SNFs are planning to for compliance obligations tied to the HPRD rules of 0.55 RN hours, 2.45 nurse aide hours, and 24/7 RN coverage.
Nursing Home Minimum Staffing Mandate Leaves OMB, Pending Finalization
The proposed minimum staffing mandate for nursing homes has left the Office of Management and Budget (OMB) and is now pending final approval. The National Rural Health Association urged CMS to rescind its minimum staffing proposals, stating that if withdrawal of the policy is not possible, CMS should exempt rural facilities from the requirements.
— Skilled Nursing News, April 16, 2024
Advocates Work Behind Scenes to Stop, Reshape Staffing Rule as Finalization Nears
Several nursing home advocacy organizations have met with the White House Office of Management and Budget in recent days, angling to change the proposed minimum staffing rule that could be issued in final form at virtually any time. Providers have said all along those marks would be impossible to meet because nurses simply aren’t available. They’ve also objected to the possible cost, which one estimate has shown could climb to $11.7 billion annually.
— McKnight’s Long-Term Care News, April 16, 2024
White House Promises Staffing Rule Is Near as Biden Courts Fresh Attention for Caregiving Agenda
President Joe Biden said Tuesday his administration plans to finalize its nursing home staffing rule in “coming weeks,” just one element of a platform meant to transform caregiving for patients and workers. The nursing home sector has repeatedly raised concerns that the rule — requiring round-the-clock registered nurse coverage as well as setting hourly minimum standards for aides and RNs — would be nearly impossible to meet during the current nursing shortage.
— McKnight’s Long-Term Care News, April 10, 2024
Biden Shares Plans To Issue Proposed Staffing Mandate for Nursing Homes in ‘Coming Weeks’
“And in the coming weeks, we plan to release new rules to strengthen staffing standards in nursing homes, to get homecare workers a bigger share of Medicaid payments,” Biden said in remarks to commemorate the Care Workers Recognition Month. “As for the Biden Administration’s proposed staffing mandates for nursing homes, again, we share the goal of ensuring quality care in nursing homes. However, mandates are not the right approach,” said Katie Smith Sloan, CEO of LeadingAge.
— Skilled Nursing News, April 9, 2024
Ahead of President Biden’s State of the Union address Thursday, a final rule mandating staffing limits and calling for greater Medicaid payment transparency was submitted for regulatory review to the Office of Management and Budget (OMB). The rule calls for Medicare- and Medicaid-certified nursing homes to provide a staffing equivalent of 3 hours per resident per day (PRPD), with 0.55 hours of care from registered nurses (RNs) and 2.45 hours of care from nurse aides.
— Skilled Nursing News, March 7, 2024
CMS isn’t expected to finalize the minimum staffing proposal until the summer at the earliest, with the agency having to wade through more than 40,000 comments before moving forward with the rule. “The Biden administration makes this (staffing) proposal, for me, a big bucket of cold water thrown right on our faces as we are still in the process of recovery,” said Clifton Porter, senior VP of Government Relations at AHCA/NCAL.
— Skilled Nursing News, February 6, 2024
CMS: Expect Final Nursing Home Staffing Rule This Year
“The team received more than 46,000 comments on the proposal, which are being used to inform development of the final rule, which we intend to finalize this year,” said Dora Hughes, MD, acting CMS chief medical officer and acting director of the Center for Clinical Standards and Quality. “This unfunded staffing mandate will have a compounding and detrimental effect on seniors’ access to long term care,” the American Health Care Association said.
— McKnight’s Long-Term Care News, January 24, 2024
CMS Official Confirms Agency’s Intention to Finalize Nursing Home Minimum Staffing Rule in 2024
The Centers for Medicare & Medicaid Services (CMS) officials are looking to finalize the nursing home minimum staffing proposal in 2024, an official at the federal agency confirmed at its national stakeholder call on Tuesday. “No matter when the rule is made final, the Center for Medicare and Medicaid Services must — before any mandates are implemented — get it right on ratios by first addressing the long-term care’s systemic issues: chronic workforce challenges and inadequate funding that does not cover the cost of care and services provided,” LeadingAge said.
— Skilled Nursing News, January 23, 2024
President Biden’s Staffing Mandate Would Crush Nonprofit Nursing Homes Too
According to the Medicare Payment Advisory Committee, the all-payer margin for freestanding nursing homes fell to a negative 1.4% nationally in 2022, a dismal performance MedPAC noted “is heavily influenced by states’ Medicaid nursing home rates.” That Biden’s anti-nursing home crusade might even take down excellent nonprofit facilities, while further engorging staffing agency profits, reveals the emptiness of his vision for long-term care.
— McKnight’s Long-Term Care News, January 8, 2024
CMS: May Take 3 Years to Finalize Nursing Home Staffing Rule
Federal regulators concede it may take up to three years to finalize a proposed nursing home staffing rule, according to an extensive document that lays out administration rule-making plans for 2024 and beyond. The Fall 2023 Unified Agenda sets September of 2026 as the deadline to finalize the “Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting.”
— McKnight’s Long-Term Care News, December 12, 2023
