03/12/2026

Health Affairs: Staffing Mandates Improve Staffing; Minimal Impact on Finances and Closures

Health Affairs released a study in their March journal that showed that state staffing mandates had limited impact on nursing home finances and closures. The study looked at nursing home data across 22 states from 2010 – 2023 to evaluate the impact of state staffing standards, comparing pre-mandate staffing data and reported profit margins to post-mandate data. The authors of the study noted that increases in staffing were driven by increases in licensed practical nurses (LPNs) and certified nurse aides (CNAs), rather than registered nurses (RNs), which had been the focus of the federal staffing mandate. Authors also conceded that the study did not investigate other factors that may have contributed to relative financial stability such as cutting staff in other departments like housekeeping and dietary, eliminating costly resident programming including quality of life activities, and reducing or eliminating Medicaid beds or long-term care altogether in favor of higher-revenue short-term skilled care. LeadingAge responded in an article in Skilled Nursing News, noting that it “cannot support policies that make these kinds of trade-offs necessary.”