President Joe Biden speaking
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US nursing homes would have three years to provide a minimum of 3.0 hours of nursing care per day, at least 0.55 hours of that by a registered nurse and 2.45 hours by a nurse aide, under a first-ever federal staffing mandate proposed Sept. 1.

Non-rural nursing homes would have three years to comply with the 3.0 standard, while rural facilities would have five years, the Centers for Medicare & Medicaid Services said.

A requirement of 24/7 RN coverage — triple the current standard — would take effect for urban providers two years after the rule is finalized, three years for rural providers.

The proposal includes an option for hardship waivers, an element pleaded for by providers, who nonetheless railed against the demands for more staffing amid record staffing shortages. An estimated 75% of providers would need to add staffing to comply, officials said. Comments are due by Nov. 6.