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May 21, 2024

Few nursing homes in Pa., N.J. meet impending staffing requirements, analysis finds

Stricter federal regulations will start taking effect in two years. Many care facilities are a long way from fulfilling them.

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Less than 20% of U.S. nursing homes meet staffing minimums that will be incrementally implemented beginning in 2026, a new analysis shows.

Less than 20% of nursing homes in Pennsylvania and just 15% of nursing homes in New Jersey meet certain staffing requirements that begin to take effect in 2026, according to a new analysis.

The nationwide picture is similar, with less than 20% of nursing homes currently meeting the staffing minimums being imposed under a new rule from the Centers for Medicare and Medicaid Services, a Kaiser Family Foundation analysis shows. The rule, released in late April, will be fully phased in by 2029.

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The stricter requirements are partly a response to the COVID-19 pandemic, when more than 167,000 nursing home residents died. Nurses, nurses aides and other staffers left the industry in large numbers, and advocates reported wide-scale abuse and neglect of the elderly in care homes. The nursing home industry, like many fields in health care, is struggling to attract and maintain staff that provide medical and care services for 1.2 million Americans.

Some advocates say the final ruling on nursing home staffing is not strict enough, while many nursing home companies have said the new requirements will force them to close their doors.

The KFF report, published Tuesday, estimates that just under 70% of nursing homes in Pennsylvania currently meet the new minimum standard of 33 minutes of care from a registered nurse per resident per day.

Only 18% of them provide the required 147 minutes of nurse aide care per resident per day, and 56% meet the overall total of nursing and aide care, plus less than 30 minutes of any type of additional nursing care. The KFF analysis reflects staffing levels from October through December, 2023. Fifteen Pennsylvania facilities did not report usable data.

In New Jersey, 55% of nursing homes currently meet the minimum standard of 33 minutes of RN care per resident per day, and 19% of them meet the minimum 147 minutes of nurse aide care per resident per day. Just over 50% of all nursing homes – with 14 facilities not reporting usable data – meet the overall nursing care requirement, according to the analysis.

Other takeaways from the analysis include:

• A smaller share of for-profit facilities currently meet all requirements in the final rule than nonprofit and government facilities (11% versus 41% and 39%, respectively).

• In over half of states, fewer than 25% of facilities meet all three staffing minimums required in the final rule.

• The share of facilities that meet the requirements range from 5% or lower in four states – Arizona, Tennessee, Texas and Louisiana – to 50% or higher in five states and Washington, D.C. Those five states are Alaska, North Dakota, Maine, Hawaii and Oregon.

• The final rule does include hardship exemptions that would allow some nursing homes to maintain lower staffing levels – with additional requirements tied to them, according to the analysis.

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