State legislation implementing nurse staffing requirements varies across state lines, with 23 states lacking any statutes or administrative codes requiring nurse staffing minimums. But states that do have staffing mandate policies do not address funding in their policies.
The patchwork of state solutions to the national nursing shortage comes as a battle brews at the federal level over how to solve the problem. The nursing home industry is suing to overturn a CMS staffing mandate rule in a Texas district court. The groupsâ argument that CMS overstepped its authority may be bolstered by the Supreme Courtâs recent decision to overturn its Chevron principle of deferring to agenciesâ interpretation of vague laws. HHS must respond to the plaintiffs — which include the American Health Care Association (AHCA), LeadingAge and the Texas Health Care Association (THCA) — by Friday (Aug. 9).
A Health Affairs study released this week, says nurse staffing legislation is becoming increasingly diverse across the country, and some of the state solutions could provide a guide for federal policy. The study, titled âHospital Nurse Staffing Legislation: Mixed Approaches In Some States, While Others Have No Requirements,â identified state policies across the country that dealt with staffing mandates as of January 2024.
California and Oregon had the most detailed policies, with required minimum staff-to-patient ratios for multiple specific hospital units. Five other states — Arizona, Massachusetts, New York, Ohio and Oklahoma — mandate ratios for only one unit type each.
Nithya Krishnamurthy, one of the studyâs authors, says federal legislation is trending toward California and Oregonâs multi-ratio model. The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2023, House bill introduced by Democrats in the House Energy & Commerce Committee last year, includes minimum staffing ratios for multiple different hospital units.
Eight states require nurse staffing committees, and 11 states have adopted staffing plans. Out of the 23 states without final staffing mandate policies, five have introduced such legislation. Idaho, however, has passed a statute prohibiting minimum staffing ratios.
But none of the state bills touch on funding, which Krishnamurthy and co-author Neha Mukherjee, both at the Icahn School of Medicine at Mount Sinai, see as a solution to factors that drive the nurse staffing issue. Staffing mandate policies should include stipulations about how funds should be acquired and used, Mukherjee told Inside Health Policy.
âWithout any adjustment to reimbursement systems, it may remain continually difficult for hospitals to invest in nurse staffing or to comply with legislation requiring minimum staffing ratios,â the study claims. âCost considerations are particularly relevant, given the national legislation on the horizon.â
Krishnamurthy told IHP she hopes the research will serve as a resource for policymakers looking to implement staffing mandates at the federal level. The study argues the diversity of state staffing mandate policies provides opportunity for comparison when evaluating efficacy of different types of policies.
Experts: Nurse Staffing Mandates Vary Across States, None Address Reimbursement
bgov.com
August 23, 2024 11:29 am
State legislation implementing nurse staffing requirements varies across state lines, with 23 states lacking any statutes or administrative codes requiring nurse staffing minimums. But states that do have staffing mandate policies do not address funding in their policies.
The patchwork of state solutions to the national nursing shortage comes as a battle brews at the federal level over how to solve the problem. The nursing home industry is suing to overturn a CMS staffing mandate rule in a Texas district court. The groupsâ argument that CMS overstepped its authority may be bolstered by the Supreme Courtâs recent decision to overturn its Chevron principle of deferring to agenciesâ interpretation of vague laws. HHS must respond to the plaintiffs — which include the American Health Care Association (AHCA), LeadingAge and the Texas Health Care Association (THCA) — by Friday (Aug. 9).
A Health Affairs study released this week, says nurse staffing legislation is becoming increasingly diverse across the country, and some of the state solutions could provide a guide for federal policy. The study, titled âHospital Nurse Staffing Legislation: Mixed Approaches In Some States, While Others Have No Requirements,â identified state policies across the country that dealt with staffing mandates as of January 2024.
California and Oregon had the most detailed policies, with required minimum staff-to-patient ratios for multiple specific hospital units. Five other states — Arizona, Massachusetts, New York, Ohio and Oklahoma — mandate ratios for only one unit type each.
Nithya Krishnamurthy, one of the studyâs authors, says federal legislation is trending toward California and Oregonâs multi-ratio model. The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2023, House bill introduced by Democrats in the House Energy & Commerce Committee last year, includes minimum staffing ratios for multiple different hospital units.
Eight states require nurse staffing committees, and 11 states have adopted staffing plans. Out of the 23 states without final staffing mandate policies, five have introduced such legislation. Idaho, however, has passed a statute prohibiting minimum staffing ratios.
But none of the state bills touch on funding, which Krishnamurthy and co-author Neha Mukherjee, both at the Icahn School of Medicine at Mount Sinai, see as a solution to factors that drive the nurse staffing issue. Staffing mandate policies should include stipulations about how funds should be acquired and used, Mukherjee told Inside Health Policy.
âWithout any adjustment to reimbursement systems, it may remain continually difficult for hospitals to invest in nurse staffing or to comply with legislation requiring minimum staffing ratios,â the study claims. âCost considerations are particularly relevant, given the national legislation on the horizon.â
Krishnamurthy told IHP she hopes the research will serve as a resource for policymakers looking to implement staffing mandates at the federal level. The study argues the diversity of state staffing mandate policies provides opportunity for comparison when evaluating efficacy of different types of policies.