New Biden executive order would tie Medicare rates to turnover

President Joe Biden signed a massive executive order Tuesday morning that includes several measures intended to improve access to long-term care and bolster job protections for those who work in skilled nursing. Among them are calls to expand on an as-yet undisclosed staffing mandate and tie Medicare payments to retention.

An early morning announcement noted that many workers providing long-term care “find themselves in low-paying jobs with few benefits,” leading to high turnover. It directs the Department of Health and Human Services to consider issuing “several” regulations and guidance documents to “build on the minimum staffing standards for nursing homes and condition a portion of Medicare payments on how well a nursing home retains workers.”

Biden first proposed a minimum staffing standard for nursing homes in February 2022. The Centers for Medicare & Medicaid Services earlier this month delayed its unveiling but said it still expected to publish a new rule “later this spring.”