Advocates for Georgia's Elderly Since 1953


New Analysis Finds Federal Staffing Mandate Would Require 3,652 Additional Full-Time Employees In Georgia, Cost $187M Per Year

For immediate release
Sept. 29, 2023

Devon Barill, Director of Communications
(678) 783-1703

9,598 Residents Risk Displacement If Nursing Homes Can't Hire Workers Needed

Stockbridge, GA — The Georgia Health Care Association (GHCA) released an analysis today by professional services firm CLA (CliftonLarsenAllen, LLP) on the impact that the Biden administration's recently announced federal staffing mandate would have on nursing homes in Georgia. The proposed rule would require specific nursing home staff to spend a minimum number of hours with each resident – 2.45 nurse aide hours per resident per day (HPRD) and 0.55 registered nurse (RN) HPRD – as well as have a 24-hour registered nurse (RN) on site. These requirements do not take into account the thousands of dedicated Licensed Practical Nurses providing care in Georgia's nursing homes, nor other competent staff such as social workers, therapists or activity professionals.
Among CLA's findings:
  • Georgia nursing homes would need to hire an estimated 3,652 additional full-time employees (2,754 nurse aides and 898 RNs).
  • The proposed mandate would cost Georgia nursing homes approximately $187 million per year.
  • 76% percent of Georgia nursing homes are currently not meeting at least one of the three proposed staffing requirements: the 2.45 nurse aide HPRD, the 0.55 RN HPRD, and the 24/7 RN. Less than 1% of nursing homes in the state meet all 3 proposed requirements.
  • Georgia nursing homes that did not meet at least one of the requirements were more likely to have a majority of their residents relying on Medicaid (75% percent average Medicaid census) compared to facilities that met the criteria (24% percent).
  • If nursing homes are unable to increase their workforce to meet these new requirements, more than 9,598 nursing home residents could be impacted by census reductions.
“This analysis underscores that Georgia's nursing homes cannot meet this staffing mandate as it's currently proposed without the proper funding and workforce programs,” said GHCA President and CEO Chris Downing. “Nursing homes across our state continue to do everything they can with limited resources to attract new caregivers to the field but continue to face challenges due to the sheer lack of available and qualified workers. We will continue to sound the alarm that Georgia's seniors are the ones that will suffer the unintended consequences of this flawed policy and urge the administration to reconsider this impossible standard.”
“Based on these figures, nursing homes will need considerable resources to meet the requirements of this mandate, but nationwide, 60 percent of the profession is currently operating in the red,” said Cory Rutledge, Chief Assurance Officer at CLA. “Nursing homes are facing increased operating costs while still struggling to rebuild their workforce and occupancy rates to pre-pandemic levels. If this rule is finalized without the financial support that nursing homes will need to hire these additional workers, too many seniors will be at risk of losing the care they need.”
In Georgia, labor shortages have led to nursing homes limiting resident admissions, closing units and wings, and many are at risk of closing their doors completely. The requirements for RN staffing outlined in CMS' proposed rule are particularly unfeasible as the National Council of State Boards of Nursing (NCSBN) 2023 Environmental Scan found that Georgia has some of the lowest ratios of employed RNs per population in the country, with fewer than 750 employed registered nurses per 100,000 people.
Rather than a federal staffing mandate that will put seniors' access to care at further risk, nursing homes need supportive solutions that will help them build a pipeline of dedicated caregivers. GHCA supports the comprehensive workforce proposals laid out in the American Health Care Association's (AHCA) Care for Our Seniors Act.
Read the full CLA analysis and the impact on each state HERE.
About GHCA
The Georgia Health Care Association is a non-profit association of skilled nursing centers, assisted living communities, and home and community based case managers called SOURCE/CCSP. Advocates for Georgia's elderly since 1953, the Association represents the best interests of patients, residents and consumers as well as owners, administrators, and other personnel. GHCA strives to enhance the ability of its members to provide competent and compassionate care to meet the ever-changing health care needs of elderly Georgians. For more information, visit