About 1 in 5 Nursing Facilities Would Currently Meet Proposed Requirements for Nursing Staff Hours

Eighty-one percent of nursing facilities would need to hire additional staff to comply with new nursing staff requirements that the Centers for Medicare and Medicaid Services (CMS) proposed earlier this month, according to a new analysis from KFF. Under the proposed rule, 19% of nursing facilities would currently meet the minimum staff hours for registered nurses and nurse aides.

A smaller share of for-profit facilities would meet the proposed staffing requirements. Compared to 60% of non-profit and government facilities, 90% of for-profit facilities would need to hire additional nursing staff. Four in five for-profit facilities would need to hire nurse aides in particular, compared to about half of non-profit and government facilities.

Current compliance with the proposed new standards also differs dramatically by state. In Alaska, 100% of nursing facilities would meet the HPRD staffing requirements, compared to just 1% of facilities in Louisiana. In 29 states, less than a quarter of nursing facilities could meet these requirements. In six states, over half of facilities could do so.

Broad workforce shortages, hardship exemptions, and issues with enforcement and funding could influence the final rule and also limit its impact. CMS’s proposed rule was released on September 1 and comments are due by November 6, 2023.

KFF’s analysis uses the most currently available data for both registered nurse and nurse aide hours from the Nursing Home Compare dataset, which includes 14,591 nursing facilities (97% of all facilities, serving 1.17 million or 98% of all residents) that reported their staffing levels in August 2023.