over time.Final ThoughtsManaging Parkinsons symptoms at home is both an art and a science. It requires deep understanding, careful planning, and a loving, patient approach. With the right tools, support systems, and caregiving partnerships, families can help their loved ones live meaningful, dignified lives at home for as long as possible.At Your Home Caregiving of Texas is honored to be a trusted partner in this journey. Our expertise in Parkinsons care, our compassionate caregivers, and our commitment to excellence ensure that families receive the support they need, every step of the way.If you are caring for a loved one with Parkinsons disease, reach out to us today. Together, we can build a personalized care plan that brings peace of mind, safety, and hope into your home. At Your Home Caregiving of Texas is committed to helping families manage Parkinsons symptoms at home with expertise, compassion, and customized support. To learn more about creating a safe, empowering home environment for your loved one, explore the Parkinsons Care Compass series or contact us today. Together, we can make every day safer, stronger, and filled with possibility.Contact us at 469-830-8414

Making the Move Easier: 6 Tips for Seniors and Caregivers Navigating a Big Transition

Whether your aging parent is transitioning to assisted living, downsizing to a senior apartment, or moving in with family, planning ahead can ease the stress for everyone involved. Moving in later life comes with unique emotional and physical challenges, but you dont have to do it alone.As a senior living placement company in the Greater Pittsburgh area, weve helped many local families navigate this journey with confidence and compassion. Here are six practical tips to support you and your loved one every step of the way.1. Start Small and Share the LoadLets face it: a lifetime of memories can be hard to pack. Many older adults have spent decades in the same home, surrounded by treasured keepsakes and familiar routines. The thought of letting go can be overwhelming.Heres how to lighten the emotional load: Begin with low-sentiment spaces like guest rooms or bathrooms. That first win builds momentum. Sort together. Create keep, donate, and pass along piles. Encourage your loved one to gift meaningful items to children, grandchildren, or close friends. Make it meaningful. Donating to local Pittsburgh charities or giving heirlooms to family members can bring peace of mind. 2. Consider Senior Move Management ServicesHiring a professional can make a world of difference. While friends and family are often eager to help, a neutral third party especially one trained in working with older adults can ease tension and smooth the process.Look for services like: Senior move managers who specialize in downsizing and relocation for older adults. Companies affiliated with the National Association of Senior Move Managers (NASMM) for trustworthy help. Local resources in Pittsburgh that offer packing, organizing, estate sales, and post-move support. If youre juggling work, caregiving, and moving logistics, outsourcing some of these tasks can give you much-needed peace of mind.3. Make Travel Safe and ComfortableGetting from point A to point B isnt always easy for older adults. Whether youre moving your loved one across town or across state lines, transportation should fit their health and comfort needs.Travel tips for seniors: Add buffer time. Frequent breaks help with circulation and comfort. Plan around mobility needs. For flights, request wheelchair service and pre-boarding. For car trips, pack medications, snacks, and extra pillows. Look into senior transportation services. In Pittsburgh and beyond, some companies offer non-emergency medical transport, including services equipped with stretchers, wheelchairs, or even nursing staff. 4. Set Up Health Care Before the MoveA new ZIP code may mean a new doctor, pharmacy, and care team. Take care of these logistics early to ensure a smooth transition especially if your loved one has ongoing health needs.To-do list: Transfer prescriptions to a nearby pharmacy. Verify insurance coverage in the new area check which local specialists and clinics are in-network. Connect with a geriatric care manager. These experts often know the best local healthcare providers and in-home care agencies in Western PA. Having a plan in place ensures continuity of care from day one.5. Help the New Space Feel Like HomeEven if the new apartment or assisted living suite is smaller, it can still feel cozy, familiar, and full of life. Small touches make a big difference.Ideas to personalize the new home: Recreate familiar spaces by placing photos and dcor just as they were before (snap a few reference photos before packing). Unpack favorite blankets, books, or that special coffee mug first. Bring beloved furniture or artwork, and explore fun updates like a new recliner or colorful accent wall. Many senior living communities surrounding Pittsburgh encourage residents to decorate their rooms to reflect their style this helps ease the emotional transition.6. Emphasize the PositivesYour loved one may be leaving behind a house filled with memories, but theyre also stepping into a new chapter one filled with support, activities, and connection.Help them see the bright side: Less worry. No more home maintenance or mowing the lawn. More connection. Many assisted living communities offer events, exercise classes, and outings. Opportunities for joy. Explore local senior centers, volunteer programs, or art classes in their new neighborhood. Encourage them to explore and celebrate whats next.Ready to Take the Next Step?Moving a senior loved one can feel like a huge undertaking but you dont have to navigate it alone. As a trusted senior living advisor in Pittsburgh, weve helped thousands of families find the right care options, whether it's assisted living, independent living, memory care, or downsizing solutions. Let us guide you through the process from personalized placement help to local resource referrals. Contact us today at Serving Our Seniors to speak with a compassionate senior care advisor who truly understands the Pittsburgh area.

