Massachusetts Attorney General Andrea Joy Campbell, California Attorney General Rob Bonta, and New York Attorney General Letitia James collectively led a cohort of 15 state attorneys general in an appeal to the federal administration, requesting more stringent nursing home staffing protocols. The group's appeal, revealed earlier today, via a press statement, called on the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS) to establish a rule demanding firmer staffing requisitions for long-term care establishments.
The recommendations put forward stressed increased staffing benchmarks for certified nursing assistants (CNAs) and registered nurses, with a requirement that at least one registered nurse should be present onsite at all times. The coalition maintains that the present staffing prerequisites are not adequate enough to ensure the safety and well being of elderly home residents.
Addressing CMS's recommended 2.45 hours per resident day (HPRD) of care from CNAs and 0.55 HPRD from RNs, the attorney generals put forward a different minimum standard of 4.1 HPRD. This includes 2.8 HPRD for CNAs, 0.75 HPRD for RNs, and 0.55 HPRD for LPNs. These recommendations are founded on CMS's 2001 nursing home staffing study, which indicated a decline in patient care quality when staffing levels lowered below 4.1 HPRD, as cited by Mass.gov.
The coalition pointed out the lack of any minimum staffing requisites for licensed practical nurses (LPNs) in the proposed regulations. They stated that the absence of such a requirement may unintentionally, encourage nursing homes to employ only RNs and CNAs, thereby escalating the workload for RNs.
Additionally, the group advocated CMS to limit exemptions from the minimum staffing benchmarks. Despite the enduring staff shortages at long-term care establishments, the coalition urges that exemptions based on workforce shortages should be granted only in emergencies. This, the group argues, will diminish opportunities for unethical facility owners to profit by neglecting appropriate staffing, whilst receiving Medicare and Medicaid funds.
Efforts like these are also in action in Massachusetts with the attorney general's office recently enforcing actions against homes not providing sufficient care to residents and engaging in settlement agreements with some for improved procedures, independent compliance monitoring, and training, as stated in the press notice.
AG Campbell also unveiled the formation of the Elder Justice Unit headed by Assistant Attorney General Mary Freeley. This unit is tasked to collaborate with the staff from the Attorney General's Criminal, Public Protection and Advocacy, and Health Care and Fair Competition Bureaus to implement measures, legislative advocacy, community interaction, and educational initiatives to elevate the safety and wellness of elderly citizens.
