Deteriorating mistreatment of the elderly
The Biden administration's proposed nursing home staffing requirements, aimed at improving care and safety, have faced significant setbacks. The long-awaited federal improvements, which include a minimum of 0.55 registered nurse (RN) hours per resident per day and 2.45 certified nursing assistant (CNA) hours per resident per day, are now postponed until at least 2035 due to court rulings and congressional action.
In 2025, a federal judge in Iowa struck down two major components of the mandate—24/7 RN coverage and the minimum 3.5 total hours per resident per day staffing standard—while a federal court in Texas issued a similar ruling negating the staffing mandate earlier. The "One Big Beautiful Bill," a large government funding package, included a hidden provision delaying the staffing mandate by 10 years.
The consequences of these delays are severe, according to advocates. Ongoing low staffing levels, lack of accountability, resident harm, and workforce burnout continue unabated.
Meanwhile, the regulatory status of antipsychotic drug use in nursing homes remains unclear. Federal nursing home regulations generally emphasize minimizing inappropriate antipsychotic medication use due to risks to residents with dementia or other conditions. The CMS monitors such practices through quality reporting programs like Care Compare, which recently underwent updates. However, no explicit new federal ruling, moratorium, or court action on antipsychotic drug use was noted in the provided information.
Research shows a direct correlation between increased nurse staffing hours per resident and a decrease in the use of antipsychotics. Unfortunately, understaffing is common in for-profit nursing homes where cost-cutting often takes priority over care.
The industry has long resisted staffing mandates, claiming there aren't enough workers to go around. However, some argue that policies that worsen the workforce shortages are self-defeating.
The use of antipsychotic medications to sedate and control elderly residents in nursing homes has been a contentious issue. Critics claim that this practice compromises the dignity and safety of vulnerable seniors, potentially accelerating cognitive decline in individuals with dementia.
The cost of the inability to mandate minimum staffing levels and adequate oversight of pharmaceuticals in nursing homes will not be measured in dollars, but in compromises to the dignity and safety of our elderly population. As we move forward, it is crucial to prioritize the well-being and care of our nation's seniors.
References: 1. Kaiser Health News 2. The New York Times 3. The Hill 4. The Washington Post
- The Biden administration's proposed policies for nursing homes, focusing on staffing requirements, have experienced setbacks, with delays until at least 2035 due to legal challenges and congressional action.
- In the upcoming years, controversies surrounding the use of antipsychotic drugs in nursing homes persist, as the regulatory status remains unclear and the CMS continues to monitor practices through quality reporting programs.
- Research highlights a connection between enhanced nurse staffing hours and a decline in antipsychotic usage, yet understaffing is prevalent in for-profit nursing homes where costs often surpass care.
- The nursing home industry has resisted staffing mandates, citing a shortage of workers, but critics argue that such policies may exacerbate workforce shortages.
- The ongoing debates about staffing levels, antipsychotic medication use, and advocacy for nursing home residents are covered extensively in general news sources such as Kaiser Health News, The New York Times, The Hill, and The Washington Post.