Understanding Skilled Nursing in the Western Slope of Colorado: A Guide for Families and Seniors

As our loved ones age or face medical challenges, finding the right level of care becomes crucial. For many families across the Western Slope of Colorado, skilled nursing is a vital solution that provides both medical support and day-to-day assistance. Whether you're planning ahead or responding to a sudden need, understanding skilled nursing and how it applies to your local area is the first step to making informed decisions.In this blog, well explore what skilled nursing is, who can benefit from it, and what options are available across the Western Slope of Colorado. What Is Skilled Nursing?Skilled nursing refers to high-level, medical care provided by licensed healthcare professionals in a clinical setting. Unlike assisted living or home care, skilled nursing facilities (SNFs) offer 24/7 access to medical services that may include:Wound care and post-surgical recoveryIV therapy and injectionsPhysical, occupational, and speech therapiesPain managementMedication administrationMonitoring of chronic health conditionsSkilled nursing is often short-term, serving as a bridge between a hospital stay and returning home. However, for some seniors with ongoing complex needs, long-term skilled nursing may be the most appropriate option. Who Needs Skilled Nursing?Not every senior requires skilled nursing care, but it is essential for individuals who:Are recovering from surgery, injury, or a strokeHave chronic illnesses that require regular monitoringNeed rehabilitation services under medical supervisionRequire complex medication managementIn many cases, a physicians referral is needed for admission to a skilled nursing facility, especially if Medicare or insurance is being used to cover the cost. Skilled Nursing in the Western Slope of ColoradoThe Western Slope covers a broad and diverse region of Coloradofrom Grand Junction to Montrose, Glenwood Springs to Durango. Access to skilled nursing here is shaped by both geography and community needs. Fortunately, there are reputable, well-equipped skilled nursing facilities throughout the area, offering a range of services tailored to the needs of local seniors.Whether youre looking for transitional care after a hospital stay or long-term skilled nursing, the Western Slope offers supportive, medically focused options in both urban and rural communities.Explore all senior housing options in the area: Western Slope Senior Housing DirectorySpecifically looking for skilled nursing? Browse here: Western Slope Skilled Nursing Listings What to Look for in a Skilled Nursing FacilityChoosing a skilled nursing provider for yourself or a loved one is an important decision. Here are some factors to consider:Licensing and accreditation: Make sure the facility is properly licensed and meets state and federal requirements.Staff qualifications: Ask about the training and experience of nurses, aides, and rehab professionals.Rehabilitation services: If short-term recovery is the goal, make sure physical, occupational, and speech therapy are available on-site.Cleanliness and safety: Tour the facility and ask about infection control procedures, especially post-COVID.Family involvement: Look for a facility that keeps family members informed and encourages participation in care planning. Paying for Skilled NursingCost is often one of the biggest concerns when it comes to skilled nursing care. In many cases, Medicare will cover short-term skilled nursing following a qualifying hospital stay. Medicaid and private insurance may also provide coverage depending on eligibility and the facility.Its helpful to meet with a care coordinator or facility representative to understand your options and what services are covered. Trusted Care Across the Western SlopeSkilled nursing plays a vital role in helping seniors recover, manage health challenges, and live with dignity. On the Western Slope of Colorado, families have access to compassionate, licensed providers who offer the care and support their loved ones need. Whether you're beginning your search or helping a loved one navigate next steps, Seniors Blue Book is here to connect you with trusted local resources.

Local Services By This Author

Ruby Care Senior Living Advisors

Housing Placement & Resource Specialists 5960 West Parker Rd Ste 278-215, Plano, Texas, 75093

When Its Time for Senior Living, We Help You Find the Perfect Community for You! With over 900 senior living options in the DFW area, Ruby Care helps families make informed decisions. We provide complimentary assistance to find the most appropriate living community including Indepenent Living, Assisted Living, Residential Care Homes, Memory Care & Nursing Home. Our ExperienceIf you've been searching for senior housing for you or your loved one, you know there are hundreds of senior living communities in the Dallas/Fort Worth area.  Let Ruby Care help you.  We do the legwork at no cost to you and help you find the place that is perfect for you and your family.Our professionals are well-known in the communities they serve.  In order to help you best, they network with health care providers, such as home health, hospice, rehabilitation facilities, hospitals, physicians and other senior service providers.Collectively, our team has over 50 years of experience in healthcare and we are trained to listen to your needs so that we can work to find the best options for you...at no cost! Why Us?We know this can be a stressful time for you as you choose your next  home.  When you work with us, you will be assigned a Senior Living  Advisor (SLA) who knows the community and has first-hand knowledge of  the communities you are considering.  Your SLA will meet with you in person and will listen to your wishes, wants and needs in order to help guide  your next steps.  Your SLA will also help you with senior living community tours and  preparation to help guide you through the selection process.  We serve as your advocate and help make this a smooth, seamless transition.  Once you have selected a community, we continue to follow up for at least the next thirty days to make sure things are going well and there are no outstanding concerns. possibilities.  placement.  peace of mind.