The volume and diversity of opposition, from formal legislation, to state-level letters, and Congressional hearings, reflect significant compliance and operational risk for skilled nursing facilities heading into 2024.
These Lawmakers Should Be More Careful About What They Ask For
“Facilities cannot find enough help as is. Piling on to an impossible demand seems akin to the adage about beatings continuing until morale improves. … Despite increased demand for services, the construction of new facilities has been minimal, with fewer than 10 built in the past five years and numerous closures. In fact, the available evidence suggests that more facilities, especially in rural areas, might soon shut down.”
— McKnight’s Long-Term Care News, November 11, 2023
15 Republican Governors Pen Letter Opposing Staffing Mandate for Nursing Homes
“This is not only unrealistic, but it also threatens to unravel the work we have done, while harming the seniors, elderly, and disabled it’s designed to help. We urge you to reconsider your commitment to unfunded mandates and instead enter into a genuine state-federal dialogue on how best to serve residents of long-term care facilities in our states.”
— Skilled Nursing News, November 2, 2023
‘Shocking’ Assumptions on Labor: Lawmakers Urge CMS to Withdraw Staffing Mandate
“It is … shocking to see the Administration assume that an available, trained workforce is sitting on the sidelines – ready to immediately fill these gaps within the next three to five years. … Since January 2020, over 400 nursing homes closed their doors and approximately 190,000 nursing home employees left the workforce. Given this current landscape, the administration’s proposal will only serve to further undermine patient access to skilled nursing care.”
— Skilled Nursing News, November 1, 2023
“This one-size-fits-all, unfunded mandate will jeopardize access to care for the 1.2 million Americans living in more than 15,000 certified nursing homes nationwide – especially those who reside in rural and underserved areas. … The Administration’s own study is clear that there is no significant correlation between any given staffing ratio and increased quality outcomes for residents.”
— U.S. Senate Committee on Finance, October 31, 2023
“This minimum staffing rule would set unrealistic staffing thresholds. Independent analyses have found that as many as 80 percent of all nursing homes would be unable to meet the requirements of the rule, meaning facilities would have to increase costs for residents, reduce censuses and stop accepting new residents, or potentially even close. Those who rely on skilled nursing care deserve better than a proposal that could dramatically curtail their care.” — Rep. Cathy McMorris Rodgers (R-WA)
— AHCA/NCAL, October 27, 2023
GOP Defends Providers, Who Decry ‘Terrifying and Heartbreaking’ Staffing Mandate Scenarios
“I am terrified this staffing mandate would force us to downsize or shut us down completely, and we would be unable to continue serving seniors in our community. We are not alone in this fear – nearly 300,000 nursing home residents nationwide could be displaced and left scrambling for alternative care if this mandate proceeds.” — Sarah Schumann, VP of Operations, Brookside Inn (CO)
— McKnight’s Long-Term Care News, October 26, 2023
House Lawmakers, Providers Clash Over Nursing Home Staffing Mandate in Hearing
“You are all aware that nursing homes are facing a historic labor shortage, but the proposed staffing mandate will only make things worse. … We have had to turn to costly temporary staffing agencies, and these contracted licensed nurses do not know our residents like our long-term employed staff do.” — Sarah Schumann, VP of Operations, Brookside Inn (CO)
— Skilled Nursing News, October 25, 2023
Bipartisan Group of Lawmakers Push Back on Proposed Nursing Home Rules
“At a time when nursing homes are already experiencing healthcare worker shortages and financial hardships, CMS and the Biden Administration should not be implementing a regulation that would only exacerbate this issue. … This one-size-fits-all regulatory requirement will result in many negative consequences, and I strongly urge Secretary Becerra to reconsider this proposal.” — Rep. Greg Pence (R-IN)
— UPI, October 23, 2023
Senators Warn of ‘Unintended Consequences,’ Closed VA Nursing Homes if Staffing Mandate Is Enacted
“Our entire healthcare system is currently grappling with a severe shortage of qualified nurses and caregivers. We recognize the importance of high-quality service, but as drafted and without revisions, this proposal may have unintended consequences that will close nursing homes.” — Sens. Kevin Cramer (R-ND) and Angus King (I-ME)
— McKnight’s Long-Term Care News, October 20, 2023
Nearly 100 House Members Ratchet Up Pressure on CMS to Scrap Nursing Home Staffing Mandate
“Finalizing this proposal would result in limited access to care for seniors, mandatory increases in state Medicaid budgets, and could most consequentially lead to widespread nursing home closures.” LeadingAge added: “We urge for a delay in the proposed rule until there are enough qualified applicants and adequate funding to address staffing levels realistically throughout the long-term care continuum.”
