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Falling Short

Rebuilding elderly care in rural America

Rural nursing homes across the country, already understaffed, face significant new federal staffing requirements. With on-the-ground reporting from INN’s Rural News Network and data analysis assistance from USA TODAY and Big Local News at Stanford University, seven newsrooms explore what the rule change would look like for residents in communities across America. Support from The National Institute for Health Care Management (NIHCM) Foundation made the project possible.


National data collaboration details impact of proposed nursing home changes

On-the-ground reporting from seven rural newsrooms conveyed the local impact of a national issue. Many of the reporters incorporated data-driven storytelling for the first time.

Assisted living facilities are the new nursing homes. Oversight falls short.
New Mexico In Depth March 31, 2024

Many assisted living centers across the state have fallen short of the mark on resident safety, and instances of neglect and delayed medical attention are prevalent, New Mexico In Depth found in a review of complaint investigations, inspection reports, and court filings for 215 facilities with nearly 6,000 beds.

On the heels of staff shortages and fines, new owners are optimistic about future of Scandia Village
Door County Knock March 27, 2024

The Sister Bay facility is not alone in its struggles with staffing. The U.S. has been experiencing a skilled nursing care staff shortage for decades. Staffing ratios have direct ties to the quality of care that aging and disabled residents receive.

Limited state staff struggles to enforce nursing home rules in NC
Carolina Public Press January 16, 2024

Federal and state nursing home rules are enforced by NC DHHS surveyors who do inspections, but their limited staffing creates challenges.

Long term care leaders urge more funding to prevent more closures of nursing homes
The Maine Monitor January 3, 2024

About three weeks after the Monitor’s initial report, long term care advocates, providers and industry leaders urged lawmakers to provide additional funding to prevent nursing home closures.

‘Everywhere you go is short staffed’: New Mexico nursing homes in crisis
New Mexico In Depth December 15, 2023

New federal staffing standards meant to improve the care of millions of Americans in nursing homes could go into effect in as soon as two years. New Mexico’s nursing homes aren’t ready. Not even close.

Door County nursing homes fall far short of federally proposed staffing minimums
Door County Knock December 15, 2023

While all three of Door County’s nursing homes meet state-mandated minimum ratios, they all would fail to meet the higher minimums contained in a pending federal proposal, according to a new analysis performed by Door County Knock in collaboration with other news organizations.

Nursing homes in Thurston County will need to increase staff levels to meet new federal standards
The Jolt News December 15, 2023

On average, the seven local nursing homes met the CMS’s proposed minimum staffing levels for CNAs in about a third of the second quarter of 2023. On the other 55 days, the same seven nursing homes would not have met the new minimum standards.

Do NC nursing homes have enough nurses?
Carolina Public Press December 14, 2023

Advocates for residents say proposed federal staffing requirements for nursing homes are ‘a step in the right direction.’ Industry supporters say they aren’t attainable.

Will Biden’s Historic Plan Address the Crisis in Rural Nursing Homes?
Barn Raiser December 14, 2023

The nursing home industry opposes the first-ever staffing minimums but advocates say the proposed rules do not go far enough.

Falling short: 99% of Mississippi nursing homes don’t meet new staffing regs
Mississippi Today December 13, 2023

In Mississippi, all but two of the 200 skilled nursing facilities – those licensed to provide medical care from registered nurses – would need to increase staffing levels under federal regulations the Biden administration proposed in September.

Maine nursing homes lead nation in meeting the Biden administration’s proposed staffing standards, but challenges loom
The Maine Monitor December 10, 2023

Concerns persist over nursing home workforce shortages and potential closures.

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