A Call for Dignity: We Must Preserve the Nursing Home Staffing Rule 

Publisher’s Notes: According to the Administration for Community Living, approximately 4.6 million Hispanic or Latino Americans were 65 and older in 2020. By 2060, this number is projected to increase to 19.9 million, or 21% of the older population. The population of Hispanic Americans aged 85 and older is also expected to grow from 500,000 in 2019 to nearly 3.4 million by 2060.

AARP New Hampshire is working to establish minimum standards for staffing levels at nursing homes in NH and across the country.


In the heart of our society lies a promise—a promise to care for our older loved ones and other people with long-term care needs with the dignity and respect they deserve. Recently, the federal Centers for Medicare & Medicaid Services (CMS) issued a rule establishing minimum standards for staffing levels at nursing homes. These standards are a long overdue fulfillment of that promise. AARP and ABLE stand in unwavering support of this rule.

Studies have shown that nursing homes with higher staffing levels provide better care to residents. Lower staffing levels translate into a greater likelihood of emergency room visits, rehospitalizations, and reports of abuse.

Let’s be clear about the human toll of inadequate staffing. With too few staff to provide proper care, nursing home residents may not get the critical medication they need when they need it, lay on the floor for hours after a fall, and get bed sores because they can’t move without assistance. Adequate staffing is needed to ensure the basic right of nursing home residents to live in dignity. What’s more, researchers from the University of Pennsylvania have found that the new rule would save 13,000 lives per year across the country.

Unfortunately, Congress is considering legislation that would roll back these new standards and prevent the U.S. Department of Health and Human Services from ever proposing any “substantially similar” regulations in the future. We can’t let that happen.

The rule has two main provisions. It requires that facilities have a registered nurse on-site at all times, ensuring round-the-clock supervision and access to critical care. It also requires that residents receive at least 3.48 hours of care per day, with at least 30 minutes provided by a registered nurse.

These standards are grounded in comprehensive research that links staffing levels to the quality of care residents need and deserve. It’s a move that promises to enhance the well-being of our older loved ones, reflecting a commitment to evidence-based improvements in long-term care.

Furthermore, the rule includes some provisions to ensure reasonable implementation. First, it phases in over time, with facilities in nonrural areas having three years to comply and facilities in rural areas having five years. Second, it creates a process for facilities to receive an exemption from these rules if they are in a workforce shortage area and demonstrate their good-faith efforts to hire staff.

Workforce shortages exist, particularly for the nursing assistants who assist patients with essential daily activities, including eating, bathing, grooming, mobility, and more. These are tough, low-quality jobs. As a result, turnover rates are quite high: nearly half of nursing homes replace 50% or more staff each year.

One way to address staff recruitment and retention is to improve job quality. Pay is one factor. As a step in the right direction, the state budget in 2023 increased Medicaid reimbursement rates, allowing agencies and facilities to offer higher pay to healthcare workers. AARP stands ready to collaborate with the nursing home industry and others on addressing workforce shortages.

One more point: this issue transcends political divides. An overwhelming majority of Americans, regardless of political affiliation, support the requirement of minimum staffing standards: 89% of Democrats, 74% of Republicans, and 70% of Independents agree that older Americans deserve quality care, a testament to the nonpartisan nature of this human concern.

We call upon our elected officials—and all who share this belief—to support the nursing home staffing rule. We must work together and keep patient safety and dignity at the forefront. Our loved ones deserve no less.


Christina FitzPatrick

Christina FitzPatrick is the AARP NH State Director. FitzPatrick’s experience includes leadership development, strategic planning, program and policy development, and volunteer engagement.

Krysten Evans is the Director of Policy and Advocacy for ABLE NH. With a lifetime of advocating for social justice, Evans’ experience includes program oversight, development, government relations, and project/personnel/budget management. 

Krysten Evans

New Hampshire Latino News and AARP New Hampshire are partners in providing greater visibility and voice to local Hispanic-Latino communities.

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