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Getting Nurses Back in Nursing Homes

With the name “nursing home” most people assume that registered nurses are always on the premises. However, some of the time that is not the case and in certain nursing home facilities, most of the time. This is because of an old law from 1987, and lawmakers today are attempting to rectify the situation.

Old Registered Nurses Law

In 1987, a federal law was enacted that required registered nurses to only be on-site at nursing homes for eight hours per day. This rules applied regardless of the size of the facility. Supporters of the law at the time realized that in a building of sick and ailing elders a health crisis could arise at any time, but the legislation required compromises to be passed that included reducing registered nursing hours.

Since the passing of that law, certain legislators have been working to increase the number of hours that registered nurses should be required to be on-site at nursing home facilities. Most feel that their constituents would be shocked to learn that their loved ones are only cared for by registered nurses a fraction of the time.

Proposed Registered Nurses Law

Representative Jan Schakowsky, a Democrat from Illinois, was completely shocked when she learned of the few hours required by registered nurses in nursing home facilities. As a result, on July 31st she introduced a bill bluntly entitled “Put a Registered Nurse in the Nursing Home Act,” otherwise known as House Vote 5373. This law would require that a direct-care registered nurse, not an administrator, be present in a nursing home facility 24 hours per day, seven days a week. It would apply to all 16,000 nursing home facilities across the country that receives Medicare or Medicaid reimbursement.

Implications of the New Law

It is difficult to determine how many nursing home facilities would be affected by the new law. Thirteen states already have some level of requirement for registered nurses to be on staff 24 hours per day. In Tennessee, Rhode Island, Hawaii, and Connecticut the rule is absolute. However, in other states like California the rule only applies to nursing homes that have more than 100 beds. There is little published research on this subject, but some experts believe that around eleven percent of all nursing homes around the country do not have the current staff to support 24 hour care.

Necessity for Registered Nurses

The new law specifies registered nurses for a reason. Unlike licensed practical nurses or aides, registered nurses are trained and licensed to evaluate a patient’s care and conduct assessments when rapid condition changes occur. Multiple studies have proven the importance of registered nurses in nursing home communities. When more registered nurses are staffed, patients have fewer bed sores, urinary tract infections, and catheterizations. Patients also stay out of hospitals longer, the nursing homes get fewer serious deficiencies from state inspectors, and cares improves but costs less.

Registered nurses also do not come as a large expense. The average salary for a registered nurse is around $68,000 per year. However, rural nursing home facilities worry about finding enough nurses when they typically prefer working for higher pay in urban or suburban hospitals. Adding registered nurses all day in nursing homes will not solve every problem, but it is a great start to improving the overall quality of care for every nursing home resident across the country.

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