The Centers for Medicare & Medicaid Services (CMS) issued April 22 a final rule aimed at bolstering nurse staffing at LTC facilities. The new regulation sets minimum staffing standards in LTC facilities and requires the presence of an onsite registered nurse (RN) 24/7. ANA is pleased to see CMS finalize this significant regulation and appreciates that the agency adopted many of our suggested refinements to the proposed rule as detailed in November 2023 comment letters on the proposed rule-one on behalf of the association and the other along with 25 state member and organizational affiliates.

ANA is especially pleased to see CMS finalize its proposal to require all LTC facilities to have an RN onsite 24 hours a day, seven days a week-something the association has long-advocated for. In addition to that requirement, LTC facilities will now have to meet a total minimum nurse staffing standard, with individual-specific standards for RNs and nurse aides (NAs). ANA urged CMS to also create a licensed practical nurse/licensed vocational nurse (LPN/LVN)-specific standard and was disappointed that the agency chose not to do so. CMS did note that LPN/LVN staffing levels are considered in calculating the total minimum nurse staffing standard. In our comments, ANA also urged the agency to ensure nurse input is included in facility assessments and that any granted exemptions to the staffing minimum requirements were considered against vigorous conditions and is happy to see that CMS incorporated our recommendations. 

ANA has analyzed the provisions of the final rule and created a summary, which can be found here.

CMS was directed to engage in this rulemaking by a February 2022 Executive Order issued by President Biden, as part of a larger focus on addressing challenges faced by nursing homes. This issue remains a top priority for the Administration with Vice President Harris announcing the release of the final rule with an accompanying White House fact sheet. The final rule will be published in the Federal Register on May 10.