Nursing Home Staffing & Medicaid Home Care Rules Arrive (White House Media Release)

On April 22, 2024, the White House issued a release, “Fact Sheet: Vice President Harris Announced Historic Advancements in Long-Term Care to Support the Care Economy,” which announced the final Nursing Home Minimum Staffing Rule and Ensuring Access to Medicaid Services Rule.

Nursing Home Minimum Staffing Rule

The breakdown of required hours, per the release, includes:

• 3.48 hours per resident per day of total staffing
• 0.55 hours per resident per day of RN staffing
• 2.45 hours per resident per day of CNA staffing
• LPNs/LVNs are not included in the hours

Facilities will also be required to have an RN onsite 24 hours a day/ 7 days a week.

The requirements for this rule will be phased in and some limited, temporary exemptions will be available for the staffing required and onsite RN requirement.

Ensuring Access to Medicaid Services

The final rule – aka the “80/20” rule – requires at least 80% of Medicaid payments for home care services to be allocated towards workers’ wages.

The rule will require states to be more transparent about the reimbursement rates for home care services, the rate setting process and the states will also be required to create a rate-setting advisory group.

Read the White House Fact Sheet here. CMSCG will provide more information on the finalized rules after review.

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In the meantime . . .

Here’s some initial other coverage on these topics:

• AHCA/NCAL: Nursing Homes React to Staffing Mandate Final Rule
• McKnight’s Long-Term Care News: Breaking: CMS increases hours to 3.48 in final staffing rule
• McKnight’s Senior Living: Breaking News: Final Medicaid Access Rule released, White House says
• McKnight’s Home Care: CMS finalizes controversial 80/20 rule
• The Hill: Nursing homes must hit minimum staffing levels under new federal rule
• Modern Healthcare (subscription): Biden administration increases nursing home staffing minimums
• Bloomberg Law (subscription): Biden’s HHS to Toughen Federal Nursing Home Staffing Requirement