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Monday, June 24, 2024
HomeHealth & FitnessBiden Administration Issues New Rules for Federally Funded Nursing Homes

Biden Administration Issues New Rules for Federally Funded Nursing Homes

Nursing and care facilities that receive federal funding have operated under the re­quirement that nurse staff­ing requirements be “suffi­cient.” What is “sufficient” has been left to state legis­lators, regulators, and care home administrators.

On Monday, April 22, 2024, the Biden administra­tion announced new rules to define “sufficient” that call for staffing equal to 3.48 hours per resident per day. Slightly more than half an hour of that is to come from registered nurses.

Anne Deneen of Grand Marais, MN, addressed the North Shore Health Board of Directors meeting during its public comment section on April 18, 2024. The pub­lic meeting was held at the Schaap Community Center on the Gunflint Trail.

Deneen spoke about staff shortages and the Care Center, where her moth­er is a resident. On March 23, Deneen wrote an email to the NSH CEO and its board describing a staffing shortage she’d witnessed that day. She reported that there were 19 patients in the wing of the nursing home where her mother re­sides, and on that day, one nurse and one nurse’s aide were on duty.

Deneen’s email asked about current staffing pol­icies and what is being done to rectify staffing shortages.

In a responsive email from NSH CEO Kimber Wraalstad dated April 18, Deneen was told, “The staffing for March 23 was 4.21 hours per resident day and for March 24 was 4.20 hour per resident day, exceeding the proposed federal staffing ratios of 3.1 hours per resident day.”

After receiving Wraals­tad’s response, Deneen wrote in an email to the Northshore Journal, “I can tell you that I got an email response from Kimber Wralstad. She stated that in all previous emails, I never asked questions and that their staffing on the weekend in question was above regulated mini­mums.”

She added, “She (Wraals­tad) skips over the fact that it GOT to minimums be­cause direct care staff and family, me, cobbled it to­gether.”

According to Medicare, “Staffing hours per resident per day is the total number of hours worked by each type of staff divided by the total number of residents.”

Under Minnesota stat­ute 144A.04, Subd.7, “the “hours of nursing person­nel” means the paid, on-du­ty, productive nursing hours of all nurses and nursing assistants, calculated on the basis of any given 24-hour period.”

The statute states, (a) The minimum number of hours of nursing personnel to be provided in a nursing home is the greater of two hours per resident per 24 hours or 0.95 hours per standardized resident day.

The statutory formula for calculating nursing hours per standardized resident day is “performed by divid­ing the total hours of nursing personnel for a given peri­od by the total of standard­ized resident days for that same period.”

Using the state formula to provide for 19 care patients for one week would re­quire 266 nursing hours, or 38 hours per day. Plugging in the new federal guidelines of 3.48 hours per patient per day, the same one-week period requires 463 hours, an average of 66 hours per day.

Interest groups represent­ing nursing home providers are opposing this new rule.

A day after the admin­istration issued the first rule, it issued another that required that 80% of the money those institutions received be used to pay workers, not administrative or overhead costs.

Steve Fernlund
Steve Fernlund
Typically these “about me” pages include a list of academic achievements (I have none) and positions held (I have had many, but who really cares about those?) So, in the words of the late Admiral James Stockwell, “Who am I? Why am I here?” I’m well into my seventh decade on this blue planet we call home. I’m a pretty successful husband, father, and grandfather, at least in my humble opinion. My progeny may disagree. We have four children and five grandchildren. I spent most of my professional life in the freight business. At the tender age of 40, early retirement beckoned and we moved to Grand Marais. A year after we got here, we bought and operated the Cook County News Herald, a weekly newspaper in Grand Marais. A sharp learning curve for a dumb freight broker to become a newspaper editor and publisher. By 1999 the News Herald was an acquisition target for a rapidly consolidating media market. We sold our businesses and “retired” again, buying a winter retreat in Nevada. In the fall of 2016, we returned to Grand Marais and bought a house from old friends of ours on the ridge overlooking Lake Superior. They were able to move closer to family and their Mexico winter home. And we came home to what we say is our last house. I’m a strong believer in the value of local newspapers--both online and those you can wrap a fish in. I write a weekly column and a couple of feature stories for the Northshore Journal. I’m most interested in writing about the everyday lives of local people and reporting on issues of importance to them.
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