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The Biden administration proposes new federal standards for nursing home care

Della Lilley visits and holds her mother, 89-year old Betty Whiteman, for the first time in two months after successfully passing a rapid Covid-19 test.
Hugh Hastings
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Getty Images
Della Lilley visits and holds her mother, 89-year old Betty Whiteman, for the first time in two months after successfully passing a rapid Covid-19 test.

In his State of the Union address, President Joe Biden made a promise to "protect seniors' lives." And he's following through on that promise with his latest push to ensure that nursing homes, serving 1.2 million seniors, are sufficiently staffed around the clock.

On Sept. 1, the Biden administration issued a proposal to establish comprehensive staffing requirements for nursing homes across the country. The President, alongside the Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), has proposed a minimum nursing staff standard for facilities participating in Medicare and Medicaid.

Since the start of the pandemic, more than 200,000 residents and staff in long-term care facilities have died because of COVID-19.

"That's unacceptable," Xavier Becerra, the secretary of HHS, told Morning Edition.

Roughly three quarters of long-term care facilities would have to hire additional staff to meet the administration's requirements, CMS estimates.

"It's a big change in the sense that the industry hasn't had to follow particular standards," Becerra said. "And it's been the wild, wild west when it comes to quality and accountability at nursing homes throughout the country. What we're simply saying is we don't want [the] wild, wild west when we send our loved ones."

Nursing is inevitably a demanding job, and it has been widely regarded as one of the most stressful occupations, according to the journal Acta Biomedica. The profession is associated with high levels of staff turnover, absenteeism and levels of burnout.

In an attempt to improve nurse retention rates and attract more people to the industry, CMS would work with private sector partners, investing over $75 million in financial incentives, such as tuition reimbursement.

Jacob Conrad edited the digital version. contributed to this story

Copyright 2023 NPR. To see more, visit https://www.npr.org.

Corrected: September 6, 2023 at 11:00 PM CDT
In an earlier description for this story, the name of the secretary of the Department of Health and Human Services was misspelled. He is Xavier Becerra, not Javier Becerra. A previous version of this story incorrectly attributed a quote about "nursing being a demanding job" to the National Library of Medicine. In fact, that quote came from the journal Acta Biomedica.
Destinee Adams
Destinee Adams (she/her) is a temporary news assistant for Morning Edition and Up First. In May 2022, a month before joining Morning Edition, she earned a bachelor's degree in Multimedia Journalism at Oklahoma State University. During her undergraduate career, she interned at the Stillwater News Press (Okla.) and participated in NPR's Next Generation Radio. In 2020, she wrote about George Floyd's impact on Black Americans, and in the following years she covered transgender identity and unpopular Black history in the South. Adams was born and raised in Oklahoma City, Oklahoma.
Steve Inskeep is a host of NPR's Morning Edition, as well as NPR's morning news podcast Up First.
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