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Writer's pictureMary Nichols

Minimum Staffing Standards and Direct Care Ratio Finalized

Grateful and relieved! Thank you, everyone, who submitted comments and stories to CMS. However, as glad as I am of this, do REMEMBER that the minimum staffing level is far below that reported as necessary in a Centers for Medicare and Medicaid Services study in 2001 - 23 YEARS AGO. It found that nursing home residents need at least 4.1 hours of daily care. Even so, the industry is squawking loudly that this will cause senior care to suffer.


“In February 2022, the President wisely determined to base any staffing ratios on research,” Ruth Katz, senior vice president of policy at LeadingAge, said at the time. “The report he commissioned said there is no single staffing level that would guarantee quality care. Policy should be based on evidence.”

It is IMPOSSIBLE to prove something that has not existed in the lifetime of anyone living today - a staffing ratio that guarantees quality care - because there IS NO EVIDENCE to prove something that has never existed. Orville and Wilbur couldn't prove flight until they flew because flight data didn't exist. That is how far we are from having enough facilities that have operated with "adequate staffing" to prove fewer people suffer from compromised care, neglect, and abuse with sufficient staff even though that seems like an obvious deduction.

On the other hand, there is abundant evidence that poor staffing levels contribute to compromised care, abuse, neglect, and real harm.

Our job as advocates protecting the health and welfare of our loved ones in long-term care facilities continues at the VERY LEAST until we make sure the federal essential caregiver legislation is in place so we KNOW that our eyes and ears will never be prevented from entering a facility again. We are Texas Caregivers for Compromise and we are #notgoingaway!



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