Last fall, Marketplace reported on a proposed federal rule that would set minimum staffing requirements for nursing homes for the first time. This week, it was finalized by the Centers for Medicare and Medicaid Services. Once the rule fully phases in, nursing homes that get federal funding from Medicaid and Medicare will have staff enough nurses and nursing assistants to be able to give at least three and a half hours of care to each resident per day. Nursing homes will also be required to have a registered nurse on hand at all times.

Until now, the only staffing rule for nursing homes has been that they have “sufficient” staff, without specifying what that means.

“This is the biggest reform in nursing home policy in decades,” said David Grabowski at Harvard Medical School. He said many nursing homes have been understaffed for years but especially since the pandemic.

“We’ve seen some really gross examples of this where facilities with low staffing have put resident lives in danger. This is going to, for the first time, set up a floor that nursing homes can’t staff below,” said Grabowski.

That’s the aim. And Priya Chidambaram at the health policy nonprofit KFF said it’s important.

“Adequate staffing in nursing homes is proven to be one of the measures that’s most strongly associated with higher quality of care,” said Chidambaram.

But she said a recent KFF study found only about 19% of nursing homes currently meet all the new requirements. And many say it’s going to be hard to comply.

“We have no dispute with the goal of quality. We fully embrace that,” said Katie Smith Sloan, who runs LeadingAge, an association of nonprofit nursing homes and other aging services. “But we believe that a mandate like this should be preceded by a government-supported effort to attract, incentivize and train registered nurses and aides because we currently have a severe shortage,” she said.

Federal and state support will be key to addressing that shortage, said Jasmine Travers at New York University’s College of Nursing.

“It’s one thing to implement the minimum staffing standards,” Travers said. “But really being able to recruit the people in these positions and not let it be an unfunded mandate, that’s going to be important.”

The Centers for Medicare and Medicaid Services said it plans to put $75 million toward recruiting and incentivizing nurses to work in nursing homes.