Investing in registered nurses may help curb abuse and neglect rates in nursing homes, experts suggested in a recent analysis.

In a study of more than 15,000 facilities, Harvard University researchers found 54% of facilities met expected staffing levels less than 20% of the time. Despite the Centers for Medicare & Medicaid Services listing expected staffing levels for RNs, 91% of facilities met those levels less than 60% of the time. 

Scrutiny has been on skilled nursing’s abuse rate, with a recent report by the Government Accountability Office noting the number of incidents reported over four years had nearly doubled. 

While CMS requires at least one registered nurse on duty for eight straight hours per day, more experts are calling for minimum staffing requirements at facilities, Bloomberg Law reported Thursday.

“Federal standards in this area are lacking unless we call on Congress to establish and enforce minimum requirements for numbers of direct-care staff, including the presence of registered nurses on site 24 hours per day,” Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care, told the Senate Finance Committee

Other experts believe larger facilities with “more complex patients” may benefit from having minimum staffing requirements, but that type of approach may not work for smaller, rural or long-term care facilities. 

“The broad differences in the types of residents and the way the facilities care for them, I don’t think means that you need to have it for everyone,” David Gifford, MD, senior vice president of quality and regulatory affairs at the American Health Care Association, told Bloomberg. “It sounds nice to say something the data supports, but to make everyone do it all the time? With no exceptions? That doesn’t make sense.”