They Are Called Nursing Homes for a Reason: RN Staffing in Long-Term Care Facilities

According to the Centers for Medicare and Medicaid Services (CMS), the Consolidated Medicare and Medicaid regulations have not been systematically reviewed and updated since 1991. Existing regulations require that, with certain exceptions, an RN provide services in a facility for 8 consecutive hours per day, 7 days per week; licensed practical nurses (LPNs) 24 hours per day; and sufficient staff to meet residents' needs. The requirements to determine "sufficient" staff remain undefined by CMS. Several national organizations support RN staffing 24 hours per day each day of the week (24/7). These organizations provided evidence refuting CMS' position that it does not have sufficient information at this time to require a specific number of staff or hours of nursing care per resident. Consideration should be given to the Institute of Medicine recommendation affrming the need for and requiring the presence of at least one RN within every nursing home facility at all times. Currently, there is a bill in the House of Representatives that supports 24/7 RN coverage in nursing homes, which must become both bipartisan and bicameral to be passed.