Q: I‘ve read that increased staffing levels for registered nurses are positively associated with a higher quality of care in skilled nursing facilities. So why is there such resistance to requiring nursing homes to have RNs on staff around the clock?
A: Currently, federal regulations require nursing homes to provide licensed nursing services 24 hours a day, with a registered nurse on staff for at least eight consecutive hours a day, seven days a week. You are correct that several studies have found a positive association between RN hours and the overall quality of residents’ care.
This has led groups to advocate for such a change in the rule. Particularly, advocates and lawmakers have proposed a new law requiring nursing homes to have an RN on staff 24 hours a day.
Most people, inside and outside of the industry, can agree that the proposed law makes sense. Studies have shown a positive correlation between RN staffing levels and resident outcomes.
For example, in one study, RN staffing levels were associated with fewer pressure ulcers, decreased infections, less improper and overuse of antipsychotics, and other notable care measures.
Any legislation created to address this issue had better include an answer to the most critical question: Amid the current and sustained nursing shortage in this country, where will we find all these new registered nurses?
The American Nurses Association estimates that more than one million new nurses need to join the workforce over the next few years to keep pace with those leaving the profession and the expected growth in population. Thus, the issue here is not just the unfunded mandate in the form of higher labor expenses for operators, but the very real problem of where we will find the one million women and men that are needed.
Please send your legal questions to Norris Cunningham at [email protected].
