The proposed rule would require 0.55 RN hours and 2.45 CNA hours per resident day with no funding mechanism, creating direct pressure on Payroll-Based Journal staffing thresholds, Five-Star ratings, and facility financial viability.
The American Health Care Association and National Center for Assisted Living (AHCA/NCAL), representing more than 14,000 nursing homes and other long term care facilities across the country that provide care to approximately five million people each year, submitted their final comments today to the Centers for Medicare & Medicaid Services (CMS) on the proposed federal staffing mandate for nursing homes. As the comment period closes today, AHCA/NCAL’s submission formally requests that CMS rescind the unfunded mandate. Implementation of the unfunded, one-size-fits-all rule amid a historic and nationwide labor shortage threatens the displacement of nearly 300,000 nursing home residents.
“[A]n unfunded federal staffing mandate will neither improve care nor address persistent staffing challenges. Without workforce development programs, staffing mandates do not create more caregivers, nor do they drive caregivers to work in long term care. Without funding, staffing mandates do not help nursing homes offer more competitive, higher-paying jobs… If CMS proceeds with this Proposed Rule, it will severely limit access to care for our nation’s seniors and individuals with disabilities.”
— AHCA/NCAL, November 06, 2023
Minimum Staff Proposal Will Fail, Provider Groups Warn CMS
Associations representing US nursing homes came out swinging in their official letters to the Centers for Medicare & Medicaid Services. It is the agency poised to impose the nation’s first federal nurse staffing minimums dictating the amount of direct patient care provided daily by certified nurse aides and registered nurses.
“The proposal will fail because it does not consider two major issues: the ongoing workforce crisis and the proposal’s astronomical implementation costs. Should CMS opt to implement it as is, older adults and families’ already limited access to care will only get worse.”
— McKnight’s Long-Term Care News, November 06, 2023
Ensign CEO: Efforts to Strike Down CMS Staffing Rule Appear ‘Futile’ – But It Can Be Shaped
“The ultimate goal here isn’t necessarily to fight it, although you see some legislation that’s been proposed,” said Port. “Given the continuing resolution around the budget, there is a window and potentially an opportunity to have that legislation somehow make its way into a voting situation – but that’s an outside chance.”
“Our goal, our focus is to shape it and make it something that we can all live with and make some sense of, and then potentially set that up for a legal challenge down the road.”
— Skilled Nursing News, October 26, 2023
Former Speaker Ryan Says CMS Staffing Mandate Can Be Overruled, Tabs Senior Care Workforce Solutions
Former US House Speaker Paul Ryan delivered on his mission of framing US economic and public policy issues here Tuesday, optimistically emphasizing that immigration reform and technology are the two best tools to help senior care operators overcome their dire staffing shortages.
“The Congressional Review Act gives us [Congress] the ability to pass a law that says that the minimum staffing rule is repealed because it was a bad rule. It can’t be filibustered in the Senate. If it passes in the Senate, it happens and it goes away, no matter who the president is.”
— McKnight’s Long-Term Care News, October 25, 2023
While workforce pressures are widespread across the U.S. economy, the nursing home and senior living sectors are facing a “very unique” staffing challenge, given the “demographic crunch” caused by the drastic increase in older people who need services versus the dwindling supply of available younger workers, he acknowledged.
“The point I’m trying to say is, it’s a good news story; this is not an unsolvable problem, it is a solvable problem.”
— Skilled Nursing News, October 24, 2023
Providers Pledge ‘Triumph’ Over Staffing Rule as Pressure Grows in Washington
Leaders of the nation’s largest nursing home association said Monday that they would continue to fight against and eventually “triumph” over a proposed federal staffing mandate that would cost providers as much as $6.8 billion annually and require facilities to hire 100,000 new workers.
“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.”
— McKnight’s Long-Term Care News, October 03, 2023
