Opinion | Congress must protect staffing standards in nursing homes

Moving into a nursing home is a complex and heart-wrenching decision faced by millions of seniors and their families every year, including here in Michigan. Despite their best efforts, these families know their older loved one now needs more care than they can provide. And that’s when the nightmare begins. All too often, nursing homes don’t provide even basic levels of care, resulting in soiled underwear, bed sores, falls, missed medications, even death — due to unsafe levels of staffing.  

In April, the Centers for Medicare and Medicaid Services (CMS) finalized minimum staffing standards for nursing homes to help ensure America’s most vulnerable seniors receive basic levels of safe care. The final safe-staffing standard ensures that nursing home residents receive a minimum level of care. Under the standard, nursing homes are required to provide at least 3 hours and 29 minutes of care each day to each resident. This includes at least 2 hours and 27 minutes from a nurse aide and 33 minutes from a registered nurse. Furthermore, a registered nurse must be on site 24 hours a day, seven days a week, to provide skilled care. Non-rural nursing homes get three years to gradually implement the new standards. Rural nursing homes get five years. 

These minimum staffing standards are a necessary step toward improving the quality of care in nursing facilities. CMS data shows that nursing homes with higher levels of nursing care have better overall ratings, better health inspection ratings, and fewer instances of abuse. AARP advocated for minimum staffing standards, which will apply to most of the nation’s 15,000 nursing homes, including 425 here in Michigan. 

The standard hasn’t even gone into effect yet and some members of Congress are trying to destroy these long-overdue protections. The House and Senate recently introduced bad bills that would block the nursing home staffing standards from implementation. As if that isn’t dangerous and heartless enough, if the process being used to block the standards – a Congressional Review Act – is successful, it means rules about minimum staffing standards for nursing homes can never be issued again. The unacceptable result: perpetually poor, unsafe levels of basic care for our most vulnerable seniors.

Michigan is one of 38 states plus Washington, D.C., that have their own staffing standards. Others have no minimum standards at all, increasing the risk for vulnerable seniors. In our state, most Michigan nursing homes (70.6%) presently exceed the federal 3.48 total hours per resident day (HPRD) staffing level required in the new rule. It’s time all seniors in the state receive basic levels of care.

By definition, a nursing home is intended to provide care for those who can’t care for themselves. In other care facilities such as hospitals, there are strict standards to ensure that the tax dollars funding Medicare and Medicaid-covered care are being used for medical care as intended. Why should the nursing home industry, which receives $80 billion annually from taxpayers through Medicaid and Medicare, be any different?  It’s common sense that a standard is needed to define the minimum level of care paid for taxpayers. 

Minimum staffing standards help protect the basic right of nursing home residents to live with dignity. We know it is what the American people want. And in this election year, members of Congress and those who hope to be, would be wise to keep this in mind: voters 50-plus decide elections. According to a recent AARP poll, they are 94% more likely to support a candidate for public office who supports minimum staffing standards for nursing homes.

As Congress considers the proposed cuts to staffing standards for nursing homes, I hope resident safety is prioritized over nursing home industry profits. A vote against these efforts to overturn or weaken the rule is a vote for safe care for our most vulnerable seniors. Congress must protect staffing standards in nursing homes. Our loved ones and their families depend on it.