CMS should be careful in what it asks for

Dec 23, 2022 | CMS' PBJ Policies, Minimum Staffing

CMS should be careful in what it asks for

Those in the nursing home sector are worried a potential staffing mandate imposed by the Centers for Medicare & Medicaid Services could be the ruination of a reeling sector. However, there is an argument to be made that such a move by CMS would be its own ruination. Let me explain.

From the provider perspective, the COVID-19 pandemic’s “Great Resignation” workforce realignment has already made staffing extraordinarily challenging. As of preliminary figures last month, Bureau of Labor Statistics data found over 311,000 fewer workers in “nursing and residential care facilities” than in March 2020, when the pandemic began to fully unleash its cruelty upon long-term care.

It is not for lack of trying on providers’ part. An accounting firm’s survey found the average wage costs for New Hampshire nursing homes rose 19.53% from 2019-21, excluding contract labor, or 23.66% including contract labor. And wages, and contract labor costs, have gone up since. The call for “$15 Now” is an anachronism in New Hampshire when it comes to licensed nursing assistants, as you will be making more than that, even though the minimum wage is the same as that set federally ($7.25 an hour). Yet you still cannot find licensed staff without resorting to agencies.




December 23, 2022


Williams, Brendan. “CMS Should Be Careful in What It Asks For.” McKnight’s Long-Term Care News, Dec. 2022,

More News in this PBJ Topic

LPN Exclusion Triggers Confusion & Questions

News Digest: Mandated Nursing Minimums Ignores Key Nursing Role CNA's, LPN's and RN's form the backbone of skilled nursing facilities.  All three roles are used in calculating and determining a facility's Five Star staffing rating.  Yet the...

read more

Understanding Staffing Compliance Issues & Exemptions

News Digest: Proposed Rule Includes More than Minimum Staffing Lost in the uproar over minimum staffing requirements for RN's and CNA's are a number of additional provisions in CMS' Proposed Minimum Staffing Rule.  A delayed rollout and provisions...

read more

Comments on Staffing Rule Pour in to CMS

News Digest: Overwhelming Response to CMS' Proposed Rule on Minimum Staffing The 60 day comment period for the Proposed Minimum Staffing Rule ended November 6, 2023.  AHCA and Leading Age associations led efforts to generate industry response. ...

read more

Plans to Defeat CMS’ Proposed Minimums Rule

News Digest: Various Strategies Floated to Avoid Proposed Minimum Staffing Rule With widespread opposition to CMS' Proposed Rule, a variety of tactics are under consideration to overcome the potential regulations.  Both a Congressional over ride...

read more

Congress Weighs in on Proposed Staffing Rule

News Digest: Legislative branch questions proposed executive rule Federal legislators in Congress vocally responded to CMS' proposed rule.  While CMS considers public comments and works on the Final Rule in 2024, the congressional push back can...

read more

Ideas Emerge to Overcome Workforce Shortages

News Digest: Minimum Staffing Rules Incent Plan to Hire More Nurses As some view a minimum staffing requirement as almost an inevitability, strategies begin to emerge to accomplish tactics such as increasing the available pool of nursing, lowering...

read more

Supporters of Staffing Mandate Speak Out

News Digest: Consumer Advocates, Unions and Some Congressman Support the Staffing Mandate With the loud and consistent negative reaction to CMS' proposed minimum staffing standards, one could fail to recognize that supporters of the new rule...

read more

Scrutiny on Private Equity & REIT Staffing Performance

News Digest: How does private equity investment affect nursing home staffing and minimum staffing requirementsOnly 6% of real estate investment trust (REIT) assets are in compliance with the federal minimum staffing proposal for nursing homes,...

read more

Analyses predict high cost of staffing mandate

News Digest: Billions needed to comply with minimim staffing mandate Competing estimates of the cost to get all skilled nursing facilities to a minimum staffing level all come in with multi-billion dollar price tags. From CMS' estimate of over $4B...

read more

Union Impact on Minimum Staffing Rule

News Digest: Unions play a role in the minimum staffing pushHealth and Human Services Secretary Xavier Becerra this week took part in a national union event supporting the proposed nursing home staffing rule, giving the labor audience and their...

read more