Quality of care, Regulations

Proposed law would mandate minimum direct care nurse hours

A bill that would establish around-the-clock registered nurse staffing hours at Medicare and Medicaid nursing homes and skilled nursing facilities was introduced by an Illinois congresswoman last week. The bill, introduced by Rep. Jan Schakowsky (D-IL), declares that long-term care facilities must use services of at least one registered nurse to provide assessment, surveillance and direct care to residents 24 hours a day, 7 days a week.

Nursing facilities have been caring for increasingly complex residents but are not required to have an RN on duty for more than eight hours a day, Schakowsky noted in a statement released Friday. If passed, the bill would amend Titles XVIII and XIX under the Social Security Act and would be effective after the first day of the first calendar quarter one year after the date of enactment. Research on the association between nursing home staffing levels and quality care has produced mixed results, although a 2013 state by state analysis from the advocacy group Families for Better Care found that states with highly staffed nursing homes ranked far better than those with lower staffing hours.