- Rep. Jan Schakowsky, D-Ill., has introduced the Put A Registered Nurse in the Nursing Home Act, which would require a direct-care nurse on site 24 hours a day, seven days a week in any nursing home that receives Medicare or Medicaid reimbursement.
- Legislation that mandated the use of on-site nurses in nursing homes was passed in 1987. It required that providers to have a nurse on-site eight hours a day. Schakowsky proposed the bill after finding out this was the only requirement associated with nursing home facilities.
- The American Association of Nurse Assessment Coordination combed through Nursing Home Compare and estimated that about 11.4% of nursing homes don't have registered nurses 24 hours a day. Thirteen states require 24-hour coverage in some way; other states, like California and New Jersey set coverage requirements based upon the number of beds in a facility.
Studies have found that quality of care is improved with larger numbers of registered nurses in nursing homes. A 2005 study from the American Journal of Nursing found that increasing the amount of time that registered nurses spend with patients reduces pressure ulcers, hospitalization and urinary tract infections. Patients also had less weight loss and catheterization, were more able to perform daily tasks and took oral medication more regularly.
The article noted that it costs an average of $68,000 for a registered nurse's annual salary in a nursing home. A 2005 study in the Journal of American Geriatrics Society found that the net societal benefit of having a registered nurse provide direct care in a high-risk, long-stay unit is about $3,000 a year per resident.