Republican lawmakers in the House and Senate are calling on the Biden administration to rethink its proposed rule on mandatory staffing requirements for Medicare-certified nursing homes.
In September, the Centers for Medicare and Medicaid Services announced a new rule requiring facilities to provide residents with 0.55 hours of care per resident per day from a registered nurse and 2.45 hours from a nurse’s aide. Estimates project that nearly 75% of all nursing home facilities would be required to increase staff to meet these new federal guidelines.
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House Energy and Commerce Committee Chairwoman Cathy McMorris Rodgers (R-WA), Ways and Means Committee Chairman Jason Smith (R-MO), and Senate Finance Committee ranking member Mike Crapo (R-ID) wrote a letter to Health and Human Services Secretary Xavier Becerra and CMS Administrator Ciquita Brooks-LaSure urging the administration to work with Congress “on tailored solutions addressing the severe health care workforce shortages in our states.”
“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,” Rodgers, Smith, and Crapo wrote.
Although there is a shortage of workers across the healthcare industry, long-term care facilities have seen an approximate 10% decrease in total employment compared to pre-pandemic levels, with nearly 200,000 workers exiting the field. Over 400 nursing home facilities have closed entirely since January 2020.
Rodgers, Smith, and Crapo argue that 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.”
CMS projects that the unfunded mandate would cost nearly $41 billion by 2033, but Republicans said that the estimate does not account for state spending that would be added to meet federal matching requirements for Medicaid.
“Eventually patients will be forced to pay even more out-of-pocket as facilities inevitably pass these additional costs on to consumers in the form of higher prices,” Rodgers, Smith, and Crapo argue.
The White House responded to the Washington Examiner’s request for comment by highlighting that the nursing home industry receives nearly $100 billion per year from taxpayers and that staffing levels are “closely linked to quality of care.”
When the proposed rule was announced, the administration referenced several studies indicating that chronic understaffing problems in nursing facilities resulted in higher COVID-19 death and infection rates.
“The federal minimum staffing standards proposed by CMS are robust yet achievable,” a White House statement in September read.
Rodgers, Smith, and Crapo also contend that “CMS is also blatantly overstepping Congress’ sole authority to set staffing requirements.”
“If there is to be any change to nursing home staffing levels, it will be at the discretion of Congress to make such a change or provide the Secretary such authority,” they argue.
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The lawmakers requested a response to several concerns, including more information on the rationale for and financial impact of the proposed rules, by Nov. 30.
Neither CMS nor HHS responded to the Washington Examiner’s inquiries by the time of publication.
