A Call to the CMS: Mandate Adequate Professional Nurse Staffing in Nursing Homes

Abstract

Editor's note: This article is by 22 nursing gerontology experts who are all advocates of nursing home reform. They are listed at the end of this article.

Dementia care education interventions on healthcare providers' outcomes in the nursing home setting: A systematic review

“…The positive yet short term effect suggested that nursing home staff are willing to learn but reinforcement is needed to sustain the learning effect, such as having skilled staff nurses to provide in-house training (Kolanowski et al, 2021) and providing booster sessions and case discussion (Pulsford et al, 2011). These strategies for continuing education among nursing-home staff highlight the importance of organizational support (Chan et al, 2020).…”

A Call to Address RN, Social Work, and Advanced Practice Registered Nurses in Nursing Homes

“…42 Experts in NH care quality have become increasingly concerned about the lack of 24-hour-a-day, 7-day-a-week RN presence. 13 , 15 In addition, Rantz and colleagues 43 have joined other voices in pointing out the critical need for NH APRNs. Key advantages of APRNs working on-site in NHs are that not only can they evaluate and treat ill residents, but they also have the skills to coach staff in their understanding of clinical assessment, early illness identification, and management of ill residents.…”

“…12 Most NHs follow the minimum federal regulations for staffing. 13 These regulations require 1 RN on duty 8 consecutive hours per day, 7 days per week, and 1 RN on call when a licensed practical nurse (LPN) is on duty. [14][15][16] The national average for licensed nursing staff hours per resident is 1 hour 44 minutes per day (RN = 46 minutes; LPN/licensed vocational nurse [LVN] = 58 minutes).…”

“…[14][15][16] The national average for licensed nursing staff hours per resident is 1 hour 44 minutes per day (RN = 46 minutes; LPN/licensed vocational nurse [LVN] = 58 minutes). 17 As noted by Kolanowski et al, 13 the general public believes that NH staffing is adequate and that RNs play a significant role in the care of NH residents. Yet, 75% of NHs never meet the Centers for Medicare & Medicaid Services (CMS) requirement for minimum RN coverage.…”

Geropsychiatric Nursing Leadership in Long-Term Care

“…23 The COVID-19 pandemic highlighted the need for the 24-h presence of registered nurses in nursing homes to meet the psychosocial and physical needs of the older adults. 24 …”