— Skilled Nursing News, October 20, 2023
US Senators Put More Pressure on CMS to Halt Nursing Home Staffing Mandate
“In many parts of the country, America’s long-term care facilities are facing severe workforce shortage issues that are harming access to critical care for our nation’s seniors. With this in mind, we are deeply concerned that now is the worst possible time for the United States to establish the nation’s first federal staffing mandate for long-term care facilities.”
— Skilled Nursing News, October 19, 2023
What They Are Saying: Nursing Home Staffing Mandate is a ‘Disaster’, ‘Insanity’, ‘Catastrophic’
“Recommending a staffing requirement that something like 80% of facilities cannot comply with is I think best described as the definition of policy insanity.” — Brian Miller, M.D., MedPAC Commissioner & Johns Hopkins University. “It’s catastrophic. There’s absolutely no way to make this work. We don’t have the workers to do this … There’s not a nursing home that does not have openings.” — Melissa Samuel, President & CEO, Health Care Association of Michigan
— AHCA/NCAL, October 10, 2023
MedPAC Members Rip ‘Brute Force Test’ of Staffing Mandate, Ponder Consequences and Possible Gaming
“This is a classic unfunded mandate and unfunded mandates just are fraught with all sorts of bad problems. … We’re likely to have some closures, and that may not be a bad thing in some locations, but … in other locations, particularly rural, that can be extremely problematic in terms of beneficiaries having access to needed services.” — Scott Sarran, M.D., MedPAC Commissioner
— McKnight’s Long-Term Care News, October 6, 2023
Nursing Home Leaders Support House Bill To Defeat CMS’ ‘Cookie-Cutter’ Minimum Staffing Proposal
“It has never been proven that cookie-cutter approaches help seniors. A blanket mandate has usually not worked so I’m very skeptical of the staffing mandate, personally … Coming up with a blanket mandate that may result in unnecessary fines and closures of nursing homes is going to create a disaster, in my opinion.” — Dr. Arif Nazir, CMO, Abode Care Partners
— Skilled Nursing News, October 4, 2023
Bill Would Block Federal Nursing Home Staffing Mandate
“The Protecting Rural Seniors Access to Care Act will keep CMS from implementing this rule until it can prove it will not result in the closure of skilled nursing facilities, will not harm patient access, and will not make workforce shortage issues worse in areas that are already struggling.” — Rep. Michelle Fischbach (R-MN)
— McKnight’s Long-Term Care News, October 4, 2023
28 Senators Push CMS to Scrap Nursing Home Staffing Mandate
“In many parts of the country, America’s long-term care facilities are facing severe workforce shortage issues that are harming access to critical care for our nation’s seniors. With this in mind, we are deeply concerned that now is the worst possible time for the United States to establish the nation’s first federal staffing mandate for long-term care facilities.”
— Skilled Nursing News, October 3, 2023
“It is unfathomable that the Biden Administration is proceeding with this federal staffing mandate proposal. Especially when just days ago, we learned that CMS’ own study found that there is no single staffing level that would guarantee quality care. … We hope to convince the administration to never finalize this rule as it is unfounded, unfunded, and unrealistic.” — American Health Care Association (AHCA)
— AHCA/NCAL, September 6, 2023
