Elderly Exploitation: A Drip-down of Neglect and Mistreatment

Elderly Exploitation: A Drip-down of Neglect and Mistreatment

In a bid to improve the safety and quality of care within nursing homes, President Joe Biden announced comprehensive reforms in February 2022. Central to these reforms were minimum staffing requirements, which aimed to ensure a minimum level of direct nursing care per resident per day. However, as of July 2025, the future of these mandates is uncertain due to ongoing legal and legislative challenges.

The Centers for Medicare & Medicaid Services (CMS) finalized the minimum staffing requirements in 2024, mandating that all Medicare- and Medicaid-certified nursing homes must have a registered nurse (RN) on-site 24/7, at least 0.55 RN hours per resident per day (HPRD), and at least 2.45 certified nurse aide (CNA) HPRD, totaling a minimum of 3.48 hours of direct nursing care per resident per day. The regulations included phased implementation deadlines, with full compliance required by May 2029.

However, on June 18, 2025, a federal court in Iowa struck down the 24/7 RN and HPRD requirements nationwide, effectively halting their enforcement. Meanwhile, Congress is debating the "One Big, Beautiful Bill," which includes a provision to impose a 10-year moratorium (until 2034) on the staffing mandate and would prohibit the Department of Health and Human Services from implementing, administering, or enforcing the rule during that period. The Senate Parliamentarian has approved this language, but as of late July 2025, the bill has not yet been enacted into law.

As a result, mandatory federal staffing standards are currently on hold, with their future dependent on both ongoing litigation and pending legislative action. It is crucial for individuals to monitor these developments closely, as the situation remains fluid and subject to rapid change.

In terms of psychotropic drug use in nursing homes, there is no evidence in the provided results of recent changes or enforcement trends. However, a 2022 HHS report found that nursing homes with lower ratios of registered nurse staff to residents were associated with higher use of psychotropic drugs. The use of such medications can potentially accelerate cognitive decline in individuals with dementia, and improved federal oversight is necessary, including a requirement that every psychotropic drug prescribed through Medicare Part D include a diagnosis code.

The cost of inadequate staffing and oversight in nursing homes will not be measured in dollars, but in compromises to the dignity and safety of vulnerable seniors. As the legal and legislative landscape evolves, it is hoped that the necessary changes will be implemented to ensure the highest possible standard of care for all nursing home residents.

**Summary Table**

| Requirement | Original CMS Final Rule (2024) | Current Status (July 2025) | |-----------------------------------|-----------------------------------------|---------------------------------------| | 24/7 RN on-site | Required | Struck down by federal court; on hold[2] | | RN hours per resident per day | 0.55 minimum | Struck down by federal court; on hold[2] | | CNA hours per resident per day | 2.45 minimum | Struck down by federal court; on hold[2] | | Total direct nursing care HPRD | 3.48 minimum | Struck down by federal court; on hold[2] | | Legislative action | Phased implementation to 2029 | 10-year moratorium proposed, not yet law[3] | | Psychotropic drug regulations | Existing CMS rules (no new changes reported) | No new information in search results |

1. The new staffing requirements in nursing homes, announced by President Biden, included mandating a registered nurse (RN) on-site 24/7.
2. The finalized minimum staffing regulations by the Centers for Medicare & Medicaid Services (CMS) in 2024, required at least 0.55 RN hours per resident per day (HPRD).
3. The CMS regulations also mandated at least 2.45 certified nurse aide (CNA) HPRD in nursing homes.
4. The total minimum hours of direct nursing care per resident per day, as per the CMS, was 3.48 hours.
5. The regulations set phased implementation deadlines, with full compliance required by May 2029.
6. In June 2025, a federal court in Iowa struck down the 24/7 RN and HPRD requirements nationwide.
7. Congress is currently debating the "One Big, Beautiful Bill," which includes a provision for a 10-year moratorium (until 2034) on the staffing mandate.
8. The Senate Parliamentarian has approved the moratorium language, but as of late July 2025, the bill has not yet been enacted into law.
9. As a result, mandatory federal staffing standards are currently on hold awaiting both ongoing litigation and legislative action.
10. Nursing homes with lower ratios of registered nurse staff to residents were associated with higher psychotropic drug use, as found in a 2022 HHS report.
11. Potential excessive usage of psychotropic drugs can potentially accelerate cognitive decline in individuals with dementia.
12. Improved federal oversight is necessary, including a requirement for a diagnosis code for every psychotropic drug prescribed through Medicare Part D.
13. The cost of inadequate staffing and oversight in nursing homes is not quantifiable in monetary terms but in compromises to the dignity and safety of vulnerable seniors.
14. The legal and legislative landscape is continually evolving, aiming to ensure the highest possible standard of care for all nursing home residents.
15. In these uncertain times, it is essential to monitor the developments closely as the situation remains fluid and subject to rapid change.
16. In the field of medical-conditions, the ongoing issues with chronic kidney disease necessitate continual research and therapies-and-treatments.
17. CBD has been gaining attention in the scientific community for its potential in treating chronic diseases, especially chronic-kidney-disease.
18. Respiratory-conditions, such as asthma and COPD, require ongoing management and proper treatment to prevent complications.
19. Digestive-health also plays a significant role in maintaining overall well-being, with conditions such as heartburn and IBS being common.
20. Eye-healthcare is another essential aspect of health-and-wellness, with annual check-ups being recommended to identify conditions like glaucoma early.
21. Hearing loss can lead to other chronic conditions, making regular hearing tests an integral part of general-healthcare.
22. Mental-health is an ever-important issue requiring attention and individualized treatment, with autoimmune-disorders also impacting psychiatric health.
23. Mental-healthcare, including therapies-and-treatments, should be discussed openly, and resources for support like mindfulness practices should be embraced.
24. Among the health challenges we face, war-and-conflicts contribute to numerous chronic diseases, injuries, and mental-health issues.
25. One positive aspect of modern times is the advancements in education-and-self-development opportunities through online-education, personal-growth workshops, and lifelong-learning programs.
26. Goal-setting is a crucial skill for personal and professional development, with car-accidents, politics, and career-development requiring focused strategies.
27. Policy-and-legislation play a significant role in shaping various aspects of society, from education and health-care to transportation and war-and-conflict resolution.
28. Sports, including football, basketball, baseball, hockey, golf, tennis, racing, and American football, provide entertainment along with promoting physical activity and teamwork.
29. In particular, the NBA, NFL, WNBA, MLB, NHL, PGA, and NASCAR attract millions of fans worldwide, inspiring many to engage in fun and competition while also inspiring career-development aspirations.

Read also: