Biden Shares Plans To Issue Proposed Staffing Mandate for Nursing Homes in ‘Coming Weeks’ 

In an address to care workers and unions, President Joe Biden said Tuesday that the federal government plans to release “in the coming weeks” new rules to bolster the workforce in nursing homes.

The Centers for Medicare & Medicaid Services has been working on finalizing the proposed staffing mandate, with some in the industry anticipating it to be released in the summer.

“And in the coming weeks, we plan to release new rules to strengthen staffing standards in nursing homes, to get homecare workers a bigger share of Medicaid payments,” Biden said in remarks to commemorate the Care Workers Recognition Month.


​​The CMS staffing rule calls for Medicare- and Medicaid-certified nursing homes to provide a staffing equivalent of 3 hours per resident per day (PRPD), with 0.55 hours of care from registered nurses (RNs) and 2.45 hours of care from nurse aides. Non-rural nursing homes will have 3 years and rural nursing homes have 5 years to meet these standards. The rule also calls for facilities to have an RN on staff 24 hours a day, daily.

Katie Smith Sloan, CEO of LeadingAge, the advocacy group for nonprofit nursing homes, said that the proposed staffing mandate wasn’t the right solution.

“As for the Biden Administration’s proposed staffing mandates for nursing homes, again, we share the goal of ensuring quality care in nursing homes. However, mandates are not the right approach,” said Smith Sloan. “Two major issues – the ongoing workforce crisis and the proposal’s astronomical implementation costs – make this proposal impractical and simply bound to fail. Instead of impractical and ineffective new rules, the administration and Congress should invest in serious solutions to tackle the aging services workforce crisis in America.”


More funding for long-term care, including support for home care, was also in the works, Biden said.

“I want to do more, and we can do more. My budget for next year makes key commitments to children, seniors, and people with disabilities, and to caregivers who look after their loved ones,” he said.

Ahead of his remarks, a fact sheet issued by the White House said that given that there has been a substantial growth of a younger population under 65 with disabilities living in nursing homes, “The President’s investments will help ensure that they can receive care in their own homes and communities.” The percentage of individuals younger than 65 living in residential nursing facilities grew from 10.6% in 2000 to 16.2% in 2017, the fact sheet said.

Biden also shared plans to reinforce the direct care workforce for home care.

“Seniors and people with disabilities, we’re going to expand Medicaid homecare services and reduce that 700,000-person backlog,” he said. “That’ll mean more folks can live and work in their own communities with dignity and independence. More homecare workers will start getting a better pay and benefits and dignity they deserve.”