Feds establish new rules for health care staffing and pay

The changes aim to bolster pay for providers — many of them low-income immigrants — and require higher minimum staffing levels.

After the COVID-19 pandemic exposed serious problems with the health care workforce and patient care, especially at nursing homes, some major changes are coming. 

This week, the federal Centers for Medicare & Medicaid Services established new minimum staffing requirements for nursing homes nationwide and set new worker pay standards for home- and community-based health care services.

The new rules govern long-term care provided to low-income disabled people and the elderly — funded with federal Medicaid dollars and administered by the states. 

One goal is to upgrade the pay and services provided by health aides that agencies send into patients’ homes to help with bathing, meals, medications and the like. Many are immigrant women earning low wages, according to Jennifer Lav, a senior attorney at the National Health Law Program.

Medicaid will now direct more health care spending into their pockets.

“80% of the rates that are paid by the state to providers have to go directly to the workers, as opposed to administrative overhead,” Lav said.

There are also new standards for minimum staffing at nursing homes, covering RNs, nurse’s aids and other workers, said Robin Rudowitz, vice president and director of the Program on Medicaid and the Uninsured at health-policy research group KFF.

“Our analysis showed that only one in five nursing facilities would meet the requirements,” she said.

Employers will have time to achieve the new staffing levels.